I-sternum (kusuka ku-Latin sternum, kusukela ku-Greek sternon) iyithambo le-thorax elakha ikheji lezimbambo engxenyeni yalo ephakathi.

I-sternum iyithambo eliyisicaba eliphambi kwethorax, emgqeni ophakathi nomzimba (maphakathi). Icacisa ohlangothini ngalunye ngezimbambo eziyisikhombisa zokuqala kanye nangama-clavicles lapho yakha khona ukuhlangana kwe-sternoclavicular. Ibekwe ebusweni ngaphansi kwesikhumba, itholakala phambi kwengxenye enkulu yenhliziyo.

Ithambo lesifuba lenziwe ngokuhlangana kwezicucu ezintathu zamathambo:

• Le handle sternal,
• Umzimba wethambo lesifuba,
• Inqubo ye-xiphoid.

Kunezimpawu ezintathu ezibalulekile zokwakheka komzimba:

• I-notch ye-jugular imaka umphetho ongaphezulu we-sternum. Ithambeka kalula ngaphansi kwesikhumba, kungumgodi esizwa ngaphansi kwentamo.
• I-engeli yangemuva isemngceleni we-sternal manubrium nomzimba. Okunye okuzwakalayo, kugqame ngendlela ye-ridge evundlile.
• Ijoyini elingaphansi le-sternal, elitholakala ekuhlanganeni phakathi komzimba we-sternum nenqubo ye-xiphoid.

I-sternum ibamba iqhaza ekwakhiweni kwesakhiwo samathambo we-rib cage. Izimbambo nama-vertebrae we-thoracic ahlangana nayo ukuze uyiqedele.

Ukuphuka kwe-Sternum :

Ukuphuka kwe-Sternum kuhlotshaniswa nokuhlukumezeka, kungakhathaliseki ukuthi kuqondile noma okungaqondile. Umthelela oqondile ungaba ngenxa yengozi yemoto (ibhande lesihlalo licindezela esifubeni noma umthelela wesondo lokuqondisa) noma elihlobene nezemidlalo. Izimbangela ezingaqondile zokuphuka zingenzeka ngokuzenzakalelayo kubantu asebekhulile abane-osteoporosis, isibonelo. Ukuphuka kwengcindezi kukhonjwe kubasubathi kulandela ukuphindaphinda kokuzivocavoca umzimba okuphezulu. Lokhu kuphuka kwethambo lesifuba kungenzeka ngokuhlukana noma kuhlotshaniswe nokunye ukulimala:

- Isodwa: i-sternum kuphela ethintekayo. Iningi leziguli lilulama ngokuphelele ngemva kwamasonto ambalwa lokululama.

- Okuhlotshaniswa nokunye ukulimala: izingxenye ezimbili kwezintathu ze-sternum fractures zihlotshaniswa nama-pathologies amakhulu angabangela ukufa ku-25 kuya ku-45% yamacala (3). Lokhu kulimala kungathinta izicubu kuphela noma kufinyelele ekujuleni kwezimbambo (ukuphuka kwezimbambo, inhliziyo, ukulimala kwamaphaphu nomgogodla, njll.).

I-Sternoclavicular dislocation : Ukususwa kwelunga phakathi kwe-clavicle ne-sternum, kungaphansi ngokuphindwe kane kune-acromioclavicular.

ubuhlungu besifuba : zinezimbangela eziningi futhi ngezinye izikhathi zingazwakala ku-sternum. Lezi zinhlungu ngokuvamile zibangelwa isifo senhliziyo (isb. i-myocardial infarction) noma isifo semithambo yegazi (isb. i-pulmonary embolism) futhi zidinga ukwelashwa ngokushesha.

Imbobo yangaphandle : ukukhubazeka okungavamile kwe-sternum, kwesizathu esingaziwa. Ngesikhathi sokuphila kombungu, kuholela ekutheni kube nokukhubazeka ekuhlanganisweni kwemigoqo yethambo ehlose ukwakha i-sternum, evame ukwenzeka ukusuka phezulu kuye phansi ukuyivala ngokuphelele. Ukuhlinzwa phakathi namasonto okuqala ngemva kokuzalwa kuvala ithambo lesifuba futhi ngaleyo ndlela kuvikela inhliziyo nemithambo emikhulu engemuva kwayo.

I-Sternocostoclavicular hyperostosis : i-pathology engavamile yembangela engaziwa, ibangela i-hypertrophy kanye nokufingqa kwe-sternum, i-collarbones nezimbambo zokuqala. Ithinta kakhulu indoda eneminyaka ephakathi. Uphawu oluyinhloko ukuvuvukala okubuhlungu ethanjeni lesifuba.

Izimila zethambo lesifuba : Izimila zethambo zodonga lwesifuba azivamile ukutholakala ethanjeni lesifuba noma kukholomu. Lolu hlobo lwesimila samathambo lumele ngaphansi kwezingu-5% zazo zonke izicubu zethambo (6).

I-Pathologies ye-sternum ibangelwa ukuhlukumezeka kwangaphandle noma izifo ezingavamile zezimbangela ezingaziwa. Ngakho-ke kubonakala kunzima ukuwavimbela.

I-Sternal puncture: umkhuba wokufaka inaliti ethanjeni lesifuba ukuze kukhishwe umnkantsha. Lo mnkantsha uqukethe okuthiwa amaseli e-hematopoietic, okuyimvelaphi yamangqamuzana egazi ahlukahlukene. Ukuhlaziywa kwaselabhorethri kwala maseli i-myelogram. Isetshenziselwa ukuhlonza ukungahambi kahle komunye wemigqa yamaseli egazi. Lokhu kubhoboza kungenziwa futhi ethanjeni le-pelvis, bese kuba ukubhoboza kwe-lumbar.

Izivivinyo zesithombe:

• I-Radiography: inqubo yezithombe yezokwelapha esebenzisa ama-X-ray. I-Radiography yamajoyini we-sternum noma we-sternoclavicular ukuhlolwa okujwayelekile okusetshenziswayo kuma-pathologies axhumene nokuhlukumezeka.
• Iskena: indlela yokuthwebula ehlanganisa “ukuskena” indawo ethile yomzimba ukuze wakhe izithombe ezihlukene, ngenxa yokusetshenziswa kwe-X-ray. Siphinde sikhulume nge-computed tomography noma ama-CT scan. Lokhu kuhlolwa kuvumela ukubonwa okuhle kwethambo le-medullary kanye nezicubu ezithambile zelunga kanye nezizungeze ilunga.
• I-MRI (i-magnetic resonance imaging): ukuhlolwa kwezokwelapha ngezinjongo zokuxilonga okwenziwa kusetshenziswa isisetshenziswa esikhulu esiyicylindrical lapho kukhiqizwa khona indawo kazibuthe namaza omsakazo. Inikeza izithombe ezinembile kakhulu zethambo le-mineralized ye-sternum.
• I-Bone scintigraphy: indlela yokuthwebula ehlanganisa ukunikeza isiguli i-tracer enemisebe esabalala emzimbeni noma ezithweni ezizohlolwa. Ngakho, yisiguli “esikhipha” imisebe ezothathwa yilo mshini. I-scintigraphy yenza kube lula ukubona amathambo namalunga. Ezimweni ze-sternum, isetshenziselwa ikakhulukazi ukuxilongwa kwe-sternocosto-clavicular hyperostosis.

Kulinganiselwa ukuthi u-5% wabantu bomhlaba “unesimo esizimele”, noma ukubhobozwa kwangaphandle, noma imbobo eyindilinga emzimbeni wethambo lesifuba. Le mbobo, efana naleyo eshiywe yinhlamvu idlula ethanjeni lesifuba, empeleni ichazwa yisiphepho ku-ossification (8,9).