Isihlakala (esivela esibhakeleni) ilunga elitholakala phakathi kwesandla nengalo.

Isihlakala sakhiwe ekugcineni okungezansi kwe-radius ne-ulna (noma i-ulna), kanye ne-carpus, uqobo lwayo enezinhla ezimbili zamathambo amane amancane. Axhunywe yimigudu, amathambo e-carpal akha “umhubhe” obizwa ngokuthi umhubhe we-carpal lapho kudlula khona imisipha yomzimba kanye nemisipha ye-flexor yeminwe. I-nerve median ibandakanyekile ekuzweleni kweminwe nasekuhambeni kweminwe nasesandleni.

Isihlakala sivumela ukunyakaza kwesandla ezindaweni ezihlukile:

• lateral (ukuthumba - ukukhishwa),
• phezulu (isandiso),
• phansi (i-flexion).

ukuphuka. Amathambo esandla angaphansi komthelela futhi aphuke kalula. Ukuqhekeka okwengeziwe kufanele kuhlukaniswe nokuqhekeka okuhlangene okubandakanya ukuhlangana nokudinga ukuhlolwa okuphelele kwezilonda.

• Ukuphuka kweScaphoid. I-Carpal bone, i-scaphoid ingaqhekeka uma kwenzeka kuwa esihlakaleni noma engalweni (5,6).
• Ukuphuka kwesihlakala. Imvamisa, lokhu kwephuka kudinga ukusimama kwesihlakala ngokushesha futhi okulungisiwe ukuze kugwenywe ukufuduka.

Izifo zamathambo.

• Isifo se-Kienbock. Lesi sifo yi-necrosis yelinye lamathambo e-carpal lapho ukuphazanyiswa kokudla okunomsoco okuvela egazini kuphazamiseka (7).
• I-osteoporosis. Le pathology iqukethe ukulahleka kwesisindo samathambo, imvamisa kubantu abangaphezu kweminyaka yobudala engama-60. Kwandisa ukuthamba kwamathambo kanye nengozi yokuqhekeka (8).

Izinkinga zemisculoskeletal (MSDs). Isihlakala singesinye sezitho eziphezulu ezithinteka ngenxa yokuphazamiseka kwemisipha, okuhlonzwa njengezifo zomsebenzi futhi okuvela ekucindezelekeni okweqile, okuphindaphindayo noma okungazelelwe emlenzeni.

• I-tendonitis yesihlakala (de Quervain). Ihambisana nokuvuvukala kwamathenda esihlakaleni (9).
• I-Carpal tunnel syndrome: Lesi sifo sisho ukuphazamiseka okuhambisana nokucindezelwa kwemizwa yangaphakathi ezingeni lomhubhe we-carpal, owenziwe ngamathambo e-carpal. Kubonakala njengokuncinza kweminwe nokulahleka kwamandla emisipha (10).

Isifo Sokuqaqamba Kwamalunga. Ihambisana nezimo ezibonakaliswa ubuhlungu emajoyintini, emigudwini, emisipheni noma emathanjeni. Efaniswa nokuguga kwe-cartilage evikela amathambo amajoyinti, i-osteoarthritis yindlela ejwayelekile kakhulu ye-arthritis. Amalunga wezandla nezihlakala nazo zingathinteka ukuvuvukala esimweni sesifo samathambo (11). Lezi zimo zingaholela ekukhubazekeni kweminwe.

Ukuvimbela ukwethuka nobuhlungu esandleni. Ukunciphisa ukukhubazeka kanye nokuphazamiseka kwemisipha, ukuvimbela ngokugqoka ukuvikela noma ukufunda ukuthinta okufanelekile kubalulekile.

Ukwelashwa kwamathambo. Ngokuya ngohlobo lokwephuka, ukufakwa kosimende noma i-resin kuzokwenziwa ukuvimbela isihlakala.

Izidakamizwa zokwelapha. Ngokuya ngesifo, ukwelashwa okuhlukahlukene kunqunyelwe ukulawula noma ukuqinisa izicubu zethambo.

Ukwelapha okuhlinzwa. Ngokuya ngohlobo lokwephuka, ukuhlinzwa kungenziwa ngokubekwa kwezikhonkwane noma amapuleti wokugoqa. Ukwelashwa kwesifo sikaKienböck kudinga nokwelashwa ngokuhlinzwa.

Ukuhlolwa kwe-imaging yezokwelapha. Ukuhlolwa komtholampilo kuvame ukuxhaswa nge-x-ray. Kwezinye izimo, odokotela bazosebenzisa i-MRI, i-CT scan, noma i-arthroscopy ukuhlola nokukhomba izilonda.

Emikhakheni ethile efana nomdanso noma i-gymnastics, abasubathi bafuna ukuthuthukisa ukungabi namandla kwamalunga, okungatholwa ngokuqeqeshwa okuthile. Noma kunjalo, lokhu kungabi namandla kungaba nemiphumela emibi. Kusazwakala kahle futhi kutholakala ukuthi sekwephuzile, i-ligament hyperlaxity yenza amalunga angazinzile, kubenze babe ntekenteke ngokwedlulele (5).