{"id":7644,"date":"2021-01-27T15:34:18","date_gmt":"2021-01-27T12:34:18","guid":{"rendered":"http:\/\/dralpergokce.com\/?page_id=7644"},"modified":"2021-01-27T15:38:17","modified_gmt":"2021-01-27T12:38:17","slug":"omuz-hastaliklari","status":"publish","type":"page","link":"https:\/\/dralpergokce.com\/en\/omuz\/omuz-hastaliklari\/","title":{"rendered":"Omuz Hastal\u0131klar\u0131"},"content":{"rendered":"
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Omuz Eklemi yap\u0131s\u0131 ve hareketleri<\/span><\/strong><\/p>\n

Kolumuzun \u00fcst k\u0131sm\u0131ndaki humerus kemi\u011finin ba\u015f\u0131 ile k\u00fcrek kemi\u011finin ucundaki glenoid yuvas\u0131 birlikte omuz eklemini olu\u015ftururlar. Asl\u0131nda omuz sadece bu eklemle s\u0131n\u0131rl\u0131 olmayan k\u00fcrek kemi\u011finin g\u00f6\u011f\u00fcs kafesi \u00fczerindeki hareketleriyle daha geni\u015f planda oynakl\u0131\u011fa ula\u015f\u0131r. Bu iki yap\u0131ya birlikte omuz eklem kav\u015fa\u011f\u0131 ad\u0131 verilmektedir. Omuz b\u00f6lgesi bu sayede hareket a\u00e7\u0131kl\u0131\u011f\u0131 anlam\u0131nda en geni\u015f hareket alan\u0131na sahip eklemdir. Oynakl\u0131\u011f\u0131n y\u00fcksek t\u00fcm eklemlerde oldu\u011fu \u00fczere stabilite yani denge durumunu koruma sorunlar\u0131 bu eklemin de \u00f6nemli hastal\u0131klar\u0131ndand\u0131r.<\/span><\/p>\n

Hastal\u0131klar\u0131n ya\u015f ile ilgisi\u00a0<\/span><\/strong><\/p>\n

Ki\u015finin ya\u015f\u0131na g\u00f6re farkl\u0131 d\u00f6nemlerde de\u011fi\u015fik hastal\u0131klar\u0131n s\u0131kl\u0131\u011f\u0131nda art\u0131\u015flar g\u00f6zlenmektedir. Ya\u015fl\u0131larda ve zamanla kamburla\u015fan omurgaya ba\u011fl\u0131 k\u00fcrek kemi\u011finin ald\u0131\u011f\u0131 yatay pozisyonlar dolay\u0131s\u0131yla \u00e7al\u0131\u015fma a\u00e7\u0131s\u0131 de\u011fi\u015fen liflerde s\u00fcrt\u00fcnmeye ba\u011fl\u0131 a\u015f\u0131nma ve y\u0131rt\u0131lma \u00f6nemli bir problemdir. Omuz \u00e7\u0131k\u0131\u011f\u0131 ve al\u0131\u015fkanl\u0131k haline gelmi\u015f omuz \u00e7\u0131k\u0131klar\u0131 gen\u00e7 eri\u015fkinlerde aktivite art\u0131\u015f\u0131ndan dolay\u0131 daha s\u0131kl\u0131kla kar\u015f\u0131la\u015f\u0131lmaktad\u0131r.<\/span><\/p>\n

Omuz \u00e7\u0131k\u0131\u011f\u0131 ve instabilitesi<\/span><\/strong><\/p>\n

Omuz \u00e7\u0131k\u0131\u011f\u0131, eklemi olu\u015fturan humerus kemi\u011finin glenoid yuvas\u0131n\u0131 terk etmesinin sonucunda g\u00f6zlenir. \u00c7\u0131k\u0131klar, spor yaralanmas\u0131 veya d\u00fc\u015fme sonucunda g\u00f6zlenir. Mekanizma olarak omuzun a\u015f\u0131r\u0131 d\u0131\u015fa d\u00f6nmesi ve eklemin g\u00f6vdeye yakla\u015fmas\u0131 sonucu uygulanan kuvvet sonucu ger\u00e7ekle\u015fir. Omuz \u00e7\u0131kt\u0131\u011f\u0131 y\u00f6ne g\u00f6re de\u011fi\u015fik \u00f6ne arkaya yukar\u0131 gibi isimlerle adland\u0131r\u0131lmaktad\u0131r. Eklemin \u00e7\u0131kt\u0131\u011f\u0131 an olduk\u00e7a \u00f6nemli ve a\u011fr\u0131l\u0131 bir eklem rahats\u0131zl\u0131\u011f\u0131 olup acil tedavi gerektirir. Aciliyetin sebeplerinden birisi de kaps\u00fcl i\u00e7i sinovyal s\u0131v\u0131n\u0131n dola\u015f\u0131m\u0131 bozuldu\u011fu i\u00e7in k\u0131k\u0131rdak canl\u0131l\u0131\u011f\u0131n\u0131 olumsuz etkilenmesidir. \u00c7o\u011funlukla kapal\u0131 y\u00f6ntem olarak adland\u0131r\u0131lan anestezi alt\u0131nda yap\u0131lan manevralarla eklem yerine yerle\u015ftirilmesi ile tedavi edilir.<\/span><\/p>\n

\u00d6ne omuzu \u00e7\u0131km\u0131\u015f bir hasta resmedilmi\u015ftir. Burada hastan\u0131n omuz ba\u015f\u0131na ait kavsinin kaybolmas\u0131 ve kemi\u011fin vatka giyilmi\u015f bir elbise misali apolet belirtisi verdi\u011fine dikkat ediniz.<\/span><\/p>\n

20 ya\u015f\u0131ndan k\u00fc\u00e7\u00fck hastalarda g\u00f6zlenen \u00e7\u0131k\u0131klar ayr\u0131 tutulmak kayd\u0131 ile eklemin kapal\u0131 olarak yerine konmas\u0131 travmatik (=kaza ile) meydana gelen ilk \u00e7\u0131k\u0131klarda yeterli olmaktad\u0131r. Omuz ba\u015f\u0131 eklemden d\u0131\u015far\u0131 \u00e7\u0131karken kaps\u00fcl ba\u011f k\u0131k\u0131rdak gibi dokularda y\u0131rt\u0131lma kopma \u015feklinde hasarlara yol a\u00e7ar. Kapal\u0131 olarak yaralanan bu dokular\u0131n iyile\u015fmesi i\u00e7in belli bir m\u00fcddet (hastaya g\u00f6re de\u011fi\u015fmekle beraber genelde 3 hafta) ask\u0131 veya bandaj kullan\u0131lmas\u0131 \u00e7\u0131k\u0131\u011f\u0131n al\u0131\u015fkanl\u0131k haline gelmemesi i\u00e7in \u00f6zellikle \u00f6nemlidir. Bandaj\u0131n \u015fekli, b\u00fcy\u00fckl\u00fc\u011f\u00fc, kullan\u0131m s\u00fcresi hastan\u0131n ya\u015fad\u0131\u011f\u0131 \u00e7\u0131k\u0131k y\u00f6n\u00fc ve \u015fiddetine ba\u011fl\u0131 olarak de\u011fi\u015fiklik g\u00f6sterir.<\/span><\/p>\n

Kol bandaj ve ask\u0131lar\u0131<\/span><\/strong><\/p>\n

Son zamanlarda g\u00f6vdeye sarar yap\u0131lan bandajlamalar\u0131n hastalar\u0131n rehabilitasyonlar\u0131nda \u00f6nemli hareket k\u0131s\u0131tlamas\u0131 sorunlar\u0131n\u0131 beraberinde getirdi\u011fi bilimsel \u00e7al\u0131\u015fmalarla bulunmu\u015ftur. Kolun g\u00f6vde ile aras\u0131nda a\u00e7\u0131lanma ve elin kar\u015f\u0131ya uzand\u0131\u011f\u0131 \u015fekliyle bandajlanmas\u0131 daha iyi netice verdi\u011fi i\u00e7in yast\u0131kl\u0131 omuz kol ask\u0131lar\u0131 tercih edilmektedir.<\/span><\/p>\n

Eklemin iyile\u015fmesine yard\u0131mc\u0131 olunmas\u0131 a\u00e7\u0131s\u0131nda hareket a\u00e7\u0131kl\u0131\u011f\u0131n\u0131 kal\u0131c\u0131 olarak s\u0131n\u0131rlamamak gerekti\u011fi ak\u0131lda tutulmal\u0131d\u0131r.<\/span><\/p>\n

Erken ya\u015flarda kar\u015f\u0131la\u015f\u0131lan t\u00fcm \u00e7\u0131k\u0131klar ve tekrarlay\u0131c\u0131 yani al\u0131\u015fkanl\u0131k haline gelmi\u015f \u00e7\u0131k\u0131k olan bireylerde omuz ekleminde stabiliz\u00f6r yap\u0131larda kal\u0131c\u0131 hasar g\u00f6r\u00fcld\u00fc\u011f\u00fc i\u00e7in artroskopik olarak tamir edilmeleri gerekmektedir. Yap\u0131lan \u00e7al\u0131\u015fmalarda artroskopik ameliyatlar teknik bir engel yoksa a\u00e7\u0131k cerrahilere e\u015fde\u011fer ba\u015far\u0131 vermektedir.<\/span><\/p>\n

Omuz eklemin yuvas\u0131n\u0131 olu\u015fturan k\u00fcrek kemi\u011finin de bir \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n (glenoid fossa) etraf\u0131n\u0131 labrum ad\u0131 verilen bir k\u0131k\u0131rdak sarar. Bu k\u0131k\u0131rdak eklenti sayesinde eklem daha esnek bir derinlik elde eder. Bu yap\u0131n\u0131n \u00e7\u0131kma esnas\u0131nda kemikten kopmas\u0131 ile omuzun sabit ve dengeli duru\u015fu bozulmu\u015f olur. Kopan labrumun (Bankart lezyonu) dikilerek omuz kemi\u011finin yuvay\u0131 terk etmesinin \u00f6n\u00fcnde engel bariyer haline getirilmesi i\u00e7in gereklidir. Eklemin ve hatta ciltte neredeyse yara a\u00e7\u0131lmadan kamera kontrol\u00fc alt\u0131nda y\u0131rt\u0131lan bu yap\u0131n\u0131n tekrar kemi\u011fe dikilerek destek olunmas\u0131 prensibine dayan\u0131r.(Artroskopik Bankart tamiri)<\/span><\/p>\n

Bankart tamiri ameliyat\u0131 yap\u0131lan bir hastan\u0131n eklem i\u00e7i foto\u011fraf\u0131nda \u015fekilde g\u00f6r\u00fcld\u00fc\u011f\u00fc \u00fczere labrumun eklem kenar\u0131ndan ayr\u0131\u015fmas\u0131 iki adet diki\u015fle tekrar kemi\u011fe yakla\u015ft\u0131r\u0131larak dikilmi\u015f ve omuzun eklemden \u00e7\u0131kmas\u0131na engel olunmu\u015ftur.<\/span><\/p>\n

\"\"<\/p>\n<\/div>\n<\/div><\/div><\/div>

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We will call you.<\/p>\n

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