{"id":1780,"date":"2019-05-03T10:27:03","date_gmt":"2019-05-03T08:27:03","guid":{"rendered":"https:\/\/www.cematec.org\/traumatologia\/artroscopies\/artroscopia-despatlla\/"},"modified":"2022-06-16T21:58:46","modified_gmt":"2022-06-16T19:58:46","slug":"artroscopia-despatlla","status":"publish","type":"page","link":"https:\/\/www.cematec.org\/ca\/traumatologia\/artroscopies\/artroscopia-despatlla\/","title":{"rendered":"Artrosc\u00f2pia d’espatlla"},"content":{"rendered":"

Amb la artrosc\u00f2pia<\/span><\/a><\/strong> d’<\/strong> espatlla<\/strong><\/a><\/span> podem<\/span> veure<\/span> i comprovar<\/span> , a diferents<\/span> posicions<\/span> del bra\u00e7<\/span> , on<\/span> existeix<\/span> la lesi\u00f3<\/span> o el conflicte<\/span> de les<\/span> estructures<\/span> internes<\/span> . Tamb\u00e9<\/span> podem<\/span> efectuar<\/span> cirurgia<\/span> dins<\/span> de la articulaci\u00f3<\/span> amb instrumental molt<\/span> petit<\/span> que<\/span> s’introdueix per<\/span> unes<\/span> petites<\/span> incisions<\/span> .<\/p>\n

\"\"<\/p>\n

QUINES<\/span> PATOLOGIES<\/span> ES PODEN<\/span> TRACTAR<\/span> PER<\/span> ARTROSC\u00d2PIA<\/span> D’ ESPATLLA<\/span> ?<\/strong><\/div>\n

La artrosc\u00f2pia<\/span> d’ espatlla<\/span><\/strong> ha perm\u00e8s<\/span> veure<\/span> millor<\/span> els petits<\/span> detalls<\/span> din\u00e0mics<\/span> i per<\/span> aix\u00f2 tant<\/span> augmentar<\/span> les<\/span> possibilitats<\/span> de tractament<\/span> de petites<\/span> lesions<\/span> que<\/span> podrien<\/span> arribar<\/span> a ser<\/span> greus sin\u00f3<\/span> es tracten<\/span> . Aix\u00ed<\/span> podem<\/span> tractar<\/span> s\u00edndromes<\/span> que<\/span> provoquen<\/span> un pin\u00e7ament<\/span> entre<\/span> els diferents<\/span> ossos<\/span> i els tendons<\/span> que<\/span> discorren<\/span> pel<\/span> espai<\/span> subacromial<\/span> (S\u00edndrome<\/span> subacromial<\/span><\/strong>)<\/p>\n

\"\"<\/p>\n

Per<\/span> artrosc\u00f2pia<\/span> es poden<\/span> reparar<\/span> els<\/span> trencaments<\/span> i els esquin\u00e7os<\/span> traum\u00e0tics<\/span> o degeneratius<\/span> dels tendons<\/span> del maneguet<\/span> rotador<\/span> (supraespin\u00f3s<\/span> i infraespin\u00f3s<\/span> ) que<\/span> impedeixen<\/span> aixecar<\/span> el espatlla<\/span> o tamb\u00e9<\/span> la luxaci\u00f3<\/span> recidivant<\/span> espatlla<\/span> <\/strong>(lesi\u00f3<\/span> de Bankart<\/span> ), solucionant<\/span> la inestabilitat<\/span> de espatlla<\/span> a la luxaci\u00f3<\/span> recidivant.<\/span><\/p>\n

\"\"<\/p>\n

QU\u00c8<\/span> HE DE<\/span> FER<\/span> DESPR\u00c9S<\/span> DE LA INTERVENCI\u00d3<\/span> ?<\/strong><\/p>\n

Habitualment<\/span> , l’ estada<\/span> a la cl\u00ednica<\/span> sol<\/span> ser<\/span> de 12-24 hores<\/span> fins a<\/span> retirar<\/span> els drenatges<\/span> .<\/p>\n

Al postoperatori<\/span> es col\u00b7loquen<\/span> bosses<\/span> de gel<\/span> i s’inicien<\/span> exercicis<\/span> passius<\/span> i pendulars<\/span> de l’ espatlla<\/span> . No obstant aix\u00f2, si<\/span> hi ha<\/span> sutures<\/span> , el bra\u00e7<\/span> romandr\u00e0<\/span> en un cabestrell<\/span> i en posici\u00f3<\/span> adequada<\/span> per<\/span> evitar<\/span> la tensi\u00f3<\/span> de la sutura<\/span> . Despr\u00e9s<\/span> es passar\u00e0<\/span> als exercicis<\/span> passius<\/span> i assistits<\/span> , per\u00f2<\/span> mai<\/span> exercicis<\/span> actius<\/span> perqu\u00e8<\/span> no<\/span> ocorreguin<\/span> trencaments<\/span> o afluixament<\/span> dels ancoratges<\/span><\/p>\n

A les<\/span> setmanes<\/span> seg\u00fcents<\/span> la rehabilitaci\u00f3<\/span> sol<\/span> incloure<\/span> crioter\u00e0pia<\/span> , exercicis<\/span> actius<\/span> per<\/span> recuperar<\/span> les<\/span> rotacions<\/span> , potenciaci\u00f3<\/span> del m\u00fascul<\/span> deltoides<\/span> i finalment<\/span> tots<\/span> els m\u00fasculs<\/span> que<\/span> formen<\/span> el maneguet<\/span> rotador<\/span> .<\/p>\n

Si no existeixen<\/span> sutures<\/span> ni<\/span> retraccions<\/span> musculars<\/span> , sol<\/span> aconseguir<\/span> -se una<\/span> mobilitat<\/span> preco\u00e7<\/span> i for\u00e7a<\/span> normal entre<\/span> 4-6 setmanes<\/span> , per\u00f2<\/span> si<\/span> hi ha<\/span> sutures<\/span> la for\u00e7a<\/span> i mobilitat<\/span> completa<\/span> es obtindran<\/span> entre<\/span> els 2-3 mesos<\/span> .<\/p>\n

Tota<\/span> cirurgia<\/span> sobre<\/span> el espatlla<\/span> s’hauria d’<\/span> efectuar<\/span> despr\u00e9s<\/span> de haver<\/span> aconseguit<\/span> una<\/span> rehabilitaci\u00f3<\/span> acceptable<\/span> , aconseguint<\/span> una<\/span> bona<\/span> mobilitat<\/span> passiva<\/span> de les<\/span> rotacions<\/span> per<\/span> obtenir<\/span> \u00f2ptims<\/span> resultats<\/span> .<\/p>\n<\/div>

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