What is a sprain
Dislocation - a persistent abnormal displacementthe articular surfaces relative to each other. If they are no longer in contact, dislocation is called complete, with partial contact - incomplete or subluxation. Dislocation is usually accompanied by rupture of the joint capsule and stepping one articular surface through the gap.
Given some bone out (dislocated)They talk about dislocation of the shoulder, hip or forearm bones, etc. It is believed that there is a dislocation of the bones, articular surface which is located distal to (further) in respect of other bones involved in the formation of the joint. An exception is the spine, the upper vertebra is displaced with respect to the underlying.
- Congenital dislocation - develop during intrauterine life of the fetus;
- purchased - as a result of injury (traumatic dislocation) or the pathological process in the joint (pathological dislocation).
- The vast majority of congenital dislocation happensa hip with one or, more frequently on both sides. Typically, they are noticed when the child starts to walk. There lameness, joint looseness, soreness in it, shortening the legs. For bilateral dislocation characteristic waddling gait (duck). The diagnosis specified X-ray diffraction.
Acquired (traumatic) sprains occurin 80-90% of cases, and therefore have the greatest practical value. Some individual anatomical and physiological characteristics of the human (mismatch value of the articular surfaces, wide joint capsule ligament apparatus fragility, etc..) Are predisposing factors. In the indirect application of force sprains develop more frequently than from the direct effects on the joint.
His capsule in traumatic dislocationsIt is broken as a slit or a significant tissue defect. Dislocations in the trochlear joints (knee, elbow, ankle) is always accompanied by a rupture of the ligamentous apparatus. It can also be seen in the field breaks tendons attaching them to the bone, hemorrhage into the surrounding tissue and joints. Simultaneous fracture of the bone close to his plots, damage of large vessels, nerves, complicating treatment of dislocation (luxation complicated).
Symptoms and course of dislocations
The circumstances of the injury and mechanism of injuryrevealed during questioning of the victim. Typical complaints of pain in the joint and the impossibility of movement in it due to increased pain. Sometimes there is numbness of the limbs that is associated with compression of nerve trunks and fixing dislocated fragment spastic muscle contraction. There involuntary wrong position and limb deformation of the joint region. For example, if a dislocation of the shoulder joint, shoulder aside 15-30 and gives the impression of an elongated, in the deltoid region has ceasing.
Towards the end of the articular bone feelingoften can not determine in an unusual place. Thus, when a dislocated shoulder he felt in the armpit or under the pectoralis major muscle. Attempts to determine the possibility of passive joint movement gives the feeling of a spring of fixing: sprained bone when forced displacement returns to its original position due to the action of spastic contraction of the muscles, strained ligaments and capsules. This symptom is characteristic of dislocations.
dislocation diagnosis is confirmed by X-rays, it also confirms or excludes the associated bone fractures about the joints, which is important for the choice of treatment.
The patient should be immediately sent totreatment facility. The wound is closed aseptic bandage. Reduction of dislocation is easier and better in the early hours of the injury. Dislocations two five-day-old reduce a very difficult, but 3-4 weeks is often required surgery, which gives much worse results.
A necessary condition for successful reposition -complete muscle relaxation, which is achieved by a good anesthesia. Inadmissibility of the use of brute force, as This results in additional damage to the joint capsule, bones and subsequent relapse - a so-called "Habitual dislocation," they are most often found in the shoulder and the jaw joint.
reposition methods are based on muscle tensionthe joint area with a number of manipulations that seem to be repeated in reverse motion, which caused dislocation. Therefore, it is important to imagine the mechanism of development and sequence of movements that led to the dislocation.
After reposition make controlling the X-raypicture, which confirms the correctness of its implementation. The limb is fixed for 6-10 days in a functionally advantageous position bandage or traction. In future regularly spend complex medical and physical fitness exercises.