Ankylosis

Ankylosis - immobility of hip joint, coming as a result of the formation of bone, cartilage or fibrous adhesions joint all the articulated bones. Ankylosis may occur due to trauma (injury, closed comminuted fracture of the articular ends of bones, injury and damage, especially repeated, accompanied interstitial hemorrhage), infectious or degenerative process in joints, as well as an incorrect treatment of diseases and injuries of joints when underused functional treatment method and is applied prolonged immobilization (see).
Movement in the joint when no frets that leads to violation of statics and is often accompanied by pain.
Operative treatment, is carried out mainly with ankylosis in functionally unfavourable (bad) position. Produce Redressal (see), osteotomy (see), arthroplasty (see), arthroplasty.

Ankylosis (from the Greek. ankylosis - the stiffening of the joints) - stiffness of the joints due to pathological changes of the joints.
Ankylosis caused Spania joint surfaces bone, cartilage, or fibrous tissue. Accordingly, there are a bony ankylosis (true), cartilage (mainly congenital) and fibrous (scar). Depending on the location of the growths distinguish ankylosis of the Central and peripheral, partial and full. A. may occur due to destructive changes, the inflammatory process (Fig. 1), injury, entailing the destruction of the articular surfaces, degenerative-atrophic processes at very prolonged immobility of a joint. The fusion of the bones that make up the joint, is mainly due to the destruction of the cartilage cover epiphyses bones, organization pathological products in the joint cavity, metaplastic restructuring and the ossification of them (Fig. 2). The destruction of the joint (for example, when fire damage with subsequent arthritis (see)] the most common causes A. true
Errors in the treatment of fractures, especially intra-articular (insufficient use of functional techniques), also often lead to the frets. The presence of ankylosis not only reduces the amount of movements, turning off one of the joints and violating the statics, dynamics of the body, but are often accompanied by pain, especially when the fibrous forms.
Diagnosis of ankylosis can represent well-known difficulties, when mobility is practically absent, but a passive swinging movement within up to 5 degrees. In these cases, it is difficult to differentiate scar A. from contractures (see).
Treatment A. - operative. Using osteotomy can give limbs more profitable functional position. Resection of joint arthroplasty (see) more difficult and give favourable outcomes only if serial comprehensive orthopedic treatment; but in these conditions to achieve sufficient movements, especially in the joints affected by inflammation, it is difficult.
Opportunities reconstructive treatment now expanded to include methods of intra-articular alloplastic prosthetics, homoplastic canned joint, "polosatova" (J. L. Tsivian, K. M Sivash, A. S. Imamaliyev).

Fig. 1. Ankylosis of the hip joint due to infectious arthritis through
5 years after the onset of illness.
Fig. 2. Long-existing ankylosis of the knee joint.

X-ray analysis of the frets. Differential diagnosis between true (bone) - frets and fibrous can be carried out only on the basis of the x-ray pictures. In some cases it is possible to find out and the etiology of the old inflammatory diseases of the joints, leading to a further diagnosis is based on the signs of the condition of the joints and bones all affected extremity (see Arthritis, x-ray diagnostics). Radiographically to recognize fibrous A. on the basis of the narrowing of the joint space, and configuration changes (flattening) articular surfaces of the bones, which can be expressed very differently from a minimum degree to very sharp manifestations (Fig. 1). But when most pronounced symptoms fibrous A. clinically often almost impossible to distinguish from the true (bone) A. x-Ray same characteristics bone A. absolutely certain; the absence of the joint space, the transition of the structure of a bone in the structure of the other (in particular, the transition path one bone to another path) and no visible contours of the articular surfaces of the bones (Fig. 2). Be aware that bone A. sometimes may be incomplete, partial, i.e. not all over the articular surfaces.