Dislocations

Dislocations - resistant offset articular ends of bones. There are full dislocations, when articulate surfaces completely lose contact with each other, and incomplete dislocation (subluxations), in which articulate surfaces protruding bones remain in partial contact. Consider sprained that bone or segment of a limb, which lies periferica, such as dislocation in the elbow joint - forearm, in dislocation in shoulder - to - shoulder. Dislocations are divided into congenital, traumatic, familiar and pathological.

Congenital dislocations

Congenital dislocation of the hip dislocations in the hip joint), the most frequent. Predominantly occur in girls. Connected with the underdevelopment of the hip joints (both one or more often). In the newborn and infant can be suspected dislocated on asymmetry of wrinkles on the inner thighs, restriction hip abduction, turn legs outwards, sometimes shortened limbs. With these signs should refer the child to a podiatrist. The obvious symptoms are detected only when the child starts to walk (usually late). Identifies limp towards the dislocation, the relative shortening of the leg (when measured from the upper-anterior iliac spine bone to the inner ankle tibia). With bilateral dislocation gait reminds duck. When x-rays of the head of the femur is detected outside the glenoid.
treatment of congenital hip dislocationTreatment of a child with congenital hip dislocation should start as early as possible. In newborns and infants reduction is achieved by assignment of the limbs in the hip joint and fixation in this position for 3-4 months. with the help of special tyres. It is strongly prohibited to swaddle the legs of the child in the position of the cast. You cannot force a child to stand and walk before he will be himself, to strive towards. In children aged 1 to 3 years have resorted to a gradual reduction with the subsequent imposition of the cast (Fig. 1). In case of unsuccessful conservative setting at the age of 2.5-3 years, or in late treatment prescribed surgical treatment.

Traumatic dislocations

Traumatic dislocations occur from excessive (beyond normal movement) movement in the joint - violent or produced victims (for example, the dislocation of the lower jaw when yawning, shoulder while waving his hand). Less dislocation occurs from a punch in the joint area. As a rule, dislocations are accompanied by a rupture of the articular capsule. The exception is the dislocation of the lower jaw.
For sprains characteristic change of the form and the restriction of movements in the joints, both active and passive. When you try to create passive movement is experiencing a sharp pain and springy resistance. During feeling detect out with a twisted end of the bone in an unusual place. The diagnosis to be confirmed rentgenograficheskie. There are dislocations, complicated fracture (dislocations fractures), damage to blood vessels, nerves, or false cover (open dislocations). Nevprawima sprains frequently occur at the infringement of the soft tissues (bags, tendons) between articular surfaces.
First aid in dislocation - rest, immobilization of the affected limb with transport bus or bandages type kerchiefs, urgent referrals.
Treatment - the earliest possible reduction of dislocation (produces doctor) under local or General anesthesia. After reduction to hold joint surfaces in the correct position impose immobilizers bandage. In subsequent treatment is reduced to manage physiotherapy, massage and medical gymnastics.
Most often traumatic dislocations of the shoulder, upper arm and fingers, the dislocation of the thigh, the lower jaw and the dislocation of the acromial end of the clavicle, rarely dislocations sternal end of the clavicle, tibia, patella. From dislocations fractures most common dislocations fractures foot at the ankle joint, less often in the joints of the foot and the dislocations fractures toes.
The dislocation of the lower jaw can be unilateral or bilateral. With bilateral dislocation mouth still open, jaw forward, and unilaterally dislocation - side.
First aid: the imposition prividno bandages, direction to the doctor.
Treatment. The reduction of dislocation performed by a physician. Wrap gauze thumbs, face the patient, impose both of the big finger in your mouth and press them on the corners of the lower jaw (rear indigenous teeth). At the same time other fingers arranged outside on the lower jaw, lift the chin of the patient. Dislocation spravlyaetsya usually clicks; immediately remove your fingers from the teeth, so that the victim does not have bitten them.
The dislocation of vertebra are observed mainly in the cervical Department of a backbone. Often accompanied by damage to the spinal cord with the emergence of tetraparesis (paralysis of upper and lower extremities). Active movements in the cervical spine is missing (passive to produce unacceptable), often forced position of the head. In dislocation in the spine patients transported in strictly horizontal position, on a special stretcher (see). For setting applies instantaneous or gradual stretching.

Habitual dislocation

Habitual dislocation most often observed in the shoulder joint to develop due to too short-term immobilization after the reduction of traumatic dislocation, with the weakness of ligaments and from other causes. Dislocation may occur multiple times from the slightest physical effort or at any particular movement in the joint.
Operative treatment.
Prevention: careful traumatic lumbar dislocated shoulder, better under General anesthesia; sufficient (usually within 3 weeks) immobilization; after removal of plaster bandages light, not forced therapeutic gymnastics. Within 6-8 weeks after the dislocation of the patient is contraindicated hard physical labor.

Pathological fractures

Pathological fractures occur in diseases of the joints, accompanied by the destruction of the articular ends of bones. Most frequent pathological fractures of the hip joint (tuberculosis, infectious inflammation, with some organic diseases of the nervous system).
Prevention of pathological dislocation in TB or infectious inflammation of the joints is to commit limbs plaster cast. In some cases it can be used surgical treatment.