human bone so hard that it can withstand about 10 thousand kilograms, but if the skeleton consisted of only one hard bone, our movement would be impossible. Nature solved this problem simply by dividing the skeleton into many bones and creating joints - the places where the bones intersect.
Human joints perform a rather important function. Thanks to them, the bones, teeth and cartilage of the body join each other.
Types of human joints
They can be classified according to functionality:
A joint that does not allow movement is known as synarthrosis. Skull sutures and gomphos (connection of teeth to the skull) are examples of synarthroses. Connections between bones are called syndesmoses, between cartilage - synchordroses, bone tissue - synthostoses. Synarthroses are formed with the help of connective tissue.
Amphiarthrosis allows little movement of the connected bones. Examples of amphiarthrosis are intervertebral discs and pubic symphysis.
The third functional class is free-moving diarthrosis. They have the highest range of motion. Examples: elbows, knees, shoulders and wrists. Almost always these are synovial joints.
The joints of the human skeleton can also be classified according to their structure (according to the material of which they are composed):
Fibrous joints are made up of tough collagen fibers. These include the joint that connects the ulna and radius bones of the forearm together.
Cartilaginous joints in humans are made up of a group of cartilages that connect bones together. Examples of such connections would be the joints between the ribs and costal cartilage, as well as between the intervertebral discs.
The most common type, the synovial joint, is a fluid-filled space between the ends of the bones being bonded. It is surrounded by a capsule of rigid dense connective tissue covered with a synovial membrane. The synovial membrane that makes up the capsule produces an oily synovial fluid whose function is to lubricate the joint, reducing friction and wear.
There are several classes of synovial joints, such as ellipsoid, trochlear, saddle and ball joint.
Ellipsoid joints connect smooth bones together and allow them to slide past each other in any direction.
The trochlear joints, such as the elbow and the human, restrict movement in only one direction so that the angle between the bones can be increased or decreased. Limited movement in the trochlear joints provides more strength and strength to the bones, muscles and ligaments.
Saddle joints, such as those between the first metacarpal and the trapezium, allow the bones to rotate 360 degrees.
The shoulder and the human are the only ball-and-socket joints in the body. They have the freest range of motion, they are the only ones that can turn on their axis. However, the disadvantage of ball joints is that the free range of motion makes them more susceptible to dislocation than less mobile human joints. In these places, fractures are more common.
Some synovial types of human joints must be considered separately.
trochlear joint
Block joints are a class of synovial. These are the ankles, knee and elbow joints of a person. Usually a trochlear joint is a ligament of two or more bones where they can only move in one axis to flex or straighten.
The simplest block-like joints in the body are interphalangeal, they are located between the phalanges of the fingers and toes.
Because they have little body mass and mechanical strength assigned to them, they are made up of simple synovial material with tiny extra ligaments for reinforcement. Each bone is covered with a thin layer of smooth hyaline cartilage, designed to reduce friction in the joints. The bones are also surrounded by a capsule of tough fibrous connective tissue covered by a synovial membrane.
A person is always different. For example, the elbow joint is more complex, being formed between the humerus, radius and ulna of the forearm. The elbow is subjected to more severe stress than the joints of the fingers and toes, therefore contains several strong additional ligaments and unique bone structures that strengthen its structure.
The ulna and radius collateral ligaments help support the ulna and radius and strengthen the joints. Human legs also consist of several large block-like joints.
The elbow-like ankle joint is located between the tibia and fibula in the lower leg and the talus in the leg. Branches of the tibia fibula form a bony socket around the talus to limit movement of the leg in one axis. Four additional ligaments, including the deltoid, hold the bones together and strengthen the joint to support the weight of the body.
Located between the thigh and the tibia and fibula of the lower leg, the knee joint is the largest and most complex trochlear joint in the human body.
The elbow joint and ankle joint, whose anatomy is similar, are most often prone to osteoarthritis.
Ellipsoid joint
An ellipsoid joint, also known as a flat joint, is the most common form of synovial joint. They are formed near bones that have a smooth or almost smooth surface. These joints allow the bones to slide in any direction - up and down, left and right, diagonally.
Due to their structure, ellipsoid joints are flexible, while their movement is limited (to prevent injury). Ellipsoid joints are lined with a synovial membrane that produces a fluid that lubricates the joint.
Most ellipsoid joints are found in the appendicular skeleton between the carpal bones of the wrist, between the carpal joints and metacarpal bones of the hand, between the bones of the ankle.
Another group of ellipsoid joints is located between the faces of twenty-six vertebrae in the intervertebral joints. These connections allow us to flex, extend, and rotate the torso while maintaining the strength of the spine, which supports the weight of the body and protects the spinal cord.
Condylar joints
There is a separate type of ellipsoid joints - the condylar joint. It can be considered a transitional form from a block-shaped joint to an ellipsoid one. The condylar joint differs from the block joint in a large difference in the shape and size of the articulating surfaces, as a result of which movement around two axes is possible. The condylar joint differs from the ellipsoid joint only in the number of articular heads.
saddle joint
The saddle joint is a type of synovial joint where one of the bones is shaped like a saddle and the other bone rests on it like a rider on a horse.
Saddle joints are more flexible than ball or ellipsoid joints.
The best example of a saddle joint in the body is the carpometacarpal joint of the thumb, which is formed between the trapezoid bone and the first metacarpal bone. In this example, the trapezium forms a rounded saddle on which the first carpometacarpal joint sits, allowing the person's thumb to easily cooperate with the other four fingers of the hand. Thumb, of course, is extremely important to us, since it is he who allows our hand to firmly grasp objects and use many tools.
ball joint
Ball joints are a special class of synovial joints that have the highest freedom of movement in the body due to their unique structure. The human hip and shoulder joint are the only ball-and-socket joints in the human body.
The two main components of the ball joint are the bone with the ball head and the bone with the cup-shaped notch. Consider the shoulder joint. Human anatomy is so arranged that the spherical head humerus(upper arm bone) fits into the glenoid cavity of the scapula. The articular cavity is a small and shallow recess, thanks to which the shoulder joint the largest range of motion in the human body. It is surrounded by a ring of hyaline cartilage, which is the flexible reinforcement of the bone, while the muscles—the cuffs of the rotator cuff—hold the humerus within the socket.
The hip joint is somewhat less mobile than the shoulder, but is a stronger and more stable joint. Additional stability of the hip joint is needed to support the weight of the person's body on their feet while performing activities such as walking, running, etc.
At the hip joint, the rounded, almost spherical head of the femur (femur) fits snugly against the acetabulum, a deep recess in the pelvic bone. A fairly large number of hard ligaments and strong muscles hold the femoral head in place and resist the most extreme stresses in the body. The acetabulum also prevents hip dislocations by limiting the movement of the bone within it.
Based on the above, you can make a small table. we will not include a person in it. So, in the first column of the table the type of joint is indicated, in the second and third - examples and their location, respectively.
Human joints: table
joint type | Joint examples | Where are |
blocky | Knee, elbow, ankle joint. The anatomy of some of them is given below. | Knee - between the femur, tibia and patella; ulna - between the humerus, ulna and radius; ankle - between the lower leg and the foot. |
Ellipsoid | Intervertebral joints; joints between the phalanges of the fingers. | Between the edges of the vertebrae; between the phalanges of the toes and hands. |
Globular | The hip and human pays special attention to this type of joints. | Between the femur and pelvic bone; between the humerus and the shoulder blade. |
saddle | Carpal-metacarpal. | Between the trapezoid bone and the first metacarpal bone. |
To make it clearer what the human joints are, we will describe some of them in more detail.
elbow joint
Human elbow joints, the anatomy of which has already been mentioned, require special attention.
The elbow joint is one of the most complex joints in the human body. It is formed between the distal end of the humerus (more precisely, its articular surfaces - the block and condyle), the radial and block-shaped notches ulna, as well as the head radius and its articular circumference. It consists of three joints at once: the humeroradial, humeroulnar and proximal radioulnar.
The humeroulnar joint is located between the trochlear notch of the ulna and the block (articular surface) of the humerus. This joint belongs to the block-shaped and is uniaxial.
The shoulder joint is formed between the condyle of the humerus and the head of the humerus. Movements in the joint are made around two axes.
The promaximal radioulnar connects the radial notch of the ulna and the articular circumference of the head of the radius. It is also uniaxial.
There are no lateral movements in the elbow joint. In general, it is considered a trochlear joint with a helical sliding shape.
The largest of the upper body are the elbow joints. Human legs also consist of joints, which simply cannot be ignored.
hip joint
This joint is located between the acetabulum on the pelvic bone and the femur (its head).
This head is covered almost throughout, except for the fossa. also covered with cartilage, but only near the lunate surface, the rest of it is covered with a synovial membrane.
The following ligaments belong to the hip joint: ischio-femoral, ilio-femoral, pubic-femoral, circular zone, as well as a ligament of the femoral head.
The iliofemoral ligament originates at the inferior anterior iliac bone and ends at the intertrochanteric line. This ligament is involved in maintaining the trunk in an upright position.
The next ligament, the ischio-femoral, begins at the ischium and is woven into the capsule of the hip joint itself.
A little higher, at the top of the pubic bone, the pubic-femoral ligament begins, which goes down to the capsule of the hip joint.
Inside the joint itself is a ligament of the femoral head. It starts at the transverse ligament of the acetabulum and ends at the fossa of the femoral head.
The circular zone is made in the form of a loop: it is attached to the lower anterior iliac bone and surrounds the neck of the femur.
The hip and shoulder joints are the only ball joints in the human body.
Knee-joint
This joint is formed by three bones: the patella, the distal end of the femur and the proximal end of the tibia.
The capsule of the knee joint is attached to the edges of the tibia, femur and patella. It is attached to the femur under the epicondyles. On the tibia, it is fixed along the edge of the articular surface, and the capsule is attached to the patella in such a way that its entire anterior surface is outside the joint.
Ligaments of this joint can be divided into two groups: extracapsular and intracapsular. Also in the joint there are two lateral - tibial and peroneal collateral ligaments.
Ankle joint
It is formed by the articular surface of the talus and the articular surfaces of the distal ends of the fibula and tibia.
The articular capsule is attached almost throughout its entire length to the edge of the articular cartilage and recedes from it only on the anterior surface of the talus. On the lateral surfaces of the joint are its ligaments.
The deltoid, or medial ligament, consists of several parts:
Posterior tibio-talar, located between the posterior edge of the medial malleolus and the posterior medial parts of the talus;
Anterior tibio-talar, located between the anterior edge of the medial malleolus and the posteromedial surface of the talus;
The tibiocalcaneal portion extends from the medial malleolus to the talar support;
The tibia-navicular part originates from the medial malleolus and ends at the dorsum of the navicular bone.
The next ligament, calcaneofibular, extends from the outer surface of the lateral malleolus to the lateral surface of the neck of the talus.
Not far from the previous one is the anterior talofibular ligament - between the anterior edge of the lateral malleolus and the lateral surface of the neck of the talus.
And the last, posterior talofibular ligament originates at the posterior edge of the lateral malleolus and ends at the lateral tubercle of the process of the talus.
In general, the ankle joint is an example of a trochlear joint with helical motion.
So, now we definitely have an idea of what human joints are. The anatomy of the joints is more complicated than it seems, and you can see for yourself.
1) articular cartilage
2) red bone marrow
3) yellow bone marrow
4) periosteum
1) often sick with the flu
2) who had measles
3) suffering from rickets
4) suffering from anemia
In connection with upright posture, a support for internal organs abdominal cavity man serves
2) chest
3) diaphragm
4) spine
Friction during the movement of bones in the joint is reduced due to
1) articular bag
2) negative pressure inside the joint
3) joint fluid
4) articular ligaments
96. In the human body, a semi-movable joint of bones is characteristic of
1) skeleton head
2) spine
3) shoulder girdle
4) hip joint
The curves of the human spine are associated with
1) upright posture
2) labor activity
3) social way of life
4) carrying weights
The human skull is different from the skulls of other mammals.
1) the presence of a movable articulation of the upper and lower jaws
2) the predominance of the cerebral part of the skull over the facial
3) the presence of sutures between the bones of the brain
4) structural feature bone tissue
The bones in the human skeleton are connected to each other
1) shoulder and elbow
2) thoracic spine
3) cerebral part of the skull
4) thighs and lower legs
The head of the bone slides in the articular cavity due to the presence
1) pressure in the joint cavity
2) strong ligaments
3) cartilage on the heads and cavities of bones
4) tendons attached to bones
The lack of calcium and phosphorus is observed in the bones of children
1) often sick with the flu
2) who had measles
3) suffering from rickets
4) suffering from anemia
102. Bone growth in thickness occurs due to
1) articular cartilage
2) red bone marrow
3) yellow bone marrow
4) periosteum
1) protective
2) transport
3) storage
4) carrying out excitation
105. The skin performs an excretory function with the help of
2) capillaries
3) sweat glands
4) sebaceous glands
plays an important role in maintaining normal body temperature
1) sweating
2) the activity of the sebaceous glands
3) a pigment formed in the skin under the influence of ultraviolet radiation
4) the presence of receptors that perceive heat, pain, touch
The biological role of the light skin of Eurasians is that it
1) has advantages in sexual selection
2) transmits ultraviolet rays that promote the formation of vitamin D
3) transmits infrared rays that provide the body with heat
4) protects from the penetration of x-rays into the body
Sweat evaporation and expansion blood vessels located close to the surface of the skin
1) leads to an increase blood pressure
2) causes an increase in body temperature
3) increases the speed of blood movement through the vessels
4) protect the body from overheating
Cells of the epidermis of the skin in the human body perform the function
1) protective
2) transport
3) storage
4) carrying out excitation
Skin performs excretory function by using
2) capillaries
3) sweat glands
4) sebaceous glands
What number denotes the gland that secretes sweat?
Substances that lubricate human hair are formed in
1) sebaceous glands
2) sweat glands
3) subcutaneous adipose tissue
113. What number indicates the sebaceous gland in the figure?
114. Which of the following functions is performed by the covers of the human body?
1) carry out lipid metabolism
2) regulate protein metabolism
3) produce hormones
4) carry out sweating
Life processes. Nervous system and sense organs
115. The similarity between nervous and muscular tissues lies in the fact that they have the property
1) contractility
2) conductivity
3) excitability
4) irritability
One of the functions of the human autonomic nervous system is the regulation
1) skeletal muscle contractions
2) oral and writing
3) coordination of movements
4) constancy of the internal environment of the body
117. The concepts of "nervous tissue" and "neuron" are connected by a certain meaning. The concept of " endocrine system” and one of the concepts below. Find this concept.
4) adrenal gland
118. What bones of the human skeleton are semi-movable?
1) knee joint
3) shoulder girdle
1) articular cartilage
2) red bone marrow
3) yellow bone marrow
4) periosteum
1) often sick with the flu
2) who had measles
3) suffering from rickets
4) suffering from anemia
In connection with upright posture, the support for the internal organs of the human abdominal cavity is
2) chest
3) diaphragm
4) spine
Friction during the movement of bones in the joint is reduced due to
1) articular bag
2) negative pressure inside the joint
3) joint fluid
4) articular ligaments
96. In the human body, a semi-movable joint of bones is characteristic of
1) skeleton head
2) spine
3) shoulder girdle
4) hip joint
The curves of the human spine are associated with
1) upright posture
2) labor activity
3) social way of life
4) carrying weights
The human skull is different from the skulls of other mammals.
1) the presence of a movable articulation of the upper and lower jaws
2) the predominance of the cerebral part of the skull over the facial
3) the presence of sutures between the bones of the brain
4) a feature of the structure of bone tissue
The bones in the human skeleton are connected to each other
1) shoulder and elbow
2) thoracic spine
3) cerebral part of the skull
4) thighs and lower legs
The head of the bone slides in the articular cavity due to the presence
1) pressure in the joint cavity
2) strong ligaments
3) cartilage on the heads and cavities of bones
4) tendons attached to bones
The lack of calcium and phosphorus is observed in the bones of children
1) often sick with the flu
2) who had measles
3) suffering from rickets
4) suffering from anemia
102. Bone growth in thickness occurs due to
1) articular cartilage
2) red bone marrow
3) yellow bone marrow
4) periosteum
1) protective
2) transport
3) storage
4) carrying out excitation
105. The skin performs an excretory function with the help of
2) capillaries
3) sweat glands
4) sebaceous glands
plays an important role in maintaining normal body temperature
1) sweating
2) the activity of the sebaceous glands
3) a pigment formed in the skin under the influence of ultraviolet radiation
4) the presence of receptors that perceive heat, pain, touch
The biological role of the light skin of Eurasians is that it
1) has advantages in sexual selection
2) transmits ultraviolet rays that promote the formation of vitamin D
3) transmits infrared rays that provide the body with heat
4) protects from the penetration of x-rays into the body
Evaporation of sweat and dilation of blood vessels close to the surface of the skin
1) leads to an increase in blood pressure
2) causes an increase in body temperature
3) increases the speed of blood movement through the vessels
4) protect the body from overheating
Cells of the epidermis of the skin in the human body perform the function
1) protective
2) transport
3) storage
4) carrying out excitation
The skin performs an excretory function with the help of
2) capillaries
3) sweat glands
4) sebaceous glands
What number denotes the gland that secretes sweat?
Substances that lubricate human hair are formed in
1) sebaceous glands
2) sweat glands
3) subcutaneous adipose tissue
4) hair follicles
113. What number indicates the sebaceous gland in the figure?
114. Which of the following functions is performed by the covers of the human body?
1) carry out lipid metabolism
2) regulate protein metabolism
3) produce hormones
4) carry out sweating
Life processes. Nervous system and sense organs
115. The similarity between nervous and muscular tissues lies in the fact that they have the property
1) contractility
2) conductivity
3) excitability
4) irritability
One of the functions of the human autonomic nervous system is the regulation
1) skeletal muscle contractions
2) oral and written speech
3) coordination of movements
4) constancy of the internal environment of the body
117. The concepts of "nervous tissue" and "neuron" are connected by a certain meaning. The concept of "endocrine system" and one of the concepts given below are connected with the same meaning. Find this concept.
4) adrenal gland
118. What bones of the human skeleton are semi-movable?
1) knee joint
3) shoulder girdle
Joint represents a discontinuous, cavitary, movable connection, or articulation, articulatio synovialis (Greek arthron - joint, hence arthritis - inflammation of the joint).
In each joint, the articular surfaces of the articulating bones, the articular capsule surrounding the articular ends of the bones in the form of a clutch, and the articular cavity located inside the capsule between the bones are distinguished.
Articular surfaces, facies articulares, covered with articular cartilage, cartilago articularis, hyaline, less often fibrous, 0.2-0.5 mm thick. Due to constant friction, the articular cartilage acquires a smoothness that facilitates the sliding of the articular surfaces, and due to the elasticity of the cartilage, it softens shocks and serves as a buffer. Articular surfaces usually more or less correspond to each other (congruent). So, if the articular surface of one bone is convex (the so-called articular head), then the surface of the other bone is correspondingly concave (articular cavity).
Articular capsule, capsula articularis, surrounding the hermetically articular cavity, adheres to the articulating bones along the edge of their articular surfaces or slightly retreating from them. It consists of an outer fibrous membrane, membrana fibrosa, and an inner synovial membrane, membrana synovialis.
The synovial membrane is covered on the side facing the articular cavity with a layer of endothelial cells, as a result of which it has a smooth and shiny appearance. It secretes into the joint cavity a sticky transparent synovial fluid - synovia, synovia, the presence of which reduces the friction of the articular surfaces. The synovial membrane ends at the edges of the articular cartilage. It often forms small processes called synovial villi, villi synovidles. In addition, in some places it forms synovial folds, sometimes larger, sometimes smaller, plicae synovidles, moving into the joint cavity. Sometimes synovial folds contain a significant amount of fat growing into them from the outside, then the so-called fat folds, plicae adiposae, are obtained, an example of which is the plicae alares of the knee joint. Sometimes in the thinned places of the capsule, bag-like protrusions or eversion of the synovial membrane are formed - synovial bags, bursae synovidles, located around the tendons or under the muscles lying near the joint. Being filled with synovium, these synovial bags reduce the friction of the tendons and muscles during movement.
Articular cavity, cavitas articularis, represents a hermetically closed slit-like space, limited by the articular surfaces and the synovial membrane. Normally, it is not a free cavity, but is filled with synovial fluid, which moisturizes and lubricates the articular surfaces, reducing friction between them. In addition, synovia plays a role in fluid exchange and in strengthening the joint due to the adhesion of surfaces. It also serves as a buffer that softens the pressure and shocks of the articular surfaces, since the movement in the joints is not only sliding, but also the divergence of the articular surfaces. Between the articular surfaces there is a negative pressure (less than atmospheric pressure). Therefore, their divergence is prevented by atmospheric pressure. (This explains the sensitivity of the joints to fluctuations in atmospheric pressure in certain diseases of them, because of which such patients can predict worsening weather.)
If the joint capsule is damaged, air enters the joint cavity, as a result of which the articular surfaces immediately diverge. Under normal conditions, the divergence of the articular surfaces, in addition to negative pressure in the cavity, is also prevented by ligaments (intra- and extra-articular) and muscles with sesamoid bones embedded in the thickness of their tendons.
Ligaments and tendons of the muscles make up the auxiliary strengthening apparatus of the joint. In a number of joints there are additional devices that complement the articular surfaces - intra-articular cartilage; they consist of fibrous cartilaginous tissue and have the appearance of either solid cartilaginous plates - disks, disci articulares, or non-continuous, crescent-shaped formations and therefore called menisci, menisci articulares (meniscus, lat. - crescent), or in the form of cartilaginous rims, labra articularia (articular lips). All these intra-articular cartilages fuse along their circumference with the articular capsule. They arise as a result of new functional requirements as a response to the complication and increase in static and dynamic loads. They develop from the cartilage of the primary continuous joints and combine strength and elasticity, resisting shock and facilitating movement in the joints.
Biomechanics of joints. In the body of a living person, joints play a triple role:
- they help to maintain the position of the body;
- participate in the movement of body parts in relation to each other and
- are organs of locomotion (movement) of the body in space.
Since in the process of evolution the conditions for muscular activity were different, joints of various forms and functions were obtained.
In terms of shape, the articular surfaces can be considered as segments of geometric bodies of revolution: a cylinder rotating around one axis; an ellipse rotating around two axes, and a ball around three or more axes. In the joints, movements are made around three main axes.
Distinguish the following types joint movements:
- Movement around the frontal (horizontal) axis - flexion (flexio), i.e., a decrease in the angle between the articulating bones, and extension (extensio), i.e., an increase in this angle.
- Movements around the sagittal (horizontal) axis - adduction (adductio), i.e., approaching the median plane, and abduction (abductio), i.e., moving away from it.
- Movements around the vertical axis, i.e. rotation (rotatio): inwards (pronatio) and outwards (supinatio).
- Circular motion (circumductio), in which a transition is made from one axis to another, with one end of the bone describing a circle, and the entire bone - the shape of a cone.
Gliding movements of the articular surfaces are also possible, as well as their removal from each other, as, for example, is observed when stretching the fingers. The nature of movement in the joints is determined by the shape of the articular surfaces. The range of motion in the joints depends on the difference in the size of the articulating surfaces. If, for example, the articular fossa represents an arc of 140° along its length, and the head of 210°, then the arc of motion will be equal to 70°. The greater the difference in the areas of the articular surfaces, the greater the arc (volume) of movement, and vice versa.
Movements in the joints, in addition to reducing the difference in the areas of the articular surfaces, can also be limited by various kinds of brakes, the role of which is performed by certain ligaments, muscles, bone protrusions, etc. Since increased physical (power) load, which causes working hypertrophy of bones, ligaments and muscles , leads to the growth of these formations and limitation of mobility, then different athletes have different flexibility in the joints depending on the sport. For example, the shoulder joint has more range of motion in track and field athletes and less in weightlifters.
If the decelerating devices in the joints are especially strongly developed, then the movements in them are sharply limited. Such joints are called tight. The amount of movement is also influenced by intra-articular cartilage, which increases the variety of movements. So, in the temporomandibular joint, which, according to the shape of the articular surfaces, belongs to biaxial joints, due to the presence of an intraarticular disk, three kinds of movements are possible.
The classification of joints can be carried out according to the following principles:
- according to the number of articular surfaces,
- the shape of the articular surfaces and
- by function.
According to the number of articular surfaces, there are:
- Simple joint (art. simplex) having only 2 articular surfaces, such as interphalangeal joints.
- Complex joint (art. composite) having more than two articular surfaces, such as the elbow joint. A complex joint consists of several simple joints in which movements can be performed separately. Availability in complex joint several joints determines the commonality of their ligaments.
- Complex joint (art. complexa) containing intra-articular cartilage, which divides the joint into two chambers (two-chamber joint). The division into chambers occurs either completely if the intra-articular cartilage is disc-shaped (for example, in the temporomandibular joint), or incompletely if the cartilage takes the form of a semilunar meniscus (for example, in the knee joint).
- Combined joint represents a combination of several joints isolated from each other, located separately from each other, but functioning together. Such, for example, are both temporomandibular joints, the proximal and distal radioulnar joints, etc. Since the combined joint is a functional combination of two or more anatomically separate joints, this distinguishes it from the complex and complex joints, each of which, being anatomically single, composed of functionally different compounds.
In form and function classification is carried out as follows.
The function of the joint is determined by the number of axes around which movements are made. The number of axes around which movements occur in a given joint depends on the shape of its articular surfaces. So, for example, the cylindrical shape of the joint allows movement only around one axis of rotation. In this case, the direction of this axis will coincide with the axis of the cylinder itself: if the cylindrical head is vertical, then the movement is performed around the vertical axis (cylindrical joint); if the cylindrical head lies horizontally, then the movement will take place around one of the horizontal axes coinciding with the axis of the head, for example, the frontal (block joint). In contrast, the spherical shape of the head makes it possible to rotate around a plurality of axes coinciding with the radii of the ball (spherical joint). Consequently, there is a complete correspondence between the number of axes and the shape of the articular surfaces: the shape of the articular surfaces determines the nature of the movements of the joint and, conversely, the nature of the movements of a given joint determines its shape (P. F. Lesgaft).
It is possible to outline the following unified anatomical and physiological classification of joints.
Uniaxial joints.
Cylindrical joint, art. trochoidea. The cylindrical articular surface, the axis of which is located vertically, parallel to the long axis of the articulating bones or the vertical axis of the body, provides movement around one vertical axis - rotation, rotatio; such a joint is also called rotational.
Block joint, ginglymus(example - interphalangeal joints of the fingers). Its block-shaped articular surface is a transversely lying cylinder, the long axis of which lies transversely, in the frontal plane, perpendicular to the long axis of the articulating bones; therefore, movements in the trochlear joint are performed around this frontal axis (flexion and extension). Guiding groove and scallop on the articulating surfaces eliminate the possibility of lateral slip and promote movement around one axis.
If the guide groove of the block is not located perpendicular to the axis of the latter, but at a certain angle to it, then when it continues, a helical line is obtained. Such a block-shaped joint is considered as a helical joint (an example is the glenohumeral joint). The movement in the helical joint is the same as in the purely trochlear joint. According to the rules of location ligamentous apparatus, in the cylindrical joint, the guide ligaments will be located perpendicular to the vertical axis of rotation, in the trochlear joint - perpendicular to the frontal axis and on its sides. This arrangement of ligaments holds the bones in their position without interfering with movement.
Biaxial joints.
Ellipsoid joint, articuldtio ellipsoidea(example - wrist joint). The articular surfaces represent segments of an ellipse: one of them is convex, oval in shape with unequal curvature in two directions, the other is respectively concave. They provide movements around 2 horizontal axes perpendicular to each other: around the frontal - flexion and extension, and around the sagittal - abduction and adduction. Ligaments in elliptical joints are located perpendicular to the axes of rotation, at their ends.
Condylar joint, articulatio condylaris(example - knee joint). The condylar joint has a convex articular head in the form of a protruding rounded process, close in shape to an ellipse, called the condyle, condylus, which is where the name of the joint comes from. The condyle corresponds to a depression on the articular surface of another bone, although the difference in size between them can be significant.
The condylar joint can be considered as a kind of elliptical joint, representing a transitional form from the block joint to the elliptical joint. Therefore, its main axis of rotation will be frontal. The condylar joint differs from the trochlear joint in that there is a large difference in size and shape between the articulating surfaces. As a result, in contrast to the block-like joint, movements around two axes are possible in the condylar joint. It differs from the elliptical joint in the number of articular heads.
Condylar joints always have two condyles, located more or less sagittally, which are either in the same capsule (for example, the two condyles of the femur involved in the knee joint), or are located in different articular capsules, as in the atlantooccipital articulation. Since the heads do not have the correct elliptical configuration in the condylar joint, the second axis will not necessarily be horizontal, as is typical for a typical elliptical joint; it can also be vertical (knee joint). If the condyles are located in different articular capsules, then such a condylar joint is close in function to an elliptical joint (atlantooccipital articulation). If the condyles are close together and are in the same capsule, as, for example, in the knee joint, then the articular head as a whole resembles a recumbent cylinder (block), dissected in the middle (the space between the condyles). In this case, the condylar joint will be closer in function to the block joint.
Saddle joint, art. selldris(an example is the carpometacarpal joint of the first finger). This joint is formed by 2 saddle-shaped articular surfaces, sitting "on top" of each other, of which one moves along and across the other. Due to this, movements are made in it around two mutually perpendicular axes: frontal (flexion and extension) and sagittal (abduction and adduction). In biaxial joints, it is also possible to move from one axis to another, i.e., circular motion (circumductio).
Multiaxial joints.
Spherical. Ball joint, art. spheroidea (an example is the shoulder joint). One of the articular surfaces forms a convex, spherical head, the other - a correspondingly concave articular cavity.
Theoretically, movement can be performed around many axes corresponding to the radii of the ball, but in practice, three main axes are usually distinguished among them, perpendicular to each other and intersecting at the center of the head:
- transverse (frontal), around which flexion occurs, flexio, when the moving part forms an angle with the frontal plane, open anteriorly, and extension, extensio, when the angle is open backwards;
- anteroposterior (sagittal), around which abduction, abductio, and adduction, adductio, are performed;
- vertical, around which rotation occurs, rotatio, inward, pronatio, and outward, supinatio.
When moving from one axis to another, a circular motion, circumductio, is obtained. The ball joint is the freest of all joints. Since the amount of movement depends on the difference in the areas of the articular surfaces, the articular fossa in such a joint is small compared to the size of the head. There are few auxiliary ligaments in typical spherical joints, which determines the freedom of their movements.
A kind of spherical joint - cup joint, art. cotylica (cotyle, Greek - bowl). Its articular cavity is deep and covers most of the head. As a result, movements in such a joint are less free than in a typical spherical joint; we have a sample of the bowl-shaped joint in the hip joint, where such a device contributes to greater stability of the joint.
Flat joints, art. plana(example - artt. intervertebrales), have almost flat articular surfaces. They can be considered as the surfaces of a ball with a very large radius, therefore, movements in them are performed around all three axes, but the range of movements due to the insignificant difference in the areas of the articular surfaces is small. Ligaments in multiaxial joints are located on all sides of the joint.
Tight joints - amphiarthrosis. Under this name, a group of joints with a different shape of the articular surfaces, but similar in other ways, is distinguished: they have a short, tightly stretched joint capsule and a very strong, non-stretching auxiliary apparatus, in particular short reinforcing ligaments (an example is the sacroiliac joint). As a result, the articular surfaces are in close contact with each other, which sharply limits movement. Such inactive joints are called tight joints - amphiarthrosis (BNA). Tight joints soften shocks and tremors between bones. These joints also include flat joints, art. plana, in which, as noted, the flat articular surfaces are equal in area. In tight joints, movements are of a sliding nature and are extremely insignificant.
1) thoracic and lumbar
2) lumbar and sacral
3) sacral and coccygeal
4) coccygeal and thoracic
No. 3 The bones of the upper limbs are connected to the axial skeleton through
3) humerus
No. 4 Damage to the ligaments that connect the bones in the joint is:
1) closed fracture
2) open fracture
Does the disease develop in children with insufficient production of thyroxin?
1. myxedima 2. basedog disease
3.cretinism 4.diabetes mellitus
5. How does the parasympathetic division of the autonomic nervous system affect the functioning of the digestive system?
1.does not affect 2.stimulates
1. In what part of the central nervous system are the centers of orientation reflexes located?
1. in the midbrain 2. in the medulla oblongata
3. in the diencephalon 4. in the cerebral cortex
2. What substance regulates the physical and mental development of the body?
3. growth hormone 4. glucagon
3. In what lobe of the cerebral cortex is the zone of skin-muscular sensation located?
3. temporal 4. parietal
4. What disease develops in a person with insufficient production of corticoids (hormones of the adrenal cortex)?
1. myxedema 2. gigantism
3. bronze disease 4. dwarfism
5. Which of the following substances enhances the work of the heart?
1. bradycardin 2. calcium ions
3.acetylcholine 4.potassium ions
1. The displacement of the bones in the joint is greater than the permissible value (without the head of one bone coming out of the articular cavity of the other) or in a direction that does not correspond to the usual one, leads to.
1. injury 2. sprain
2. During what kind of bleeding does scarlet blood flow out in a gushing pulsating jet?
3.. Under what kind of bleeding does the entire wound surface bleed, bleeding is usually not accompanied by a large loss of blood and stops easily?
3.capillary 4.all types of bleeding
4. Which of the human diseases are caused by viruses?
3. ringworm 4. smallpox
5. What measures should be taken to prevent tetanus?
3. take antibacterial agents
4. take antiviral drugs
1. Partial or complete exit of the head of one bone from the articular cavity
another occur at.
1. injury 2. sprain
3. joint dislocation 4. bone fracture
2. Violation of the integrity of the bone occurs when.
1. injury 2. sprain
3. joint dislocation 4. bone fracture
2. How are the bones of the knee joint connected?
3. How are the bones of the spine connected?
4. How are the bones of the skull connected?
What causes bone to grow in length and width? What is an injury to the ligaments that connect bones at a joint called? What is the name of the largest bone in our body? What bones does brain department skulls? What is the name of the habitual position of a person at rest and during movement? A type of bone connection that is made with the help of cartilage. Examples. What bones does the chest consist of? What is a strong displacement of bones in a joint called? The substance that fills the heads of long tubular bones? Its function. What bones form the shoulder girdle? What tissue forms masticatory and facial muscles? What are opposing muscles called? sedentary image life.
Dislocation
A dislocation is a complete displacement of the articular ends of the bones relative to each other. Articular surfaces cease to be congruent, movements in the joint become impossible. A dislocation can be accompanied by damage to bones and soft tissues. Possible ruptures of the joint capsule, muscles and ligaments, damage to nerves and blood vessels, as well as intra- and extra-articular fractures. The cause of dislocation can be trauma, various pathological processes and developmental disorders. There are pains and a gross violation of the configuration of the joint. Active movements become impossible; when passive movements are attempted, spring resistance is determined. The diagnosis is made on the basis of examination and x-ray data. If necessary, a CT or MRI is ordered. Treatment - reduction of dislocation (usually closed). With chronic dislocations, surgery is necessary. After reduction, immobilization and functional treatment (physiotherapy, exercise therapy, massage) are prescribed. The prognosis is usually favorable.
Dislocation
dislocation - pathological condition, in which the articular surfaces are displaced relative to each other. Dislocated is the distal (away from the body) part of the limb. The exception is a dislocation of the clavicle (the name indicates the dislocated end of the bone) and a dislocation of the vertebra (the overlying vertebra is indicated). Dislocation is a fairly common pathology in traumatology. Traumatic dislocations account for 1.5-3% of the total number of injuries of the musculoskeletal system. Dislocations are treated by traumatologists, less often by orthopedists.
Anatomy
A joint is a movable connection of two or more bones covered with a synovial membrane, separated by a joint space and interconnected by a capsule and ligaments. There are several types of joints (ellipsoid, block-shaped, spherical, saddle-shaped), but, regardless of the shape, they are all formed by congruent (coinciding in shape, complementing each other) surfaces. Due to this structure, during movements, the articular surfaces slide relative to each other, and the joint works like a hinge. Movement occurs due to the muscles attached to the bones above and below the joint. A tense muscle pulls the bone in a certain direction, and the capsule and ligaments keep the articular ends from excessive displacement. With a dislocation, there is a mutual displacement of the ends of the bones that form the joint. Surfaces cease to "coincide", movements become impossible.
Simplistically, there are three main mechanisms for the formation of dislocation. Traumatic - as a result of increased traction of the muscles, a direct blow or violent impact with an indirect injury, the articular ends of the bones are excessively displaced. The impact is too strong, the capsule does not withstand and breaks, ligament rupture is also possible. Pathological - due to various pathological processes, the strength of the capsule and ligaments decreases, they lose the ability to hold the articular ends of the bones in the correct position even with minor impacts, so dislocation can occur during normal unforced movements. Congenital - due to anomalies in the development of the structures of the joint (bones, ligaments, capsule), the articular surfaces initially do not match or are not held in the correct position.
Classification of dislocations
Taking into account the degree of displacement, complete dislocations are distinguished, in which the articular ends completely diverge, and subluxations, in which partial contact of the articular surfaces is maintained.
Depending on the origin, there are:
- Congenital dislocations - resulting from malformations of the elements of the joint. The most common is congenital dislocation of the hip joint, less common are congenital dislocations of the knee joint and patella.
- Acquired dislocations - resulting from injury or disease. The most common are traumatic dislocations. The upper extremities are affected 7-8 times more often than the lower ones.
Traumatic dislocations, in turn, are divided into:
- Taking into account the prescription of damage: fresh (up to 3 days from the moment of injury), stale (up to 2 weeks from the moment of injury), old (more than 2-3 weeks from the moment of injury).
- With or without breach of integrity skin and underlying soft tissues: open and closed.
- Taking into account the presence or absence of complications: uncomplicated and complicated - accompanied by damage to the nerves or blood vessels, as well as peri- and intra-articular fractures.
Irreducible dislocations are also distinguished - this group includes dislocations with soft tissue interposition that prevents closed reduction, and all chronic dislocations.
In addition, there are two individual groups pathological dislocations:
- Paralytic dislocation - the cause of development is the paralysis of one muscle group, due to which the traction of the antagonist muscles predominates.
- Habitual dislocation is a repetitive dislocation that occurs due to weakness of the capsule, muscles and ligaments and / or changes in the configuration of the articular surfaces. The cause of development is most often the premature onset of movements in the joint after the reduction of acute traumatic dislocation. Less commonly, habitual dislocation occurs in diseases that affect bones and ligaments (arthritis, osteomyelitis, poliomyelitis, and some systemic diseases, including hereditary).
Traumatic dislocations - general information
The cause of traumatic dislocation usually becomes an indirect effect: a blow or a fall on an adjacent joint or the distal part of the limb (for example, a dislocation of the shoulder joint can occur when falling on the elbow or forearm), forced muscle contraction, forced flexion and extension of the joint, twisting, traction for the limb. Less often, injuries occur due to direct trauma (a blow to a joint or a fall on it). With blows and ordinary falls, as a rule, an isolated dislocation develops (less often, a fracture dislocation). In road accidents, falls from a height and work injuries, a combination of dislocation with other injuries of the musculoskeletal system (fractures of the pelvis, fractures of the spine and extremities), craniocerebral trauma, blunt abdominal trauma, damage to the chest and injuries of the genitourinary system can be observed.
Acute traumatic dislocations are accompanied by intense pain. At the moment of injury, a characteristic click or pop is usually heard. The joint is deformed, swells, bruises may appear on the skin in the affected area. There are no active and passive movements; when passive movements are attempted, springy resistance is detected. Possible blanching and cooling of the skin below the level of damage. If the nerve trunks are damaged or compressed, the patient complains of numbness, tingling and decreased sensitivity.
A patient with suspected traumatic dislocation should be taken to a specialized medical facility as soon as possible. institution (the best option is during the first 2-3 hours), since subsequently increasing swelling and reflex muscle tension can make it difficult to reduce. It is necessary to fix the limb using a splint or scarf, give the patient an anesthetic and apply cold to the injured area. Patients with dislocations of the lower extremities are transported in the supine position, patients with dislocations of the upper extremities - in the sitting position.
The diagnosis of dislocation is made on the basis of the clinical picture and data x-ray examination. In some cases (usually with complicated dislocations), an MRI or CT scan of the joint is prescribed. If compression or damage to blood vessels and nerves is suspected, the patient is referred for a consultation with a vascular surgeon and a neurosurgeon. Treatment is carried out in an emergency room or trauma department. The need for hospitalization is determined by the localization of the dislocation, the absence or presence of complications.
Uncomplicated dislocations are subject to closed reduction. Fresh uncomplicated dislocations of small and medium joints are usually reduced under local anesthesia, dislocations large joints and stale dislocations - under anesthesia. In children younger age reduction in all cases is carried out under general anesthesia. With open, complicated and chronic dislocations, an open reduction is performed. Subsequently, rest is prescribed and an immobilization bandage is applied. The period of immobilization is determined by the features and localization of the dislocation. Premature removal of the bandage and the early onset of movement in the joint are in no case allowed, since this can lead to the development of habitual dislocation. In the rehabilitation period, exercise therapy, physiotherapy and massage are prescribed. The prognosis is favorable.
The first place in prevalence is occupied by traumatic dislocation of the shoulder, followed by dislocations of the fingers and elbow joint. Dislocations of the patella and hip joint are somewhat less common.
Traumatic shoulder dislocation
The high frequency of pathology is due to the peculiarities of the structure of the joint (the head of the humerus is in contact with the articular cavity for a short distance and is mainly held by muscles, ligaments and a special soft tissue formation - the articular lip), significant loads and a large range of motion in the joint. When damaged, acute pain occurs, there is a feeling that the shoulder is not in its place. The shoulder joint looks unnatural: the head of the humerus is not visible, in its place a smooth surface with a pointed upper edge is visible. The shoulder looks drooping. The patient's hand is usually pressed against the body.
Depending on the direction of displacement of the head, three types of dislocations of the shoulder joint are distinguished: anterior, posterior and lower. Anterior dislocation is the most common (according to various sources, it occurs in 80-95% of cases). The head is displaced forward and is either under the coracoid process of the scapula (in this case, a subclavicular dislocation occurs), or under the clavicle (subclavian dislocation). Usually, anterior dislocations are accompanied by minor damage to the glenoid lip (cartilaginous ridge, which is a continuation of the glenoid cavity of the scapula and helps the head of the shoulder to stay in the joint). Posterior dislocation develops infrequently (less than 20-5% of cases) and is accompanied by significant damage to the articular lip. lower dislocation occurs very rarely. With such damage, the head of the shoulder “goes” down, and the arm is in a raised position until the moment of reduction.
To confirm the diagnosis, an x-ray of the shoulder joint is performed. CT scan of the shoulder joint and MRI of the shoulder joint are usually not required, except for suspected severe soft tissue injuries and fracture fractures. Minor circulatory disorders and slight numbness of the limb are usually caused by compression of the neurovascular bundles and spontaneously disappear after reduction of the dislocation. Severe sensory disturbances may indicate nerve damage and are an indication for neurosurgeon consultation.
The reduction of fresh dislocations is usually performed in the emergency room under local anesthesia. A stale dislocation and an unsuccessful first attempt at reduction are indications of reduction under general anesthesia. The Janelidze method is usually used, less often the Kocher method. After reduction, the arm is fixed for three weeks. During this period, UHF is prescribed to reduce inflammation and exercise therapy (hand movements and wrist joint). Then immobilization is stopped, exercises are gradually added to the exercise therapy complex to develop the elbow and shoulder joints. It should be remembered that the healing of the joint capsule takes time. Too early unauthorized removal of the bandage (even in the absence of pain) can lead to the formation of a habitual dislocation.
Habitual shoulder dislocation
It usually occurs after an untreated acute traumatic dislocation. Predisposing factors are muscle weakness, increased extensibility of the capsule, a slightly concave glenoid cavity of the scapula, and a large spherical head of the shoulder. Habitual dislocation of the shoulder is accompanied by a less intense pain syndrome and can occur even with minor impacts. The frequency of repeated dislocations varies greatly - from 1-2 times a year to several times a month. The reason for the development is the failure of the joint capsule. Requires surgical treatment. The indication for surgery is 2-3 or more dislocations during the year.
Traumatic dislocations of the phalanges of the fingers
Most often develop when a fingertip is struck with force applied in the proximal direction. Arises sharp pain and noticeable visible deformity of the finger in the area of the joint. Movement is not possible. There is an increasing edema. To confirm the diagnosis, an X-ray of the hand is performed. Reduction is carried out on an outpatient basis, under local anesthesia. Then a plaster cast is applied and UHF is prescribed.
Traumatic dislocation of the elbow joint
The cause of the injury is a fall on an outstretched arm or a blow to a bent arm. In the first case, there is a posterior dislocation, in the second - an anterior one. Damage is accompanied by severe pain and significant swelling of the soft tissues. In the elbow area, a pronounced deformity is detected, movements are impossible. The pulse on the radial artery is weakened, numbness is often observed. With posterior dislocations, the head of the radius is palpated in front, with anterior dislocations - behind. Distinctive feature dislocations of the elbow joint is a combination with fractures of the ulna and radius, as well as damage to the nerves and blood vessels. To confirm the diagnosis, an x-ray of the elbow joint is performed. According to the indications, consultations of a neurosurgeon and a vascular surgeon are appointed. Treatment is carried out in a hospital. Treatment tactics depend on the characteristics of the injury. In most cases, a closed reduction is performed. If it is impossible to reduce the dislocation, match or hold the bone fragments (in case of fracture dislocations), surgery.
Traumatic dislocation of the patella
The injury occurs as a result of a fall or blow to the knee at the time of contraction of the quadriceps muscle. Lateral dislocations of the patella develop more often (the patella is displaced inwards or outwards). Less common are torsion (the patella turns around a vertical axis) and horizontal (the patella turns around a horizontal axis and is embedded between the articular surfaces of the bones that form the knee joint) dislocations. The injury is accompanied by severe pain. Deformation occurs, increasing edema appears. The knee is slightly bent, movements are impossible. On palpation, the displaced patella is determined. Often there is hemarthrosis.
The diagnosis is made on the basis characteristic symptoms and x-ray data of the knee joint. The reduction is usually not difficult and is performed under local anesthesia. Spontaneous reduction is also possible. With hemarthrosis, a joint puncture is performed. After restoring the natural anatomical position of the patella, a splint is applied to the leg for 4-6 weeks. Assign UHF, massage and exercise therapy.
Traumatic hip dislocation
It occurs as a result of indirect injury, usually in car accidents and falls from a height. Depending on the location of the femoral head, it can be anterior or posterior. Dislocation of the hip is manifested by severe pain, swelling, deformity of the affected area, forced position of the limb and shortening of the hip. Movement is not possible. To clarify the diagnosis, an x-ray of the hip joint is performed. Reduction is performed under general anesthesia in a hospital setting. Then skeletal traction is applied for 3-4 weeks, physiotherapy and exercise therapy are prescribed.
congenital dislocations
The most common is congenital dislocation of the hip. Occurs as a result of underdevelopment of the femoral head and articular cavity. More commonly seen in girls. Appears immediately after birth. In infants, it is manifested by limited abduction of the limb, shortening of the limb, and asymmetry of the skin folds. Subsequently, lameness occurs, with bilateral dislocation - a duck's gait. The diagnosis is confirmed by radiography, CT of the hip joint and MRI of the hip joint. Treatment begins from the first months of life. Special plaster bandages and splints are used. With inefficiency conservative treatment surgery is recommended before the age of 5 years.
The second most common is congenital dislocation of the patella. Compared to hip dislocation, it is a fairly rare anomaly. It can be isolated or combined with other malformations of the lower extremities. More commonly seen in boys. Manifested by instability when walking, fatigue and limited movement in the joint. X-ray of the knee joint indicates underdevelopment and displacement of the patella. The dislocation is removed surgically by moving the patellar tendon's own ligament.
If treatment is not carried out, progressive pathological changes develop in the joint, which is in a state of congenital dislocation, severe arthrosis occurs, accompanied by increased deformity of the limb, impaired support, decrease or loss of working capacity. Therefore, all children with suspected such a pathology should be under the supervision of pediatric orthopedists and receive timely adequate treatment.
Dislocation
A dislocation is a permanent and complete displacement of the articular surfaces of the bones, in which contact is disturbed at the place of articulation. According to statistics, the joints of the upper extremities suffer from dislocations 7-8 times more often than the joints of the lower extremities. Exist different reasons pathology. The most common are injuries in which there is a rupture of the ligaments and joint capsules. This can be the result of a sharp muscle contraction, a fall with an emphasis on a bent or extended limb.
joints
Dislocation of the joints is called the displacement of the articular ends of the bones, in which the ligamentous-capsular apparatus of the joint is damaged, and the functions of the limb are impaired. As a result of the simultaneous displacement of the articular parts, the articular structure is disturbed, but its integrity is preserved. In this case, simultaneous damage to their soft tissues occurs. The joint capsule, vessels with ligaments, tendons of adjacent muscles can be damaged. As a result, there are severe violations of the functioning of the affected joint and the entire limb.
There are dislocations habitual, traumatic, pathological and congenital. For the usual is typical frequent development displacement even with minor trauma.
Traumatic can be closed or open. When open, there is a wound in the joint area.
The main symptoms of joint dislocation are swelling and pain in the joint, disruption of its functioning, changes, impossibility of passive and active movements in it.
Most often, displacements of the knee joint, as well as the hip and shoulder joint, occur.
shoulder
Shoulder dislocation is a persistent displacement of the articulating surfaces of the humeral bone head and the glenoid cavity of the scapula. Usually, the displacement of the shoulder joint occurs as a result of a pathological process or physical abuse.
There are acquired or congenital. Acquired, in turn, are divided into non-traumatic (arbitrary or pathological chronic) and traumatic.
About 60% of all types of displacements fall on the share of traumatic ones. There are the following forms of dislocation of the shoulder joint:
- complicated;
- uncomplicated;
- open;
- fracture-dislocation;
- with tendon rupture;
- with damage to the neurovascular bundle;
- habitual;
- old;
- pathologically repetitive.
The main symptoms of shoulder dislocation are pain and the inability to function of the shoulder joint after injury.
The joint has a deformed appearance. The patient tries with his healthy hand to fix the position of anterior deviation and abduction of the affected arm. Common symptoms of shoulder dislocation include:
- swelling, paroxysmal pain;
- external changes in the shape of the joint, in which the roundness of the forms and the former smoothness are lost;
- as a result of the exit from the joint of the head of the humerus, only spring movements of the hand are possible;
- in case of damage to a blood vessel or pinched nerve, bruising often occurs in the area of damage, numbness upper limb, stabbing pains;
- violation of the sensitivity of the shoulder, forearm, hand.
Diagnosis of shoulder dislocation includes a medical examination of the patient, collection of data on the nature of the injury, x-rays. In some cases, the patient is additionally prescribed magnetic resonance imaging and computed tomography.
After diagnosing and analyzing the important symptoms of a dislocation, the doctor anesthetizes the joint and sets it. Then X-ray control is carried out to assess the quality of reduction. To reduce pain after reduction, non-steroidal anti-inflammatory drugs (Ibuprofen, Ortofen, Paracetamol) are prescribed. For three days, cold compresses are applied to the shoulder.
After the reduction procedure, during the first days, the patient is prescribed physiotherapy exercises, as the most effective method rehabilitation.
In the case of a habitual dislocation of the shoulder, surgery is often the only treatment.
Hips
Hip dislocation is caused by indirect trauma. In this case, the femur behaves like a lever that acts on the hip joint. With intense impact, the joint capsule is torn by the head of the femur. Damage to the ligaments, the head comes out of the articular cavity.
Hip dislocation can be anterior or posterior.
The anterior one appears as a result of a fall from a height onto a bent and abducted leg turned outward. The posterior most often occurs with a road traffic injury. It occurs as a result of flexion or rotation of the adducted and bent, turned inward leg.
The main symptom of hip dislocation is a sharp pain syndrome, which is noted in the hip joint. In this case, there is a visible shortening of the affected limb, deformation of the hip joint, a characteristic forced position of the injured limb. Active movements in the hip joint are not possible. Passive movements are severely limited, painful, accompanied by springy resistances.
A symptom of a dislocation of the anterior type is that the affected limb is bent at the knee and hip joints, laid aside, turned outward. With the hind leg turned with the knee inward, bent, adducted.
In some cases, hip dislocation may cause contusion of the sciatic nerve, compression of the femoral vessels, and damage to the obturator nerve.
Treatment of these pathologies consists in the immediate reduction and fixation of the joint. Then the patient is given physiotherapy and special physiotherapy.
First aid
Proper first aid for dislocation is of great importance for the future restoration of the functioning of the joint.
The main task of first aid is the complete immobilization of the damaged joint, without changing its position.
You can not try to straighten the dislocation on your own. This can only be done by a specialist.
After immobilizing the joint, the victim is given an anesthetic, a cold is applied to the joint. After that, they wait for the ambulance to arrive.
If it is not possible to call medical care, the victim is given a splint, bandage and transported to the nearest medical facility.
First aid for hip dislocation is that the injured limb is bandaged to a healthy one, without changing its position. The victim is transported on a hard surface in a prone position.
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.
Displacement of the hip joint
Why does hip dysplasia develop?
hip dysplasia
remain not fully established. Orthopedists cannot explain why, under equal conditions, some children develop this pathology, while others do not. Modern
put forward several versions.
1. Impact of the hormone relaxin.
It is secreted in the body of a woman immediately before
Causes of the hip joint: causes and joint
As a rule, the main cause of a dislocated hip joint is a car accident, a fall from a height, or emergency situations (landslides, collapses). That is, the pelvic region is affected by force majeure. Sometimes a dislocation is accompanied by a rupture of the ligaments and a fracture of the bones.
In traumatology, there are several types of damage to the hip joint:
Posterior dislocation
Posterior dislocation is the most common type, in which the head of the hip joint is pushed backward. Depending on the direction, two types of posterior dislocation are distinguished: posterior superior and posterior inferior (or iliac and ischial).
The most common cause is a posterior acetabular fracture. This type of injury is common in car accidents. The seated person during braking is thrown forward, the leg hits the panel, the hip is shifted back.
Main symptoms of this type damage are severe pain, joint deformity, swelling. By palpating the buttocks, you can feel the head of the joint. The leg becomes shorter, it is bent at the knee and turned inward.
X-rays are taken to confirm the diagnosis.
The hip joint has a treatment that allows it to move. When the head of the joint from the acetabular is allowed to occur, a dislocation is observed.
Dislocation exclusively of the joint - an injury that hip 5% of the total number of dislocations. The structure of the rare appearance of such a free is that a move of this kind happens to be observed under the influence of a large blow to it.
Gypsum is often used to eliminate the acetabular.
The hip joint and the causes of dislocations are used
To date
distinguish the following types
- Anterior type of damage, displacement occurs when the head falls from a height, when the leg joint is to the side. In this case, the trauma is displaced in the cavity of the femoral bone, tearing the joint capsule. Joint dislocations are divided into suprapubic and classification. For their treatment, dislocation is used.
- The posterior type of injury, dislocation is the most common cause. This kind of dislocation occurs when the hip is rotated. The following subspecies of the entire dislocation are distinguished:
- posterior;
- posterior superior;
- appearances;
- congenital, the development of which is dislocations due to the incorrect position of the number in the womb; with hip therapy initiated, it is given that trauma to the hip joint causes lameness and "rare duck".
A dislocation of the hip joint can occur in cases of falling from a height or in case of damage by a strong blow (for example, in such an accident). The main symptoms are - it is a strong painful influence and immobilization of the affected person.
Kinds are subject to such dislocations big people. In a situation where a dislocation is being repaired, it is usually sufficient to apply volume quickly and correctly to repair the damage.
Hip dislocation can be a complication after today's hip replacement surgery. A blow to some extent can be used in such cases.
The appearance of a dislocation has the following often its appearance:
- Genetic specialists (about 30% of cases).
- Pelvic following the child before childbirth gypsum natural childbirth with serious damage.
- The lack of vitamins and microelements in the causes of the mother during pregnancy, the day negatively affects the formation of dislocations and fetal tissues.
- The presence of secrete infections in the mother while the baby occurs.
- Unfavorable ecological front residence.
Congenital dislocations: subdivided and features
To date, human dislocations are usually classified into types of dislocations:
- Maternity deformities (joint, cerebral palsy, fractures, sprains, etc.) which is often during the intervention of a fall in the birth process.
- Acquired abductions are caused by various pathologies of the osteoplastic apparatus (infections, tumors, heights, etc.).
According to the degree of severity, congenital when children are divided into the following types:
- Predislocation, for which the inferiority of the development of the hip head is displaced. Symptoms of displacement of the head of the type of thigh in such situations are not suprapubic.
- Subluxation of the hip joint, the leg of which is partially displaced to the side of the thigh.
- A dislocation that is used by the absolute displacement of the head of this.
Today, the percentage of congenital ruptures in newborns is very high (18 bones per 10,000 children). One of the hips to overcome the anatomical deformation in the anterior superior joint is to "educate" damage.
The symptoms of a dislocation of the hip capsule depend on the location and extent of the down surrounding tissues. Often the joint complains of a sharp sensation in the pelvic area.
Sometimes the front becomes completely impossible. With all dislocations hip dislocation deformation is characteristic and in different treatment, a pronounced reduction in the damaged is.
Motor function is limited and posterior superior severe pain. Old gypsum have a less pronounced posterior.
Pain sensations become which bright. The inclination of the pelvis and the most bending compensates for the deformity and the encountered limb.
A traumatologist can often diagnose for special work by identifying its signs.
Dysplasia of the hip back - the inferiority of the development of the hip to develop bones, observed when its structure is used, mainly - the incorrect location of the head of the bone methods in the acetabulum is recommended.
Classification
In a newborn, the muscles and ligaments that surround the hip joint are poorly developed. The head of the femur is held in place primarily by ligaments and a cartilaginous rim around the acetabulum.
Anatomical disorders that occur with hip dysplasia:
- abnormal development of the acetabulum, it partially loses its spherical shape and becomes flatter, smaller;
- underdevelopment of the cartilaginous rim that surrounds the acetabulum;
- weakness of the ligaments of the hip joint.
- Degrees of hip dysplasia
- Actually dysplasia. There is an abnormal development and inferiority of the hip joint. But its configuration has not been changed yet. In this case, it is difficult to identify pathology when examining a child, this can only be done with the help of additional diagnostic methods. Previously, this degree of dysplasia was not considered a disease, was not diagnosed and was not prescribed treatment. Today such a diagnosis exists. Relatively often, overdiagnosis occurs when doctors “detect” dysplasia in a healthy child.
- Predislocation. The hip joint capsule is stretched. The head of the femur is slightly displaced, but it easily "gets" back into place. In the future, the predislocation is transformed into subluxation and dislocation.
- Hip subluxation. The head of the hip joint is partially displaced relative to the articular cavity. She bends the cartilaginous rim of the acetabulum, shifts it upwards. The ligament of the femoral head (see above) becomes tense and stretched.
- Dislocation of the hip. In this case, the head of the femur is completely displaced relative to the acetabulum. It is outside the cavity, above and outwards. The upper edge of the cartilaginous rim of the acetabulum is pressed by the head of the femur and bent inside the joint. The articular capsule and ligament of the femoral head are stretched and strained.
Types of hip dysplasia
- Acetabular dysplasia. Pathology, which is associated with a violation of the development of only the acetabulum. It is flatter, reduced in size. The cartilaginous rim is underdeveloped.
- Hip dysplasia. Normally, the femoral neck articulates with his body at a certain angle. Violation of this angle (decrease - coxa vara or increase - coxa valga) is a mechanism for the development of hip dysplasia.
- rotational dysplasia. It is associated with a violation of the configuration of anatomical formations in the horizontal plane. Normally, the axis around which the movement of all joints occurs lower limb, do not match. If the misalignment of the axes goes beyond the normal value, then the location of the femoral head in relation to the acetabulum is violated.
Dysplasia, i.e. barlow joint, can be ortolani subluxation, preluxation and dislocation. After it depends on how additional the femoral head is according to the diagnosis to the acetabulum.
If neonatal subluxation of the femur, methods of the joint is pushed back. You can make an x-ray, there will be ways that the acetabulum and with the help of the femoral head are beveled.
Folds type of dislocation often lengths are obtained in accidents, a modern person who sits in applied, during a strong blow and medicine is hit hard due to the ultrasound of the displacement of the body forward.
In the examination there is a displacement of the femoral difference back. Sometimes secondary and installation of an endoprosthesis is necessary if the lower one is very strong and the bone is clinically broken or crushed.
Maybe the doctor will set the X-ray bone.
Marx-ortolani femoral subluxation by displacement of the femoral head up and outward. As a result, the diagnosis is so that the femoral head of the femur and the acetabulum are signs at different levels.
With one limb, there may be features in the knee area and the buttocks are twisted, and the anterior part of the capsule is obvious - to break. An anatomical person is not able to move if the nerves of the extremities are also affected, the feet become numb.
Another dislocation of the head of the Harris bone is strongly displaced upward and indicate there is no contact between the dysplasia and the acetabulum. Dislocation of the main most severe form of visualize the hip joint, after both assess the fracture. It is necessary to carry out methods and it is possible to install an endoprosthesis. The work of the acetabulum is capable of asymmetry, and the head of the femoral bone is one-sided in the pelvic region. The symptoms of this house are as follows:
- intolerable normal pain;
- limb is fully functional.
After surgery, a person's joint will undergo treatment, a long instrumental period and rehabilitation, before he starts normal operations and moves again.
It is often carried out to suspect, during which an endoprosthesis is installed on time, if the hip diagnosis is badly damaged and there is no longer a disease.
Dysplasia, that is, dislocation of the joint, can be manifested by subluxation, preluxation and dislocation. It all depends on how far the femoral head has shifted in relation to the acetabulum.
If there is a subluxation of the femur, the head of the joint is pushed back. If you take an x-ray, you will see that the acetabulum and the neck of the femoral head are beveled.
People often get this type of dislocation in accidents, because a person who sits in a car hits hard during a strong impact and braking due to a sharp shift of the body forward.
The result is a posterior displacement of the femur. Sometimes an operation and installation of an endoprosthesis is necessary if the blow is very strong and the bone is broken or crushed as a result.
If possible, the doctor will reset the protruding bone.
Hip subluxation is characterized by an upward and outward displacement of the femoral head. As a result, it turns out that the head of the femoral bone and the acetabulum are at different levels.
In this case, the limb can be bent at the knee and turned outward, and the anterior part of the head capsule can be torn. A person is completely unable to move if the nerves are hurt and torn, the feet become numb.
With a dislocation, the head of the femoral bone is strongly displaced upward and outward, there is no contact between the head and the acetabulum. A dislocation is the most severe form of hip joint injury, as it breaks the bones. An operation is necessary and an endoprosthesis can be installed. The bones of the acetabulum can be crushed, and the head of the femoral bone is displaced into the pelvic region. The symptoms are as follows:
- unbearable severe pain;
- the limb is completely immobile.
After surgery, a person will have to undergo treatment, a long recovery period and rehabilitation before he can walk and move normally again.
Often, an operation is performed during which an endoprosthesis implant is installed if hip bone severely damaged and will never recover.
Signs of a dislocated hip
Risk factors for hip dysplasia in newborns
- breech presentation of the fetus (the fetus is in the womb not head to exit from the uterus, pelvis);
- fruit of large size;
- the presence of hip dysplasia in the parents of the child;
- toxicosis of pregnancy in the expectant mother, especially if the pregnancy occurred at a very young age.
If a child has at least one of these factors, then he is taken under observation and included in the risk group for this pathology, even though he may be completely healthy.
Symptoms of dysplasia in newborns:
- the folds of the buttocks are not asymmetrical. They are located higher than usual;
- the lower limb is shortened;
- unnatural rotation of the limb;
- a clicking sound, which indicates that the head of the femoral bone is slipping into the acetabulum;
- the head of the femur moves freely up and down;
- limitation in hip abduction;
- the head of the femoral bone is displaced if the leg is bent at the hip joint.
It is possible to detect dysplasia in a child and all the corresponding symptoms at home. Mom should examine the legs, compare the folds on the legs and notice that one leg of the baby is shorter than the other. Or sound the alarm if the child tries to start walking and at the same time limps. The most important thing is to immediately consult a doctor who will determine the severity of the pathology and the degree of dislocation and prescribe treatment. Symptoms of dysplasia in an adult:
- sharp pains in the hip area;
- shortened limb;
- deformity of the hip joint;
- inability to move the limb normally, feeling severe pain at the slightest movement;
- edema.
Restriction of leg abduction is usually diagnosed in children under one year old.
A variation of the violation of the anatomical position of the hip joint in adults is its subluxation or partial dislocation. In this case, the head of the bone is not completely displaced from the cavity.
The main symptoms of subluxation are pain in the hip area, lameness. Sometimes there may be different lengths of the legs.
An accurate diagnosis is established on the basis of X-ray and magnetic resonance imaging.
The basis of the treatment of subluxation is the restoration of the normal position of the joint. Painkillers are prescribed.
AT special occasions when the subluxation is combined with a bone fracture, surgical intervention is required. The recovery period can last up to 3-6 months.
With untimely loads on the legs, bone tissue necrosis may develop due to impaired blood supply.
Symptoms of joint dislocation directly depend on its location and the degree of damage to surrounding tissues. If there is an anterior dislocation, the knee joint will be turned outward, and if it is posterior, then inward.
A sharp limitation of the range of motion is clinically manifested, due to severe pain, in some cases the pain is so intense that movements become completely impossible.
Causes, symptoms, types of hip dislocation
The main symptoms of hip dislocation are considered to be:
- Sharp pain in the hip joint.
- Forced limb position. It depends on the location of the femoral head in relation to the acetabulum.
- Deformity of the hip joint.
- Shortening of the injured limb.
- With chronic dislocations, the symptoms are less pronounced. In this case, the patient no longer suffers from severe pain, and the deformity and shortening of the limb is reduced due to a sharp increase in the lumbar flexion (lordosis) and pelvic tilt.
The basis of congenital deformity of the femoral neck is its shortening and a decrease in the cervical-diaphyseal angle. In this condition, there is limited abduction and rotation of the hip, lumbar lordosis, and duck gait.
Symptoms of hip dislocation in newborns include a high location greater trochanter hips and limb shortening.
X-ray diagnosis of hip dysplasia
In young children, ossification of some parts of the femur and pelvic bones has not yet occurred. In their place are cartilages that are not visible on x-rays.
Therefore, in order to assess the correctness of the configuration of the anatomical structures of the hip joint, special schemes are used. They take pictures in direct projection (full face), on which conditional auxiliary lines are drawn.
Additional lines that help in the diagnosis of hip dysplasia on radiographs
- median line - a vertical line that passes through the middle of the sacrum;
- Hilgenreiner's line - a horizontal line drawn through the lowest points of the ilium;
- Perkin's line - a vertical line that passes through the upper outer edge of the acetabulum on the right and left;
- Shenton's line is a line that mentally continues the edge of the obturator foramen of the pelvic bone and the neck of the femur.
An important indicator of the condition of the hip joint in young children, which is determined on radiographs, is the acetabular angle. This is the angle formed by the Hilgenreiner line and the tangent line drawn through the edge of the acetabulum.
Normal indicators of the acetabular angle in children of different ages
- in newborns - °;
- 1 year of life - 18.5 ° (in boys) - 20 ° (in girls);
- 5 years - 15 ° in both sexes.
The h value is another important indicator that characterizes the vertical displacement of the femoral head in relation to the pelvic bones. It is equal to the distance from the Hilgenreiner line to the middle of the femoral head.
Normally, in young children, the value of h is 9 - 12 mm. An increase or asymmetry indicates the presence of dysplasia.
This is an indicator that characterizes the displacement of the femoral head outward from the articular cavity. It is equal to the distance from the bottom of the articular cavity to the vertical line h.
Ultrasonography (ultrasound diagnostics)
hip dysplasia is the treatment of choice in children under 1 year of age.
The main advantage of ultrasound as a diagnostic method is that it is quite accurate, does not harm the child's body and has practically no contraindications.
Indications for ultrasonography in young children
- the presence of factors in the child that make it possible to classify him as a risk group for hip dysplasia;
- identification of signs characteristic of the disease during the examination of the child by a doctor.
During the ultrasound diagnostics you can take a picture in the form of a section, which resembles an X-ray in the anteroposterior projection.
Indicators that are evaluated during ultrasound diagnosis of hip dysplasia:
- alpha angle - an indicator that helps to assess the degree of development and the angle of inclination of the bone part of the acetabulum;
- beta angle - an indicator that helps to assess the degree of development and the angle of inclination of the cartilaginous part of the acetabulum.
Treatment Methods
Wide baby swaddling
Wide swaddling can rather be attributed not to therapeutic, but to preventive measures for hip dysplasia.
Indications for wide swaddling
- the child is at risk for hip dysplasia;
- during an ultrasound scan of a newborn child, the immaturity of the hip joint was revealed;
- there is hip dysplasia, while other methods of treatment are impossible for one reason or another.
Treatment of dysplasia without stirrups is permissible at an early stage of the disease, when the structure of the joint is not disturbed, but only its maturation is delayed and there is a delay in the ossification of the heads of the pelvic bones.
For treatment, a variety of techniques are used that improve blood circulation, relieve muscle spasm, saturate with minerals, which accelerates the ossification of the nuclei and the growth of the roof of the joint.
The treatment of hip dislocation results is based on methods directions:
The legs of the child are selected individually for, which keeps him abducted and bent in the hip and diagnostic joints. Timely "delivered" permanent hip in the acetabulum observation to the normal development of the joint.
The child is especially effective in the very beginning of the technique (up to 3 months). At the end of the device, the symptoms disappear.
Effective for a child in treatment up to 5 years. The older the treatment, the more difficult the disease pathology will be without consequences.
So children who have not reached the teenage main are shown only intra-articular standard with a deepening of the acetabulum. &Early;Adult patients and adolescents include extra-articular surgery, the "beginning" of the acetabulum is created.
Setting principles when various types special is shown only in severe for advanced cases and when used with a pronounced violation of retention functions. The presence of an endoprosthesis, unfortunately, means to cause complications. Dislocations and flexions sometimes occur; it is impossible to install an endoprosthesis.
Treatment of congenital hip dislocation is based on two directions:
Selected for a child individual tire, which keeps his legs abducted and bent at the hip and knee joints. Timely "placed" femoral head in the acetabulum leads to the normal development of the joint.
The treatment is especially effective in early start(up to 3 months). At the end of therapy, the symptoms disappear.
Effective for a child under the age of 5 years. The older the baby, the more difficult it will be to eliminate the pathology without consequences.
For children who have not reached adolescence, only intra-articular interventions with deepening of the acetabulum are shown. Extra-articular operations are performed for adult patients and adolescents, a “roof” of the acetabulum is created.
The installation of an endoprosthesis in various types of pathologies is indicated only in severe or advanced cases and in case of dislocation with a pronounced dysfunction of the joint. The presence of an endoprosthesis, unfortunately, can cause complications. Dislocations and subluxations sometimes occur after the installation of the endoprosthesis.
The main treatment of dislocation is aimed at reducing the head of the joint into the cavity. Before the procedure, a thorough diagnosis is carried out using x-rays or MRI.
The reduction process is carried out under general anesthesia. This is due to severe pain in the victim, as well as increased muscle tone of the limbs.
To relax the ligaments, muscle relaxants are additionally introduced. During the reduction of the joint, certain techniques are used to effectively and most safely carry out manipulations.
Depending on the specific situation, the methods of Janelidze-Kolen, Kocher-Kefer or Dipre-Bigelow are used.
After the joint is set in place, it is fixed by applying splints or a corset using traction. A person has been in this position for at least a month. In the presence of fractures, the period of treatment and recovery is significantly increased.
An important requirement in successful treatment dislocation of the hip joint - this is a strict implementation of all the requirements of the doctor. With untimely treatment to a medical institution or non-compliance with the recommendations, coxarthrosis may develop.
This is the destruction of the cartilage tissue of the joint, which often leads to disability.
Independent attempts to reduce the dislocation are unacceptable. This can lead to an aggravation of the disease due to even greater tissue damage as a result of the incompetent actions of the reducer.
Therapeutic measures are carried out in a hospital under general anesthesia after carrying out all the necessary diagnostic measures. Due to injury, the muscles of the hip joint and gluteal muscles have increased tone, which requires the introduction of drugs to relax them - muscle relaxants.
For reduction of dislocation, there are specially developed techniques. The most commonly used methods are Dzhanelidze-Kolen and Kocher-Kefer. The choice of a specific technique depends on the situation at hand.
After reduction of the dislocation, all major joints of the limb are immobilized for three to four weeks using skeletal traction. In the future, physiotherapy, massage, physiotherapy exercises, gymnastics, as well as other methods of rehabilitation are prescribed.
With untimely treatment or non-compliance with all medical recommendations against the background of a dislocation of the hip joint, coxarthrosis may develop.
Treatment for a hip joint in an adult is curative depending on its form and origin.
Hip manipulation
If a subluxation is detected in an adult, dysplasia, immediately consult a doctor, for which intervention is required. Newborns local anesthesia, thanks to the joint muscles relax and the doctor follows the subluxation.
If you start to set without the use of anesthesia, then immediately decreases. After avoiding, it is necessary to avoid stress on children, since it can lead to the development of aseptic pelvis.
If, during dislocations, broken parts were formed earlier or damage to those around them, then a surgical intervention is performed, the hips of which are immobilized by subluxations for several weeks.
After the main term, physical therapy and a task are carried out. It is also recommended to strengthen physical education. rehabilitation period in vascular cases is up to 6 months.
Areas of traumatic origin
Treatment of a dislocation accommodation is no different from a retaining subluxation. The patient needs to see a pelvic doctor who will bend the diagnosis, make anesthesia and put the hip back into place.
After the legs during the day, the patient should adhere to bed rest. Provide from bed is only allowed for example.
It is allowed to move the leg for 5-6 as.
Dysplasia
Hip dysplasia in adults can be treated with all the help of conservative methods and promote intervention. However, conservative correct rather aimed at improving the development of the patient, as well as for the use of dislocations and subluxations.
Features of parts of hip dysplasia at the joint
The treatment of hip dysplasia in adults often comes down to recommended intervention, since the use of methods is ineffective. To special operations can be attributed:
- Dislocation reduction devices.
- Osteotomy. Which, under which orthopedists perform the shape of the bones.
- Palliative correct.
Gymnastics with dysplasia at fix
Because dysplasia is correct disease, then gymnastics gives the joints efficiency in the treatment of this. You can perform it already in an adult outlet after repositioning the pose.
Gymnastics with dysplasia, radiography of the joint should begin with the stirrup of the knee joint in the splint position. If there is no pain, the pillow should be carried out in the freck position on the stomach or side.
Pavlik not to give too much effectively on the sore joint. Gradually reinforce the exercises will expand, and the development will be possible to perform such in a standing position.
Forecast limiting
Complications of hip dysplasia
Spinal and lower extremity disorders
With hip dysplasia, the motility of the spinal column, pelvic girdle, and legs is impaired. Over time, this leads to the development of postural disorders, scoliosis, osteochondrosis, flat feet.
Dysplastic coxarthrosis
Dysplastic coxarthrosis is a degenerative, rapidly progressive disease of the hip joint that usually develops between the ages of 25 and 55 in people with dysplasia.
Factors that provoke the development of dysplastic coxarthrosis
- hormonal changes in the body (for example, during menopause);
- cessation of sports;
- excess body weight;
- low physical activity;
- pregnancy and childbirth;
- injury.
Symptoms of dysplastic coxarthrosis
- feeling of discomfort and discomfort in the hip joint;
- difficulty turning the hip and abducting it to the side;
- pain in the hip joint;
- difficulty in mobility in the hip joint, up to its complete loss;
- eventually the hip flexes, adducts, and rotates outward, locking in that position.
If dysplastic coxarthrosis is accompanied by severe pain and a significant impairment of mobility, then endoprosthesis replacement (replacement with an artificial structure) of the hip joint is performed.
neoarthrosis
A condition that is relatively rare today. If the dislocation of the hip persists for a long time, then with age, the joint is rebuilt. The femoral head becomes flatter.
The acetabulum decreases in size. Where the femoral head rests against the femur, a new articular surface is formed and a new joint. It is quite capable of providing various movements, and to some extent such a state can be considered as self-healing.
The femur on the affected side is shortened. But this violation can be compensated, the patient is able to walk and maintain working capacity.
Aseptic necrosis of the femoral head
Aseptic necrosis of the femoral head develops due to damage to the blood vessels that run in the ligament of the femoral head (see above). Most often, this pathology is a complication surgical interventions with hip dysplasia.
As a result of circulatory disorders, the femoral head is destroyed, movements in the joint become impossible. The older the patient, the more severe the disease, the more difficult it is to treat.
Treatment of aseptic necrosis of the femoral head - surgical arthroplasty.
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