MEDICAL

Often, the crunch of the joints associated with their increased mobility. Doctors call this condition hypermobility. This is found it is mostly women, and young. This phenomenon is due to the fact that the body produces slightly modified protein of connective tissue that make up the joints – collagen – it is more stretching than usual. As a result, the joints become more mobile due to increased elasticity ligamentous apparatus. In everyday life it is a condition called "weak ligaments. How times are provoking pops and pain. When hypermobility of joints and failure of vessels observed, because they are walls also consist of collagen. If he is "weak", then under the pressure of the blood vessels very quickly stretched. Hence, in these patients is early varicose disease. Blue Snake veins show through on his feet as early as 25, and sometimes even in 20 years.

Genes can not be changed. Therefore, we can limit ourselves to general recommendations. Such patients should not choose a job where you’d like a long time to stay in the same situation. This is especially true of teachers, vendors, surgeons, hairdressers – in general, all who have to stand for several hours. These people are already very high risk of varices and arthrosis. In addition, care should be taken to treat sports – exercises to choose those that do not lead to even greater hyperextension of ligaments. That is best handled on an individual program.

It often happens that a person begins to engage in sports, and after a while he has an articular crunch. He has several explanations. First, it is not excluded trauma, most often a sprain.In this case, the joint must unload, give him a rest. For these purposes, best suited for special devices that restrict the mobility of the legs. They consist of semi-rigid cuff and fixing straps. For some time a person feels relief, crunching and pain it will no longer bother. Later, he calmly can do sports, but it should be done accurately than before. All exercises should perform properly and under the supervision of an experienced instructor. Then the risk of re-injury will be reduced to a minimum.

Sometimes the crunch in the joint comes from the arthritis. This is one of the most common joint diseases. Its essence lies in a kind of "wear" the joint – cartilage surfaces become thinner, they can no longer normal to slide over each other, and that’s when there are pains and crunch. In this case, will help limit the burden on the patient and the joint anti-inflammatory ointments. Be sure to consult a doctor (general practitioner, surgeon) for inspection and examination, not to run disease.

There are drugs that restore the structure of the joint. The structure of these drugs usually consists of chondroitin, glucosamine or collagen. All these substances are the building blocks for cartilage. They restore the elasticity of the articular surfaces and the lost volume, eliminate pain, increase the effect of anti-inflammatory drugs. Despite this, we can not say that the funds are permanently cure arthrosis. It could be used only for time to restore the structure of cartilage. Then all return to square one, and the treatment must be repeated again. If it is done regularly, the manifestations of the disease will be minimized. The precise dosage of drugs depends on the weight of the patient and severity of the disease. Take these drugs should be at least 2-3 months in a row. Only in this case, you can count on a long and stable result. Repeated course can be made within two months. Pregnancy is contraindicated (because there is still no data on the safety of drugs for the fetus), violations of blood coagulation and thrombophlebitis. Preparations vary good portability and security to the adverse reactions include allergy, as drugs, in its essence is a protein of animal origin.

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Trauma (from the Greek. Trauma – injury), damage in the body caused by the action of environmental factors. There are injuries: Depending on the type of traumatic factors – mechanical, thermal (burns, frostbite), chemical injury, barotrauma (due to abrupt changes in atmospheric pressure), electrical accident, etc., as well as combined injuries, such as a combination of mechanical trauma and burns, prolonged exposure to traumatic factors – acute and chronic trauma of the circumstances under which the injury occurred, – domestic, industrial, sports, fighting, etc.

Mechanical injuries may be open (wound) or closed, ie, without destroying the integrity of skin is not complicated, and the development of complications – suppuration, osteomyelitis, sepsis, traumatic toxicosis, etc.; isolated (within the body or segment of course), multiple (damage several organs in one cavity or several segments of the limbs) and concurrent (simultaneous damage to internal organs and musculoskeletal system). Excrete bruises, sprains, dislocations, fractures, compression of the tissues and internal organs, shock, tears.They may be accompanied by bleeding, edema, inflammatory reaction, necrosis (gangrene) tissues. Severe and extensive trauma accompanied by shock and life-threatening. A special kind of trauma – trauma associated with severe experiences (in particular, as a result of the traumatic impact of the verbal), it can cause painful reactions to mental and autonomic areas (depression, neurosis, etc.).

Timely first aid for injuries and treatment (which, depending on the nature of the injury done by doctors of different specialties) may prevent severe post-traumatic complications.

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Bony growths in the form of spikes or the beak of the plantar surface of the tuber calcaneus, or at the place of attachment of the Achilles tendon is called heel spurs. Most heel spurs are the result of involutive processes of the human body and anatomical features as found in individuals older middle age.

Reasons education spurs can be longitudinal arches, acute and chronic trauma, rheumatic fever, infection, vascular and neurodystrophic disorder.

The clinical picture in the heel spur is typical. Most patients complain of so-called ’starting pain. Those who suffer from this ailment hardest to give the first steps after sleep, prolonged sitting. Pain in the heel spur may be burning, sharp, while relying on the heel, ill-defined as a feeling of a nail in the heel. The pain may spread throughout the heel area, or localized on the inner surface of the heel. Pain may appear suddenly and be acute or develop slowly, turning into chronic. Patients involuntarily try to relieve the heel.

When viewed from the heel area, as a rule, pathological changes were detected. Pressing the hill from the calcaneal bone in the soles and heels are pressed from the sides determined soreness.

At the back of the heel spur pain is noted at the place of attachment of the Achilles tendon during walking and pressure backdrop of shoes. Possible swelling of this area, callus skin.

The intensity of the pain does not depend on the size of the spurs, as determined on radiographs. Quite often acute in shape and large-sized spurs are accidental radiological finding. At the same time, there may be severe pain in the heel area with normal X-ray film.

Thus, the clinical symptoms of heel spur due, primarily, not from the spur itself, and changes in soft tissues: inflammation of the mucous membranes deep bags (podpyatochny bursitis, ahilobursit), the phenomena of periostitis and most of plantar fasciitis.

Plantar fasciitis is inflammation of the plantar fascia. The plantar fascia – a broad band of fibrous tissue that runs along the sole of the foot from heel to forefoot. There is a justifiable opinion that the development of heel spurs is the primary plantar fasciitis. Inflammation causes reactive osteoblastic process, which develops and heel spurs.

Symptoms of plantar fasciitis are well identified with ultrasound of soft tissues of the foot. It is advisable to choose the method of treatment of heel spurs produce ultrasound of soft tissues of the foot.

Treatment of heel spurs conservative and depends on the cause of disease and the stage of the process. Recommended a set of therapeutic measures aimed at eliminating the inflammatory process. Appointed by nonsteroidal anti-inflammatory drugs, place gels and ointments, possessing anti-inflammatory and absorbing effect, phonophoresis with hydrocortisone, cryotherapy. A good and stable effect gives a single dose of diprospana locally.

Most important condition for ensuring the effectiveness of treatment unloading painful area. To do this with calcaneal spur on the testimony of the individual appointed orthopedic insoles with calculations of internal and external longitudinal arches, deepening and cushioning under the heel. As a temporary measure is recommended to use Heel Straps with depression or hole in the center – the so-called unloading device in the heel spur. Such devices are sold in orthopedic shops. The most valuable is unloaded with the help of orthopedic shoes with a hollow in the heel. At the back is done in the spur of the deepening backdrop. As a temporary measure in the treatment of heel spurs can recommend wearing shoes without backs. In the complex treatment of heel spurs include warm baths with sea salt soap, soda, gymnastics, massage the muscles of the foot and lower leg. These activities are aimed at improving blood supply to the tissues of the foot.

After stihaniya inflammatory process, which must be confirmed by ultrasound diagnosis, is appointed by the shock-wave therapy.

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Fractures - bone fractures, which are accompanied by violation of their integrity. Are rare congenital fractures, which usually occur in various inherited diseases of the skeleton, leading to a reduction of its strength. Acquired fractures occur as a result of mechanical forces on bone, if its value exceeds the strength of bone tissue. The action of excessive force by one-stage (a blow, fall, gunshot wound, etc.) there is a so-called traumatic fracture, and in painful conditions, accompanied by a decrease in the strength of the bone (osteomyelitis, tumors, certain endocrine diseases, etc.) fracture occurs when the action is much lesser force or spontaneously, and it is called pathological. They arise without much violence, even in sleep.First aid for these fractures is the same as in traumatic.

When fractures of both bones broken by damage to the integrity of surrounding soft tissue can traumatize adjacent muscles, blood vessels, nerves, and others with a concomitant fracture of skin lesions and the presence of a wound is called an open fracture, but if the skin is intact – in private. Depending on how the pass line break bones, distinguish transverse, oblique, longitudinal fractures. If the bone is broken completely and divided into two parts, it is a simple fracture (but treated it can be very difficult). When separated from the bones of one or more fragments called comminuted fracture or multisplintered, but if a lot of fragments, it is fragmented fracture. Sometimes the bone breaks down partially, ie, cracks – incomplete fracture.Complete fractures are often accompanied by the displacement of bone fragments in different directions. This usually occurs as a result of the emerging post-injury muscle contraction.Complete fracture without displacement are relatively rare, mainly in children. Incomplete fractures also occur more frequently in childhood.

In elderly and senile age, when the declining strength of bones and deteriorating motor coordination, fractures occur more frequently. Occupy a special place for compression fractures (usually the vertebral bodies), in which the bone was not dropped, but flattened.

The most frequent fractures of long tubular bones – the humerus, ulnar, radial, femoral, tibial.

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Habitual dislocation of the shoulder joint occurs during normal movements in the joint during grooming, washing, carrying normal loads. The frequency of habitual dislocation reaches 16% of all dislocations of the shoulder. Usually the first redislocation develops within 6 months after the reduction is the primary dislocation. Then the dislocations are repeated with a frequency of up to 10 per year. In some patients, the frequency of habitual dislocations of up to several times a day. With each re-dislocation of the changes in the joint is increasing and the intervals that experience repeated dislocations are reduced. Much more often habitual shoulder dislocations occur in young adults up to 20 years. Elderly patients after primary shoulder dislocation habitual dislocation is rare.

The shoulder joint – the most mobile of all the joints of the human body. Habitual dislocation of the shoulder is called, which is repeated in the same patient after the primary dislocation, obtained mostly as a result of trauma.

The reasons for the development of habitual dislocations of the shoulder joint are:

It is believed that the predisposing factors of habitual dislocation of the shoulder are the elements and features of the shoulder joint:

Traumatic dislocation of the shoulder joint happens when the indirect effects of a large traumatic force due to the formation of the lever. Joint capsule is stretched and torn, the head of the humerus out of the glenoid cavity vanes. This can happen gap articular lip of the depression scapula. Some authors consider this moment the main cause of habitual dislocation of the shoulder. Often occurs when dislocation rupture or tear of the tendon of the biceps muscles of the shoulder, which passes through the cavity of the shoulder joint and strengthens the joint.

To exclude the occurrence of habitual dislocation of the required method of reduction is the right choice dislocation, immobilization after reduction is complete, timely surgical treatment and long-term rehabilitation. Often dislocated shoulder joint is incomplete and the patient’s feeling concerned about instability in the joint. This condition was formerly called joint subluxation, now talk about instability in the shoulder joint, referring to the instability of the joint and habitual dislocation of the shoulder.

Diagnosis of habitual dislocation of the shoulder joint is usually not difficult. In addition to repeated episodes of dislocation, the patient discovered during the inspection of the restriction of movement in the shoulder joint. But some patients of restrictions of movements can not identify. Over time, if untreated, develop degenerative-dystrophic changes in the joint (deforming arthrosis of the shoulder joint). There are constant nagging pain in the joints, reinforced with a load. Appears when the crunch movement in the joint. Gradually developed muscle atrophy shoulder, accompanied by weakness in the hand.

If the patient’s habitual dislocation is repeated more than 2 times a year, this is an indication for surgical treatment. Methods of surgical treatment of habitual dislocation of the shoulder for about 300, but none of them are not considered to be generally recognized.

All operations can be divided into:

Most often resorted to the combined method of surgical intervention.

After surgery appointed fixing wearing bandages from one week to a month, depending on the type of operation. Of great importance is the correct rehabilitation (restorative treatment) after surgery. The purpose of rehabilitation – strengthening the shoulder girdle muscles and strengthen their stabilizing effect on the joint. Initially, therapeutic exercise is performed under the guidance of the instructor. In the future, the patient must regularly engage in at home. Rehabilitation may take from 2 to 4 months, and the total load on the joint is possible on the expiration of six months from surgical treatment.

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Torticollis - tilt the head to turn it aside due to changes in soft tissues, skeleton and nerves of the neck.

The cause of congenital torticollis is a defect in the development of cervical spine (eg, additional wedge-shaped vertebrae) or, more often, a shortening of the sternoclavicular-mastoid muscle.

Occurs acquired torticollis in connection with the pathological process of the spine, muscles, resulting in long cycle of the head due to the nature of professional work or limit the vision in one eye. With long-term existence of torticollis in a patient develops asymmetry person.

Recognition torticollis. Diagnosis is simple, based on the typical position of the head. To clarify the cause of the disease is important radiographs of the cervical spine.

Treatment of torticollis defined Cause: When the shortening of the sternoclavicular-mastoid muscle, produce section of plastic surgery or plastic elongation of the muscle to restore the correct position of the head.

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Clubfoot innate. It occurs in 1 in 1000-1500 newborns. Sometimes one-and two-sided. Characterized by extreme supination of the foot, with a turn inside its front. Therefore, shoes worn out from the inside.

The most compelling reason for the development of this defect is a delay of a stop in the early embryonic period, when the foot is physiologically located in the "clubfoot".

Treatment of clubfoot. They begin with the first days after birth. It is manual straightening of the foot, massage and bandaging of soft bandage in the correct position. In later cases, after the forcible straightening of the foot (redressatsiya) to keep it in the correct position plaster bandage. Often in one step to straighten the foot can not, then do again redressatsiyu (STAGE redressatsiya) followed gypsuming foot.

When pronounced clubfoot, when the doctor called later and conservative methods fail to correct the defect, have resorted to operations in the ligaments of the foot or make a wedge or sickle-resection of the foot. These operations are best done at an age when completed growth of the organism.

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Deformations of the chest are congenital and acquired.

Dislocation - Resistant to an abnormal displacement of the articular surfaces in relation to each other. If they are no longer in contact, dislocation is complete, with partial contact – incomplete or subluxation. Dislocation is usually accompanied by rupture of the joint capsule and going out of one articular surface through the gap.

Given how the bone came out (dislocated), talk about dislocation of the shoulder, hip or forearm bones, etc. It is believed that the dislocation is that the bones, articular surface of which is located distal to (below) in relation to other bones involved in the formation of this joint. Exception is the spine, shifts the upper vertebra in relation to the underlying.

Excrete congenital - developed during intrauterine life the fetus, and acquired - as a result of trauma (traumatic dislocation) or a pathological process in the joint (pathological dislocation).

The vast majority of congenital dislocation of the hip joint is one or, more often, on both sides. As a rule, they notice when the child begins to walk. There is lameness, razboltannost joint, pain in it, shortening the legs. For bilateral dislocation characteristic waddle ( "duck"). Diagnosis clarifies radiograph.

Acquired (traumatic) sprains occur in 80-90% of cases and therefore have the greatest practical importance. Some individual anatomofiziologicheskie human characteristics (mismatch magnitude articular surfaces, wide joint capsule, ligamentous instability of the apparatus, etc.) are predisposing factors.

In the indirect application of force dislocations develop more frequently than from direct effects on the joint. His capsule in traumatic dislocation breaks in the form of cracks or in the form of a significant tissue defect.

Sprains in ginglymoid joints (knee, elbow, ankle) is always accompanied by the rupture of the ligamentous apparatus. May also notes the gaps in the tendons attaching them to the bone, bleeding into the surrounding tissues and joints.

Simultaneous fracture close to it plots bones, damage to major vessels, nerves complicating treatment of dislocation (complicated dislocation).

a – caudineural dislocation b – lowback dislocation; in – peredneverhny dislocation d – anteroinferior dislocation.

Symptoms and flow. The circumstances of injury and damage to the mechanism being investigated for questioning the victim. Typical complaints of pain in the joint and the impossibility of motion in it because of growing pains. Sometimes there numbness, which is associated with compression of nerve trunks and fixation of a dislocated fragment of spastic muscle contraction. There stimulated wrong position and limb deformity of the joint. For example, in dislocation of the shoulder joint, shoulder allocated to 15-30 degrees and the impression of an elongated, in the deltoid muscle is zapadanie. Jumped an end to the bone feeling often possible to determine in an unusual place. Thus, when he dislocated shoulder detectable in the armpit or under the pectoral muscle. Attempts to determine the possibility of passive movements in the joint gives you the feeling springy fixation: dislocated bone in the forced displacement then returns to its original position, which is due to spastic contraction of the muscles, strained ligaments and capsule. This symptom is characteristic of dislocations.

Recognition. Diagnosis is confirmed by X-ray study of dislocation, it also confirms or excludes associated fractures near the joints, which is important to select the method of treatment.

Treatment. The patient should be immediately sent to hospital. The wound is closed aseptic bandage.

Reposition of dislocation is easier and better in the first hours of injury. Dislocations of the two-day five-day statute of limitations reduce a very difficult, but 3-4 weeks is often required surgical intervention, which gives much worse results.

A necessary condition for successful reduction is – complete muscle relaxation, which is achieved good anesthesia.

Unacceptable use of brute force, since this leads to additional damage to the joint capsule, bone and relapse – so-called "Habitual dislocations, they most often occur in the shoulder and jaw joints.

Methods of reduction is based on stretching the muscles of the joint with the use of a number of manipulations that seem to be repeated in reverse motion that caused the dislocation. It is therefore important to provide a mechanism for development and the sequence of movements that led to the dislocation.

After the reduction is done controlling an X-ray, which confirms the correctness of its implementation. Finiteness record for 6-10 days in a functional disadvantage bandage or traction.Later regularly complex therapeutic physical training exercises.

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