Types of hip fractures

Hip fractures are divided into intra-articular (medial), and extra-articular (lateral). Intra-articular fractures, in turn, are divided into below the head and in the middle of the neck, extra-articular - to pass through between spits and spits.

Intra-articular fractures occur most often in the fall on its side or (more rarely) on divorced legs - in such cases the fracture may be impacted (one piece neck peg to another).

All intraarticular fractures are divided into:

• valgus or abduction when the angle between the hip bone and the main increases, they tend to be impacted;
• varus or adduktsionnye - the angle between the hip and the underlying bone is reduced, these fractures are usually not impacted.

How does a hip fracture

As intra-and extra-articular fractures of the hip are more often in the elderly. At the same time, patients complain of pain in the hip, groin, which rest not expressed sharply. Leg with a fractured turned outwards (This is especially pronounced in extra-articular fractures) and shortened by a few centimeters. Active motion in the injured leg is not possible, one can not even pick it up. The patient can not pick up and retain the straightened leg, but can bend it so that the heel slips over the surface. Passive (leg movements of the patient by doctors) movement in the hip joint painful and sharply limited.

In some impacted fracture patients can walk, making it difficult to diagnose. The main feature of allowing suspected hip fracture in these patients, is a pain in the groin, aggravated by stress on the foot and sometimes extending to the knee.

Diagnosis of hip fractures

Diagnosis of hip fractures are usually not difficult, because all changes are taking place against the backdrop of a thigh injury. It confirms the diagnosis by means of X-ray studies. On X-rays, which are made with a different position of the injured leg (in different projections) you can see the fracture and determine its character.

Treatment of hip fractures

Treatment valrusnyh (abduction, impacted) hip fractures conservative. To hold the fragments in a stable position of the patient impose a special shortened plaster cast for 3-4 months. In obese patients, who are struggling to carry a plaster bandage, apply skeletal traction (leg stretches with the help of cargo priveshennogo with steel needles, threaded through the bone) load of 3 kg in two months.

The main method of treatment of varus (adduktsionnyh not impacted) of hip fractures is surgical: the integrity of the bone is reduced using a special nail that is inserted into both sides of the broken bone. In some cases, surgery is performed to replace the hip joint with an artificial prosthesis.

Hip fractures also occur occasionally in children and adolescents, it is usually (given the strong possibility of recovery of a young body) is conducted conservative treatment with skeletal traction.

Employability of patients recovered after about six months, in elderly patients with severe concomitant diseases and osteoporosis Osteoporosis - he threatens you?   this period may be delayed.

What is torticollis, its causes and types

Torticollis - a neck strain, different in nature and manifestations, but brings together the leading sign - wrong position of the head. There are many different forms of torticollis, but they are divided into two large groups - congenital and acquired.

For congenital deformities of the neck are different types of congenital muscular torticollis (the most common kind of change in infants), a wedge-shaped neck, torticollis kinds arising from the fusion of other changes in the cervical vertebrae and ribs.

Acquired torticollis occur against the backdrop of increasing the tone of the neck muscles and paravertebral muscles after extensive damage to the skin of the neck, after a deep scar formed on the site of inflammation in the neck, injuries of the cervical spine, against various inflammatory processes in the middle ear, parotid gland and other surrounding soft tissue and for some other reasons.

Causes of congenital muscular torticollis

Congenital muscular torticollis occurs because of a mismatch of the length of one sternocleidomastoid muscle (paired long surface muscles of the neck, which starts from the breastbone and collarbone and is attached behind the ear to the mastoid process of the temporal bone) and cervical spine. Inadequate length of the muscle due to its congenital hypoplasia, changes occurring under the influence of labor and various factors in the postpartum period. This causes a head tilt toward the affected muscles and rotate in the opposite direction, which is accompanied by changes in the spine, collarbone and skull.

The main reasons for congenital torticollis is fiber tear sternocleidomastoid muscle during labor, prolonged tilt position of the fetus in the uterus, which contributes to a shortening of the muscle, chronic inflammation in the muscle, metabolic abnormalities in the muscle due to insufficient blood supply, malformations grudino- clavicular-mastoid muscle.

How is

Severe strain in the first ten days of life is noticeable only in a small part of newborns with torticollis. Most of them at the end of the second - the beginning of the third week of life or average srednenizhnyaya of the sternocleidomastoid muscle thickens and this place becomes dense. Thickening muscles gradually increases with a simultaneous increase in inclination of the head towards the changes of muscles and decrease the volume of its movements.

In some children thickening and compaction muscles after a period of increase gradually disappear completely by the age of two months to a year, and the muscle becomes normal elasticity. But in some children with a decrease in muscle thickening and seal it becomes less elastic, lagging behind in growth from the muscles on the opposite side, thinner and compacted.

With the age of the child increases muscle changes, as well as preserved muscle fibers are subject to change due to the fact that underdeveloped muscle fiber has a deficiency of the enzyme that breaks metabolism. The three-six years in the deformation of the neck is greatly enhanced.

Manifestations

In children with congenital muscular torticollis head tilted to the side muscle changes, some forward and rotated in the opposite direction. From the changes of muscles have higher standing shoulder girdle, the asymmetry of the face and skull. Behind you can also see the asymmetry of the head and neck in combination with the curvature of the cervical spine to the side (scoliosis). All changes to the face and head are adaptive and disappear after the timely conduct of the operation.

The measures

Since the establishment of the correct diagnosis immediately begin to spend conservatively (without surgery) treatment of torticollis: special exercises (head tilt in the opposite direction and turn toward shortened muscles), a sliding oppressive stroking altered muscle and more vigorous massage healthy half neck warm neck lamp " SoLux "or heaters. Children under the age of 1, 5-2 months and older prescribed electrophoresis with potassium iodide.

When child care with congenital muscular torticollis must be laid on the bed so that the curvature of the neck are not intensified, not to keep it ahead of time in an upright position. To keep the head in the correct position using a plaster bed, bags with sand cap with a ribbon, attached to the outer clothing, various types of dressings. Sometimes to sternocleidomastoid muscle introduced various absorbable drugs. Conservative treatment allows to the age of 5-6 months of treatment to achieve the majority of children.

If, despite treatment in a child older than one year are denominated manifestation torticollis, it is the indication for surgery to lengthen sternocleidomastoid muscle, which is best done at the age of 3-4 years.

Congenital muscular torticollis most often goes its own, but even if it fails, you can always help your child.

Galina Romanenko