Operation on the joints

Musculo-skeletal system of the human body is the most important anatomical structure, provides performance support functions and virtually unlimited movement in space. Despite the fact that the skeleton and muscles of any morphology, or appearance do not have anything in common, they are united harmoniously complementary systems. Indeed, lack of muscle hardly anything distinguishes man from the fixed dummy and no skeletal apparatus, we have turned into a thinking amёboobraznuyu substance. That is why the musculoskeletal system physicians are often called the musculoskeletal system that from a functional point of view is more correct.

Given the huge exercise, which daily have to endure the musculoskeletal system of man, nature prudently made sure to musculoskeletal elements could this stress effectively resist: high strength fabric, the presence of numerous ligaments, tendons, fascia, periarticular bags and connective tissue capsules provide body high mechanical resilience. This is eloquent testimony to the achievements of modern weightlifting, working with weights of several hundred kilograms.

However, sometimes even the most durable fabric can fail. This occurs most often when injuries and infectious and inflammatory diseases of the musculoskeletal system.

Operation prosthetic joints

One of the most common places suffering from the effects of pathological factors are joints .  Usually the clinical picture begins with pain in some joints .  Depending on the severity and type of damage to the joint activity in everyday processes motor pain may be different in nature and length, but usually, over time in the absence of proper treatment of pain amplified .  Unfortunately, in some cases, timely and adequate therapy is conservative (non-surgical) methods are not able to stop the pathology .  This is evidenced not only enhance the pain that deliver real patient suffering, but also the gradual loss of functional capacity of the joint .  This range of motion in the joint becomes more and more limited up to a total loss of mobility .  In this situation, the patient regain the joy of an active life often remains only one way - endoprosthesis .  The method consists in integrating into the region of the joint special prosthesis, perfectly follows the shape of the mating surfaces .  Because of the internal arrangement of these structures are called endoprosthesis (from the Greek "endo" - internal), and the method - arthroplasty .

Operation of endoprosthesis is most often done on the joints experiencing the greatest burden: hip and knee .  Sometimes, however, a way to restore mobility applies in relation to other joints: shoulder, elbow and pastern joints numerous, wrist, ankle and foot .  The material for the implant may be metal, ceramics and high polymer materials .  At the same time, experts give preference to metal products, as the most durable and allows to maintain the data structure for a sufficiently long period .  In general, the duration of operation of the endoprosthesis is more than ten years, the metallic material can last up to fifteen or even twenty years: it all depends on the patient's age and his lifestyle .  Contrary to popular opinion, the implants last longer for older people as their daily activities much inferior energetic activities of young people, that is age-load their patients 'new' joints more moderate that in the case of endoprostheses is paramount .

Operation arthroplasty performed not as long as might be expected, given its complexity: an average of only about an hour. The real difficulty for the patient after the operation starts. Firstly, the mandatory need to comply with all medical prescriptions, especially in the first few days. Otherwise, you may develop severe complications such as thrombosis Thrombosis - the cause of heart attack and stroke   pulmonary artery fatal. Secondly, it should devote much time to the development of joint, performing special exercises. Thirdly, it is necessary to constantly monitor so as not to expose the joint significant load. Of course, over time resolvable load will gradually increase until the absolute recovery of functional ability. However, the decision to increase the degree of load takes only a doctor! The total duration of the recovery period can vary from one to four months.

Zhiguli Andrew

Types and causes of limb shortening

Shortening of the limbs can be of three types: true, relative and total.

The real change leg length - a shortening of the length of an individual segment of a limb (thigh, shoulder, leg and so on) This change could be due to the destruction of articular ends of the long bones (epiphysis), improper seam fractures and other - shortened the bone and the surrounding soft tissue . The relative change in the length of the limbs occurs in sprains Dislocation - Prevention and Treatment . Total shortening - a reduction in the total length of the course includes a real, relative and apparent (at constant bending limbs). Shortening of a limb - it is always a consequence of a disease or injury.

They can be shortened and the two limbs - is more common in congenital deformities and hereditary diseases. Finally, a man with a proportional addition may be a slight increase, which does not suit him and is responsible for a variety of stressful situations.

How can lengthen limbs

Enlarge growth is possible only in an age when the body has not yet formed, and closed zones of bone growth. They are closed at different times, someone at 14, but someone in the 20. After this growth can be increased only by surgery. The indications for the extension of one limb shortening is it not less than 3 75 cm, as less shortening can be offset by the special orthopedic shoes Orthopedic shoes - how to determine what is right for you? .

With significant shortening can be performed sequentially lengthening the femur and tibia (with shortening of more than 10 cm). Nowadays, the most common two types of operations for limb lengthening - dissection of bone followed by the imposition of various external fixation devices (for example, by Ilizarov, Volkov-Oganesyan Gudushauri and others), or with the imposition of a compact device that is fully implanted in the bone (method A .I.Bliskunova).

The compression-distraction osteosynthesis method GA Ilizarov

This technique was developed by GA Ilizarov in the 50s of the last century for the treatment of fractures. Later it was used for limb lengthening. The operation consists in that the incised bone (femur or tibia), and then it establishes a special apparatus, whereby the bone fragments are in a fixed state. After 10-12 days after the operation start lengthening bones. When the screw several times a day, the distance between the bone fragments mildly (mm fraction) increases. The day such increase should not exceed 1 mm, otherwise the bones grow together. But too slowly increase the distance it is impossible - bones can grow together too quickly. Thus, an increase in limb 6 cm it will require about 60-70 days. Walking on crutches, the patient is allowed to have a few days after surgery.

Once the foot is stretched to the desired length, a period of fixation - certainly fix it until full recovery (about 3 more months). Gradually, the patient is allowed to increase the burden on the feet, and by the mid-term fix, they can walk without crutches. At the same time in this period is assigned to therapeutic exercises to restore muscle function.

With such an operation can increase the length of the thigh 10 cm, shin - 6 cm.

When using external fixation devices may experience the following complications:

• Injury of blood vessels and nerves, which can result in bleeding or be broken innervation of the limbs;
• as the needles pass through the Ilizarov limb tissue and come out through the holes in the skin into the bone and soft tissue infection can penetrate; In some cases (especially if the patient has impaired immunity) it negates all efforts to carry out the operation;
• breaking the individual spokes or other elements of the Ilizarov fixator may require re-operation;
• sometimes in the treatment of pain there is significant.

Osteosynthesis followed by the imposition of the device AI Bliskunova

A new trend in orthopedics has become the method of Professor A. Bliskunova, he developed about 20 years ago. To lengthen limbs Bliskunov proposed use of compact devices that are fully implanted into the bone. These devices have a special device - a ratchet, which operates under the control of the patient. For the implantation of the device was developed by a special technology and equipment.

Bliskunova method allows to increase the height of a man on a 5-20 cm. The absence of external hardware, stable fixation, complete autonomy allow the patient to a week after surgery to walk, take a shower, bath, swim in the pool, doing gymnastics.

If the extension of the legs is not vital, it is worth considering whether to make this a painful and not always a safe operation.

Galina Romanenko