The knee joint - the most complex joint in the structure. It consists of the femur and tibia, patella, intra-articular cartilage - the menisci, ligaments and joint capsule machine. One of the most serious injuries in the knee joint is dislocated tibia.

Causes and types of dislocations shin

Dislocation of the lower leg is very rare, because it occurs when severe impacts. In most cases, such damage occurs in situations when the victim is fixed tibia in a fixed position and the hip, however, remains relatively free.

The main cause of this injury - squeezing shin bumper car. Also, dislocation often occurs in people who are in the interior of a vehicle during an accident.

In order to articular surface of the tibia and the femur is completely shifted relative to each other, we have to break almost all knee ligament. When dislocation shin damaged joint capsule, menisci, sometimes popliteal vessels and peroneal nerve.

There are several types of injuries. Depending on the direction in which the femur is displaced relative to the tibia, isolated front and rear (they occur more frequently), external and internal dislocations.

Signs

Already in appearance it can be assumed that there was dislocation of the tibia. The injured leg becomes "shtykoobrazny" appearance and looks shorter. If a damaged blood vessels and in the knee joint cavity enters the blood, then such a state is called hemarthrosis. When this knee is increased in size. Because of severe pain sufferer can not change the position of the limbs.

Sometimes trauma damaged nerve fibers. Numbness - an important sign of this complication.

Almost always due to compression or damage to blood vessels in the popliteal fossa disturbed blood supply to the lower leg. Thus it becomes pale or bluish color becomes. Man complains of feeling cold snap in the calf. Ripple vessels, which are located below the injury may not be palpable.

Man with a dislocation of the tibia is an urgent need to bring to the hospital. Before that, on the injured limb impose tire suitable as a special design, and the means at hand (eg, boards, laths). The victim was subcutaneously administered painkillers. To the fault can be applied cold.

Examination

The physician should determine the conditions under which there was a dislocation of the tibia, found the complaints of the patient and examine him. In order to clarify the nature of the injury and to determine the possible complications Several studies are:

• Radiography. When dislocation of the tibia on the X-ray image is determined by the displacement of the tibia relative to the femur. This method also allows you to determine whether the integrity is not broken bones.
• Heart rate below the injury site. It can be felt when the arteries are damaged and blood circulation in the lower leg and foot is not broken.
• Arteriography (x-ray of the arteries by using a contrast agent) also allows you to find out whether there is a violation of the integrity of blood vessels.
• Doppler ultrasound - a type of ultrasound, which is designed to assess the condition of the vessels. The contrast agent is not used, a special preparation of the patient is not necessary.
• Neurological research. If the nerves are damaged, the skin sensitivity below the injury site decreases, movement of certain muscle groups become impossible.

Treatment

Man with a dislocation of the tibia to be delivered in the casualty department. Popliteal vessels are damaged, you will need to help angiohirurga - a doctor who performs surgery on veins and arteries.

Dislocation of the urgent need to right. This manipulation is performed under local or general anesthesia. The patient is placed on his back. After that, a physician assistant fixes the patient's hip and trauma produces extension of the foot. The doctor then returns the tibia in its normal position. With posterior dislocation doctor should shift the tibia anteriorly, with anterior - posterior, with side - inwards or outwards. After reposition of the cavity of the knee introduce a special needle with a syringe and removed its contents.

In the lower limbs, which should be in the unbent state, imposed a plaster cast for a period of about two months. It covers the patient's leg from the upper thigh to the toes.

On the third day after reduction is assigned to UHF. The doctor of physical therapy teaches the patient some exercise. A week later, the patient can already walk on crutches.

When the patient will remove the plaster cast, he needs to use crutches for a month, because during this time, the load on the leg should be minimal. The patient is prescribed exercise therapy and physiotherapy.

Sometimes shin splints treated surgically. If necessary, restore ligament. The operation was carried out in the following cases:

• When the soft tissue between the bones are infringed;
• In open dislocations, when the knee there is a wound. In this process it is required to carry out and remove dead tissue.

Chronic dislocations, which are not treated for a long time, reduce a closed method with special devices. Apparatus Volkova-Oganesyan is a rigid frame, which is fixed on the needles passing through the bone. With this machine the ends of the femur and tibia are gradually moving away from each other, and then there is reduction of dislocation.

Dislocation of the tibia - is a serious injury that requires immediate assistance trauma. Independently try to reduce a dislocated prohibited. If the treatment will be carried out soon after the injury, the patient can return to normal life after just four months.

  Man has always wanted to know how his body is arranged. Already in ancient Egypt, doctors began to describe some organs such as the brain and heart. And gradually, over many centuries of knowledge about the structure of the human body evolved into the most important medical science - anatomy. It helps to study anatomical atlas - a collection of images of all organs and systems.

The history of anatomical atlases

One of the first known Greek anatomists was Hippocrates. He is in his writings described the structure of some internal organs, eyes, bones, skull, ribs, vertebrae, muscles, joints, and most large blood vessels. Gerofil Erasistratus and were the first scholars of ancient Greece, who dissected human corpses and thus studied the structure of organs.

Galen, a distinguished physician of ancient Rome, because of the ban on autopsies of people studied anatomy on the corpses of sheep, dogs and pigs. However, he believed that the structure of the body of animals and humans no different, which is why in his works there had been a number of significant errors. Galen codified all the while anatomical details, and it works for thirteen centuries, served for the training of doctors.

In the Middle Ages because of the dominance of the Church the study of anatomy has almost stopped, but in the Renaissance, this science in its development has taken a big step forward. Leonardo da Vinci, a famous artist, philosopher and scientist was interested in plastic anatomy, and he made a lot of accurate drawings of the internal organs, muscles and bones of humans and animals. It was the first anatomically correct images of the human body, its organs and systems. But the work of this outstanding scientist were not widely known among his contemporaries.

Andreas Vesalius is considered the creator of systematic human anatomy. By studying the corpses of executed criminals, he described the organs and systems of the human body and have many anatomists errors in his work "On the structure of the human body." Seven volumes of this book is accompanied by excellent illustrations. Students Vesalius made many discoveries in the field of anatomy and corrected some mistakes that were made by scientists before.

One of the most famous anatomical atlases of XVII-XVIII centuries was G. Bidloo book "Anatomy of the human body in the 105 tables, images from nature." She left in 1685, and especially for Peter I has been translated into Russian. Later, in 1729, the book was translated again, but like the first time, existed only in manuscript form.

In Russia, the first anatomical atlas was drawn up in 1744 M.I.Sheinym, it was called "Dictionnaire, or an illustrated index of all parts of the human body." Author independently carried out the majority of illustrations for this edition. In 1757, MI Shein translated into Russian "Reducing anatomy" L. heister and thus became the founder of scientific medical terminology in Russia. Many of the names of the anatomical structures that are proposed to this scientist, currently in use. For example, the terms "blood vessels", "ileum", "ureter" were transferred to the MI Shein.

In XX century anatomical atlases have continued to improve. A great contribution to the development of anatomy made VP Vorobiev, a professor of anatomy in Kharkov Medical Institute and Lenin Prize winner. He was a wonderful teacher, has written several books and created an anatomical atlas, which has long been used for the training of doctors.

RD Sinelnikov, a disciple of VP Vorobyov, was for many years head of the department of anatomy Kharkov Medical Institute. The first edition of its "Atlas of Human Anatomy" was released in 1938-1942, respectively, and consisted of five volumes. Since this benefit is one of the most popular for students of higher medical schools. This anatomical atlas has been translated into English, Czech, Spanish, Bulgarian and Arabic. The last (seventh) edition of the book was published in 2007-2011 in Moscow.

What can be learned from anatomical atlases

Atlas helps medical students understand the structure and position of organs in the classroom or in the anatomical museum in the sectional hall. Also thanks to this tutorial at home training, you can easily remember and repeat the structure of anatomical specimens. The book consists of several core units:

• Osteology, and arthrology syndesmology, which describe the structure of bones and their connections to each other;
• Myology - a section that is dedicated to the muscles. In this case, it certainly is reflected not only their structures, but also their relation to bone formation;
• Splanhnologiya - the doctrine of internal organs. This section details the respiratory, digestive and urinary systems;
• The structure of endocrine glands;
• The structure of the heart and blood vessels (arteries, veins and capillaries of the large and small circulation);
• The structure of the lymphatic vessels and the spleen;
• Neurology - the structure of the central, peripheral and autonomic nervous system;
• Esthesiology - the doctrine of the structure of the senses.

Each section consists of numerous detailed illustrations are accompanied by descriptions of them. In addition to drawing benefits may include pictures of anatomical specimens and radiographic images that help to create a more complete picture of the structure of the human body. All anatomical structures are named in Latin, and the language in which the published atlas. Most sections are supplemented by information on the development and age of the features.

The study of the human body, all the organs and systems is impossible without the help of an anatomical atlas. The information that they contain, are necessary not only for the students of medical institutions, but also for many practitioners.