How does the calcaneus

The bones of the foot are divided into the tarsal bones, metatarsal bones and toes. Tarsus - the rear part of the foot, it includes seven bones, including the heel, metatarsus - the midfoot, formed by five short tubular bones, bones of the fingers - the front part of the foot.

Calcaneus is in the low back area of ​​the tarsus. This is the largest bone of the foot, which has an elongated shape, laterally flattened it lightly. Calcaneus is facing anteriorly body protruding posterior tubercle. On the upper surface of the bone has articular surface for articulation with the talus, the front surface - articular surface for articulation with the cuboid bone. On the inner surface of the calcaneus has a protrusion on it rests the talus, which sits on top of the calcaneus.

All the bones of the foot are united in a single body by means of joints that attach the foot mobility and flexibility. Strengthens the joints muscles and ligaments. Musculo-skeletal system forms the foot arches of the foot (five longitudinal and one transverse), the function of which is that they allow a person to bounce while walking.

As there are fractures of the calcaneus and their types

Of all fractures of the foot are the most common fractures of the calcaneus. They arise from a drop in the heel. Options calcaneus fractures are highly variable. There are marginal and isolated fractures with displacement and without displacement of bone fragments. Depending on the height of the fall there are simple or fragmented (including comminuted) fractures. The position of the foot during impact determines the direction of the fracture line and the displacement of bone fragments.

When dropped from a height often the impaction of the talus and the calcaneus in the last split. There are also compression (when squeezed) fractures with no injury or damage to the articular surfaces. In some cases, break down once both heel bones.

Fractures of the calcaneus are also divided into extra-articular (ie, fracture calcaneal tuberosity) and intraarticular (in the subtalar joint) fractures.

Signs of fracture

At the turn there is a strong pain in the heel, the heel area is extended, flattened arch. At provincial and isolated fractures of the signs are less pronounced, perhaps even the load on feet and walking. The most constant feature of such a fracture - a pain in the heel area, the greatest pain when it corresponds to the fracture site.

Compression fractures of the calcaneus offset flattened arch, in fractures with large displacement, he is absent. When pressed on the heel on the sides and bottom of a marked tenderness, the load on the heel or lifting the toes are not possible, patients can not walk, but the movement in the ankle joint are preserved. Gastrocnemius muscle tension causes increased pain. There are bleeding and swelling Prevention and treatment of edema - it is important to understand the root cause   soft tissues, mainly in the field podlodyzhechnoy, rapidly spreading to the area of ​​the Achilles tendon.

If a suspected fracture of the calcaneus, necessarily carried out X-ray examination. The turning point can be seen on radiographs is good, but to assess the degree of displacement of bone fragments and the condition of the arch is sometimes difficult. In such cases, the comparison is carried out X-ray of the second, a healthy foot.

What to do

Treatment of fractures of the calcaneus without displacement performed by applying a plaster cast up to the knee. The term immobilization is dependent on the type of fracture and from 3 to 8 weeks.

For fractures with displacement under local anesthesia produce closed manually reposition (comparison) fragments: fragment departed pressing, squeezing the expanded heel bone from the sides and so on. If it is impossible to hold a closed manually reposition hold open fixation of bone fragments using screws.

Then applied a plaster cast with the modeling codes 1, 5-2 months, and with the unloading of the foot for 3-4 months. Later prescribed massage, medical gymnastics, warm baths and wearing orthopedic shoes Orthopedic shoes - how to determine what is right for you? .

With timely treatment for medical prognosis of fractures of the calcaneus is usually favorable.

Galina Romanenko

Types of dislocations shin

Open position of the leg and that it makes the load of the entire body, explains the relatively frequent damage to this part of the body - tension, torn ligaments, sprains and subluxations, fractures. The cause of damage can be an immediate impact on the shin, or (more commonly) indirect impact, such as falling from a height on his feet.

The structure of the human tibia

Shin - is part of the lower limb, located below the knee and limited knee and ankle joints. The drumstick consists of two bones: the inner surface of the tibia is located on the outside - fibula. Between the two bones of the interosseous membrane stretched thick. At tibia has front and rear surfaces, the rear surface of the top of the bone, there are three strong muscles in the front surface and no large muscle can be palpated tibia.

The knee joint - a movable joint of the femur with the tibia, which involves a small bone, covering the joint front - patella. Ankle - is also moving articulation of the tibia and fibula to the talus foot.

Dislocations shin - a dislocation of the knee (tibia bones themselves and the patella), as the name defines dislocated bone located below the joint.

Dislocations of the tibia in the knee joint

The rarity of dislocation tibia (up to 0, 6% of all dislocations) is due to the anatomical features of the knee joint, firmly reinforced ligamentous apparatus. Dislocations in the knee result from direct, indirect and combined injuries of great strength and are accompanied by rupture of the joint capsule and ligaments. Dislocations tibia can occur in all directions, but the more common front dislocations. With posterior dislocation is frequently observed damage to the neurovascular bundle, which is located in the popliteal fossa.

When dislocation shin appear sharp pain, change in shape of the knee joint, the lack of movement, inability to support the feet, shattered position (balloting) patellar because bleeding into the joint (hemarthrosis), rupture of ligaments. Often joint surrounding soft tissues (including blood vessels and nerves popliteal fossa) fall within the cavity, causing circulatory disorders limb.

The x-ray is a clear picture of the dislocation of the tibia bone in relation to the femur.

Treatment of dislocation of the tibia is an immediate manual reduction of dislocation under anesthesia by means of traction on the axis of the limb in the opposite direction of displacement. After that applied a plaster cast for a period of 6-8 weeks. In some cases, reduction of dislocation imposed skeletal traction with two crossed spokes. Surgical treatment of fresh dislocation Dislocation - Prevention and Treatment   tibia shown in the case where the dislocation straighten closed method fails due to ingress into the joint area of ​​the surrounding soft tissues.

In open primaries sprains shin debridement (remove dead tissue), followed by open reduction of dislocation. When chronic sprains good results are obtained with a gradual closed reduction using special devices (eg, device-Oganesyan Volkova).

Patellar dislocation

Traumatic dislocation of the patella are fairly common. They can be sharp and familiar, complete and incomplete (subluxations). The reason for such an injury is often a drop to one knee, hit on it with a hard object or a sharp turn to the hip. Thus there is a shift of the patella outwards with rupture of the joint capsule.

Acute patellar dislocation is characterized by severe pain, changes in the shape of the knee (patella is displaced laterally and the knee as it becomes wider), the lack of movement because of the pain. The knee is usually bent, shins turned out, on the outside of the knee patella palpable, tense muscles surrounding the joint. Often there is bleeding into the joint, or joint effusion fluid - it further increases the pain and limits movement in the joint. Leg bent at the knee and lower leg rotated outwards.

The presence of dislocation is confirmed by radiological studies. Reduction of dislocation of the patella Dislocation of the patella: a common knee injury   held closed method under anesthesia, and then applied plaster splint for three weeks, which is carried out after removing the regenerative treatment.

Part of the displacement of the patella leads to dislocation or subluxation that becomes habitual. With newly developed habitual dislocation Habitual dislocation - that kind of attack you pursue?   spend conservatively (without surgery) treatment: applied plaster bandage appoint physiotherapy and massage. If this does not help, surgery is shown in the form of plastic surgery at the joint capsule and tendon muscles.

First aid in the dislocation of the tibia

If you suspect that reduce a dislocation of the tibia it in any case should not be. The leg must be locked in the position which it adopted after the injury. To do this, you can bandage a healthy leg. In place of the injury should be accompanied by cold and immediately bring the victim to the hospital.

The sooner the victim is taken to hospital, the better the prognosis injury.

Galina Romanenko