The structure of the human tibia

Shin - is a part of the lower limbs, limited knee and ankle joints. Bone base represented by two shin bones: closer to the midline of the body is the tibia outwards from it - fibula. Between the two bones are connected by a strong interosseous membrane of leg. There are front and back of the leg. On the back of the leg there are three powerful muscle, located on top of the bones on the anterior surface of the muscle is not strong and can be felt shin bone foundation.

Features tibial fractures and their types

Tibia has several features that are to some extent determine the features of fractures of her bones. Since the surface of the anterior-shin is not protected by the muscles in this place fractures are often open, with damage to the skin. Helical oblique fractures of the tibia and often lead to primary and repeated (after reduction - combining) the displacement of the bones. Often the bone heals very slowly due to their lack of blood supply. Finally, powerful muscles contribute to the displacement of bone fragments.

For tibial fractures include fractures of the distal tibia (lower third), diaphyseal fractures (in the middle third of the leg), and fractures of the tibial condyle (upper third of the lower leg). On the mechanism of trauma fractures are divided into oblique and spiral (occur when a sharp turn to the stationary foot, falling to his feet), transverse, comminuted and kosopoperechnye (the result of direct trauma - shock, compression, bending). Children can subperiosteal fractures when bone breaks as a green twig (periosteum remains intact). Fractures can be open (in violation of the integrity of the skin) and closed.

How does the shin bone fractures

When closed fractures in the area of ​​injury occurs swelling and bruising. The function of a limb is broken, movement is limited and painful. When viewed from the legs it can be seen that it has changed its form in the fracture appeared abnormal mobility. The affected limb is usually shorter than the healthy.

Usually, even with isolated tibial fractures observed displacement of fragments. For shaft fractures (middle part) tibia typical displacement of the central fragment medially and anteriorly, and peripheral - posteriorly and laterally. At the turn of the two leg bones strongly affected limb function, expressed deformation due to a hematoma (bleeding), and displacement of fragments, the limb is bent to form an angle open anteriorly and laterally. With a rapidly increasing edema Prevention and treatment of edema - it is important to understand the root cause   appear on the skin bubbles with bloody content. When tibial fractures without displacement and isolated fractures of the tibia or fibula fracture, not all features are expressed quite clearly.

Diagnostics

In addition to the diagnosis of the fracture outward signs of fractures are important radiological examinations. Radiography in two projections to avoid diagnostic errors, specify the type and level of fracture, the nature of the displacement of bone fragments before and after reduction.

Treatment of fractures of the shin bone

The main method of treatment of tibial fractures is conservative: a plaster cast, and skeletal traction. The cast is used for isolated fractures of the tibia and fibula, transverse fracture of both bones without moving or after satisfactory reduction. The cast is applied from the toes to the middle or upper thigh. At the turn of the fibula in the outer ankle bandage is applied to the knee joint.

Load on the limb with a broken fibula is permitted on day 2-3, the transverse fracture of the tibia or both shin bones - 2 weeks, with helical or oblique fracture - not earlier than 6 weeks. The average time imposing the cast - 8-10 weeks, after which necessarily need rentgenkontrol.

Some types of fractures, when there is a possibility of secondary displacement of fragments, appoint skeletal traction (a special needle threaded into the bone and produce a stretching of the bone with the help of the cargo).

In open fractures, the threat of crushing blood vessels and nerves, inability to produce overlapping fragments of the closed method of fracture surgery is performed with the elimination of the effects of trauma.

First aid for fractures of the shin bone

For fractures of the shin bone main task of first aid should be to ensure a relaxing and most comfortable position for the injured limb, which is achieved by its complete immobility. This is also necessary to prevent damage to surrounding soft tissue, including blood vessels and nerves. Damage to the limbs applied bus (any improvised material of sufficient length - board, umbrella, stick), which is to capture at least two joints (knee and ankle). Pribintovyvayut bus to the foot of the victim, to the point of fracture applied cold. If the fracture is open, then the wound bandage of sterile bandage. After that, the victim should be immediately hospitalized.

Galina Romanenko

What is the cause of the dislocation, and dislocation of the shoulder

Dislocation - a persistent shift articular ends of bones forming a joint, beyond their physiological mobility that leads to disruption of the joint. Dislocations are full (with a complete loss of contact between the articular surfaces) and incomplete (partial loss of contact). Sprained considered peripheral bone, the title of which is denoted by a dislocation. Thus, when a dislocation of the shoulder joint suggests a dislocated shoulder.

Due to the occurrence of traumatic dislocations are divided into, the usual (sometimes develop after the initial dislocation in the wrong, or untimely assistance provided), congenital (the result of improper fetal development) and pathological (occurring in various diseases of the joints, which leads to a change in the articular surfaces of the bones).

Traumatic dislocation of the shoulder

Traumatic dislocation of the shoulder are much more likely dislocation Dislocation - Prevention and Treatment   due to the fact that the shoulder joint has a pronounced discrepancy between the surfaces of the bones forming the joint, between the quantity and the shape of the humeral head and the glenoid surface of the scapula. The appearance of traumatic shoulder dislocation is most often associated with indirect injury or fast strong violent movement in the joint.

Traumatic dislocation, usually accompanied by rupture of the joint capsule over a large area, damage to the muscles and ligaments in the form of tears and sprains, intra-articular hemorrhage, detachment of muscles, ligaments and bones. Also can damage nerves and blood vessels. All this is accompanied by severe pain and can further give a complication in the form of arthrosis Osteoarthritis - when the joint loses its function   - Proliferation of connective tissue in the joint limiting its function.

Depending on the time elapsed since the injury, a dislocated shoulder is divided into fresh (since the injury was not more than 3 days), stale (3-4 weeks) and chronic (over a month), and depending on the condition of the skin on closed and open.

When dislocation of the humeral head may move anteriorly, posteriorly or downward from the glenoid cavity, so share the front (most common), and lower back sprains.

Signs of traumatic shoulder dislocation

Dislocation of the shoulder is always accompanied by severe pain and a complete disruption of the hand. The head of the victim is usually tilted down and turned into the damaged side, shoulder girdle is omitted, good hand it supports the injured arm. The injured arm is usually bent at the elbow, take aside (it can not lead to the body) and looks longer than the healthy. Movement in the injured arm sharply violated, the victim can not touch the fingers of the hand of his abdomen. If you try to lift the other person, or take the side injured hand, there is a spring resistance. The muscles that surround the shoulder joint, tense.

Released from the joint head of the humerus can compress blood vessels and nerves, which in turn will cause a discoloration of the skin (pallor or cyanosis), especially in the fingers injured hand, the weakening or absence of a pulse in the traditional measurement site (the wrist, below the thumb) and various sensory disturbances in the area.

The contours of the shoulder joint, instead of the normal rounded, flattened. When the feeling his hands the head of the humerus in the glenoid cavity of the blade is not, moving forward, backward or down.

First aid

If you suspect a dislocated shoulder in any case can not reduce a dislocation of their own, this can lead to additional injury: damage and even bone fracture A bone fracture - the scourge of children and the elderly , Damage to blood vessels, nerves and soft tissues.

It is necessary to fix the arm in a position in which it is located, attach to the cold area of ​​the joint, if the surface of the skin has an open wound, then it is better to apply a sterile bandage, and then as quickly as possible to bring the victim to the emergency room. Secure the arm can be using any available material, giving it the shape of gussets (triangle) and fasten around the neck.

Diagnosis and treatment

The diagnosis of shoulder dislocation can be delivered immediately after the examination, it is confirmed by X-ray examination.

Reduction of dislocated shoulder held by a physician under general or local anesthesia. There are many ways to reposition the shoulder (Hippocrates-Cooper, Kocher, Janelidze, etc.) - all of them can only be carried out by the doctor. After repeated reduction of dislocation do an x-ray to make sure that the dislocation vpravlen, and on the injured limb is applied in two or three weeks, plaster bandage, fixing his hand to his chest. A week later appointed physiotherapy, massage and physiotherapy. The work of the joint is reduced by 1-1, 5 months. To engage in heavy physical labor and lifting weights is not recommended for three months.

Dislocated shoulder - it is a serious injury, so the victim must be as fast as possible to deliver to the traumatologist.

Galina Romanenko