Hip joint: fracture and its consequences. Endoprosthetics of the hip joint, postoperative rehabilitation

Not everyone can imagine what a hip joint is. Fracture of this part of the skeleton causes a lot of problems. After all, a person becomes immobilized for a while. Most often, tissue integrity disorder occurs in the neck of the femur, which is located below the head located in the hollow of the hip joint, and also in the intervertebral part - the upper outer part of the femur. In this case, the fracture can be complete or partial.

Classification

Fracture of the bones of the hip joint is classified as follows:

1. Violation of the integrity of the neck of the thigh.
2. Fracture of upper thigh.

In this case, disruption of the integrity of the femoral neck tissue is divided into categories. Everything depends on the fracture lines:

1. A major bone fracture is a head injury.
2. Subcupital. In this case, the fracture line passes directly under the head of the hip bone.
3. Transcervical, or proderchechny, - injury in the femoral neck.
4. Basis cervical fracture - lines of trauma pass through the base of the neck in the area of its connection with the body of the bone.

Classification of simple and complex fractures

There are also more simple fractures. These include:

1. Fracture of posterior wall.
2. Fracture of the posterior column.
3. Violation of the integrity of the front wall.
4. Fracture of the anterior column.
5. Fracture transverse.

To more complex injuries include:

1. T-shaped fracture.
2. Violation of the integrity of the rear column and the rear wall.
3. Fracture of posterior wall and transverse.
4. Violation of the integrity of both columns.

Symptoms of a fracture

How to determine if a hip joint is damaged? Fracture of bones in this area, as a rule, is accompanied by characteristic symptoms. Among them is the following:

1. Pain in the groin. They can be weakly expressed in a state of rest. However, when trying to move a damaged leg, there is a sharp pain.
2. Hematoma. This sign is not early, as it can only appear a few days after the injury.
3. If the fracture of the foot lies with the entire outer edge on a horizontal surface.
4. Absence of active internal rotation of the lower limb. If a hip joint is broken, a person can not rotate the injured leg and turn it inward with the foot. It is for this reason that the foot remains constantly in a position outside.
5. The lower limb is shorter by about 3-4 centimeters.
6. Symptom of Girgolov. When it occurs, pulsation of the femoral artery increases. In this case, the victim can unbend and bend the limb, but the heel will still slide along the horizontal surface. In addition, the victim is unable to lift and hold his leg in a raised position.

Why there is a fracture

Not everyone is immune from injuries and is able to maintain the integrity of the hip joint. Fracture in young people - a violation that occurs for certain reasons. These include:

1. The presence of a variety of diseases.
2. Injuries (accident, fall).

As for the elderly, in addition to the above reasons, fracture of the hip joint with and without bias can occur against the background of a decrease in the strength of bone tissue. This, in turn, is one of the consequences of a disease such as osteoporosis. This ailment often develops after the onset of menopause. Often, osteoporosis occurs in men in old age, but to a lesser extent.

It is worth noting that the fracture of the hip joint often occurs as a result of a fall. The risk factors for the violation of its integrity include weakened vision, neurological or oncological disease, reduced physical activity, as well as unbalanced nutrition. After reaching 50 years of age, the risk of injury is significantly increased. Every year around 1.6 million hip joint fractures occur worldwide.

Effects

Is the hip joint fully restored? Fracture of this part of the skeleton is a serious trauma, which for a certain period immobilizes a person. The victim with a violation of the integrity of the tissues needs immediate hospitalization. Pressure ulcers are dangerous for traumatological patients with such fractures. Most often they are formed on the buttocks and in the sacrum. First of all it is connected with disturbances of a trophism of fabrics.

Thrombosis and stagnant processes

For the health and life of the patient, thrombosis of the vessels of the lower extremities, as well as venous congestion, is a great threat. Prolonged bed rest often leads to a violation of blood circulation. In patients of advanced age, pulmonary embolism may occur. This violation often leads to death. In addition, respiratory failure and congestive pneumonia may occur.

It is worth noting that prolonged bed rest often causes abnormalities of the gastrointestinal tract. This is manifested by a decrease in intestinal peristalsis, and also leads to the development of constipation.

Hypodinamy often leads patients to depression. In such situations, support from relatives is very important. In addition to the above, patients with a trauma of the acetabulum may experience aseptic necrosis of the head of bone and cavity itself. In some cases, coxarthrosis develops.

First Aid

How does first aid come if a hip joint is broken? With such injuries, you must act carefully. The procedure is as follows:

1. First of all, the person who suffered the violation of the integrity of the bones of the hip joint should be reassured and laid on his back.
2. To relieve pain, inject a non-narcotic analgesic. In this case, use "Analgin". If the pain syndrome is pronounced, then the use of narcotic drugs is allowed. It can be analgesics or Ketorol.
3. Transportation of the injured person in such trauma must be carried out only on stretchers.
4. In no case should you try to return the injured lower limb to its original position.
5. On the injured leg it is required to impose a special tire, which allows to immobilize the hip joint.

During the transportation of the victim it is necessary to monitor his condition, pay attention to the color of the mucous membranes and skin.

What to do with additional damages

A fracture of the hip joint, the treatment of which should be performed in a hospital, is a serious trauma that can be accompanied by a violation of the integrity of the soft tissues. What to do with such damage?

1. If blood vessels are damaged, the tourniquet should be applied above the spot where bleeding has occurred. After two hours it will need to be removed. In such a trauma, the victim is injected intramuscularly with 12.5% "Etamsilat" and 1% "Vikasol". The tourniquet should not be covered with a gauze bandage
2. If the skin is damaged, then they must be treated with iodine, and then apply an aseptic bandage.
3. If the victim has a pain or post-traumatic shock, then urgent resuscitation should be carried out, which are aimed at maintaining the basic functions of vital systems.

How is this fracture treated?

In some cases, a hip joint prosthesis is performed. Since the trauma is marked by pronounced pain syndrome, often for the removal of discomfort the doctor introduces a local anesthetic into the damaged area. In addition, the patient is prescribed non-narcotic analgesics, as well as non-steroidal anti-inflammatory drugs. The tactics of therapy in this case depends on the integrity of what tissue was broken, whether large vessels, muscles and ligaments are damaged.

The injured with a fracture in the hip joint make a comparison of parts of the bone, and then the skeletal traction is superimposed. In this position the patient should lie for 1 to 2 months. With such therapy, the amount of cargo is gradually reduced. After that, the affected person is impregnated with a plaster bandage. This allows you to move with crutches. The motor mode in the patient gradually expands. However, it is strictly forbidden to focus on the injured lower limb. In the process of rehabilitation, patients with such trauma are prescribed massage and physiotherapy. In addition, exercise therapy is shown for fracture of the hip joint.

It is worth noting that the full physical load on the damaged limb is only shown after 3 months. If the elderly patient does not have any diseases in which general anesthesia is not allowed, the doctor can perform a surgical procedure. After all, in some situations, hip replacement is required. In addition, surgery reduces the length of bed rest, which is very important.

In certain situations, endoprosthetics of the hip are prescribed . Rehabilitation after surgery is much faster. It is worth noting that the replacement of bones in this area is a high-tech and complex operation.

The process of rehabilitation after prosthetics

Is it easy to endoprosthetics of the hip joint? Rehabilitation after surgery can be performed in the department of physiotherapy or physiotherapy. From the first day after surgery, exercise therapy is performed under the strict supervision of an instructor or a doctor in charge. A few days later, the patient is allowed to move with crutches. In addition, after the surgical intervention, drug therapy is performed. Patients after endoprosthetics, as a rule, prescribe vasoregulators, intravenous infusions, low molecular weight heparins for the prevention of thrombosis, analgesics and antibiotics. After the operation, the patient must stay in the hospital for at least 5 days.

Rehabilitation after fracture

Open or closed fracture of the hip joint - this trauma, after which a long period of rehabilitation is required. In this case, special therapy is carried out. It is prescribed from the very first days of bed rest. Its main direction is the prevention and elimination of stagnant processes, as well as postoperative complications.

Above the patient's bed there are special straps. With their help, he can gently change the position of the body. This avoids the formation of pressure sores. In addition, the rehabilitator should regularly hold a patient with respiratory gymnastics and various exercises that allow filling tissues with oxygen and prevent the development of congestive pneumonia.

Is there a diet

As for nutrition, patients with similar injuries should adhere to a certain diet, which includes foods with a high content of vitamins and calcium. Vegetables and fruits can improve the work of the digestive tract, as well as avoid the occurrence of persistent constipation. In addition, the patient with such trauma should not forget about the sanatorium treatment.