Dislocation

Innate v. occur as a result of the incorrect intrauterine development of fruit - underdevelopment of articulate cavity and head of thigh (dysplasia). More frequently are noted v. of hip joints (2-5 on 1000 newborns), thinner - v. of knee cap, knee joint. In the breast child v. of thigh it is manifested by the asymmetry of folds on vnutr. of the surface of thighs, by the limitation of the removal of foot, etc; when child begins to walk and it is later - by lameness and by the relative shortening of one lower extremity, with the double-sided dislocation by "duck" gait. Innate v. of knee cap is manifested by pains, complete immobility of joint, by its inflammation, hemarthrosis; walk children badly, frequently they fall. Treatment innate v. of thigh (setting, the imposition of special tires or plaster bandages) must begin as early as possible - the best results he gives in children 3 mo., but possibly of up to 2 years. With the futility of this treatment in 2-4 years - khirurgich. operation. Preventive maintenance: ortopedich. the inspection of newborns. It cannot be tightly pelenat' (and all the more to wind), forcibly legs, it is premature to place the child (itself is earlier than child will arise to the legs).

Acquired In. they appear with the injury - traumatic or with the diseases (for example, osteomyelitis, poliomyelitis and other.) - pathologic, or spontaneous.

Dislocation: and - normal humeral joint (right); 6 - dislocation of right arm.

Travmatich. V. in the majority of the cases occur under the effect of the indirect injury, when the place of application of force is removed from the damaged joint (for example, with the drop on the brush of the elongated hand it occurs v. in the humeral joint). By reason for travmatich. V. there can be the sharp reduction of muscles, which causes the motion, which falls outside the limits of the normal mobility of this joint (for example, v. of lower jaw with the excessive opening of mouth). Considerably more rarely appear v. from the straight injury - impact into the region of joint. In children at the age of 1-3 years Vol. n are observed. "v. from the extraction", that appears in the joints (humeral, elbow) from the sharp jerk of child for the hand (when him they conduct for the knob and it it stumbled). They are manifested by severe pains in the region of joint, deformation, disturbance or loss of motions.

With v. almost always occurs the break of the capsule of joints, can be damaged tendons, muscles, bones, vessels and nerves; such v. NAZ complicated. V. can be closed - without the damage of the skin above the joint and opened, when is formed the wound, which penetrates into the cavity of joint. Sometimes as a result of it means, the tensions of articular bursa and bonds with v., and also without the correct treatment v. it appears again even with the small violence. This Vol. n. customary v. (most frequent in the humeral joint).

Patologich. V. more frequently appears in the hip and humeral joints usually as a result of destroying the articulate surfaces as a result of the path. process; paralitich. V. is observed with paralysis or paresis of surrounding joint muscles these v. they appear without the noticeable application of external force, as it is spontaneous, for example, during walking, turning in the bed, etc.

The first aid: fixation by the damaged to extremity kerchief, by tire and the like (see immobilization). Treatment: the setting of the articulate ends (to avoid he will only by doctor supplement, the traumatizations of cloths) immediately after the establishment of diagnosis with the subsequent immobilization; subsequently - functional treatment (gymnastics, massage, etc.). With the inveterate in. (3 weeks after damage) - khirurgich. operation. With patologich. In. - the treatment of the disease, which led to v. for restoring the function is sometimes necessary khirurgich. operation.

Lit.: Chromiums b. M., dislocations and breaks, 2 publ., l., 1960; M is Volkov. V., diagnostics and the treatment of the chronic dislocation of thigh, M., 1969. V. l. andrianov.