Not everyone knows what a hip joint is. A fracture of this part of the skeleton causes many problems. After all, a person becomes immobilized for a while. Most often, a violation of the integrity of tissues occurs in the neck of the femur, which is located below the head, located in the cavity of the hip joint, as well as in the intertrochanteric area - the upper outer part of the femur. In this case, the fracture can be complete or partial.
Classification
Hip fracture is classified as follows:
- Violation of the integrity of the femoral neck.
- Upper thigh fracture.
In this case, the violation of the integrity of the tissues of the femoral neck is divided into categories. It all depends on the fracture lines:
- Major bone fracture - head injury.
- Subcapital. In this case, the fracture line passes directly under the head of the femoral bone.
- Transcervical, or transcervical, - trauma in the femoralneck.
- Basiscervical fracture - the lines of injury 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 simpler fractures. These include:
- Fracture of the posterior wall.
- Posterior column fracture.
- Violation of the integrity of the front wall.
- Fracture of the anterior column.
- Fracture transverse.
More complex injuries include:
- T-fracture.
- Violation of the integrity of the back column and back wall.
- Fracture of the posterior wall and transverse.
- Violation of the integrity of both columns.
Fracture symptoms
How to determine if the hip joint is damaged? Fracture of bones in this area, as a rule, is accompanied by characteristic symptoms. Among them it is worth highlighting:
- Pain in the groin area. They may be mild at rest. However, when trying to move the injured leg, there is a sharp pain.
- Hematoma. This symptom is not early, as it can only appear a few days after the injury.
- In case of a fracture, the foot lies with the entire outer edge on a horizontal surface.
- Lack of active internal rotation of the lower limb. With a hip fracture, a person cannot rotate the injured leg and turn the foot inward. It is for this reason that the foot remains constantly in the outward position.
- The lower limb becomes shorter by about 3-4 centimeters.
- Girgolov's symptom. When it occurs, the pulsation of the femoral artery increases. In this case, the victim can unbend and bend the limb, but the heel will still slide on a horizontal surface. In addition, the victim is unable to lift and hold the leg in an elevated position.
Why fracture happens
Not everyone is immune from injuries and is able to keep the hip joint intact. A fracture in young people is a disorder that occurs for certain reasons. These should include:
- Presence of various diseases.
- Injuries (accident, fall).
As for the elderly, in addition to the above reasons, a hip fracture with and without displacement can occur against the background of a decrease in the strength of bone tissues. This, in turn, is one of the consequences of a disease such as osteoporosis. This disease often develops after the onset of menopause. Often, osteoporosis also occurs in older men, but to a lesser extent.
It is worth noting that a hip fracture often occurs as a result of a fall. Risk factors for violating its integrity include impaired vision, a neurological or oncological disease, decreased physical activity, and an unbalanced diet. After reaching the age of 50, the risk of injury increases significantly. About 1.6 million tissue fractures occur every year in the world.hip joint.
Consequences
Is the hip joint fully restored? A fracture of this part of the skeleton is a serious injury that immobilizes a person for a certain period of time. A victim with a violation of the integrity of the tissues needs immediate hospitalization. For patients in the trauma department with such fractures, bedsores are dangerous. Most often they are formed on the buttocks and in the sacrum. First of all, this is due to violations of tissue trophism.
Thrombosis and stagnant processes
For the he alth and life of the patient, thrombosis of the vessels of the lower extremities, as well as venous congestion, poses a great threat. Prolonged bed rest often leads to circulatory disorders. Elderly patients may experience pulmonary embolism. 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 gastrointestinal dysfunction. This is manifested by a decrease in intestinal motility, and also leads to the development of constipation.
Inactivity often leads patients to depression. In such situations, support from loved ones is very important. In addition to the above, in victims with an injury to the acetabulum, aseptic necrosis of the head of the bone and the cavity may occur. In some cases, coxarthrosis develops.
First aid
How is first aid provided for a hip fracture? With such injuries, care must be taken. The procedure is as follows:
- First of all, the victim in violation of the integrity of the bones of the hip joint must be calmed and laid on his back.
- To relieve pain, a non-narcotic analgesic is administered. In this case, use "Analgin". If the pain syndrome is pronounced, then the use of narcotic drugs is allowed. These can be analgesics or Ketorol.
- Transportation of the victim with such an injury should be carried out only on a stretcher.
- In no case should you try to return the injured lower limb to its original position.
- A special splint is required on the injured leg 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 damage
Fracture of the hip joint, which must be treated in a hospital, is a serious injury that can be accompanied by a violation of the integrity of soft tissues. What to do with such damage?
- If the blood vessels are damaged, then a tourniquet should be applied above the place where the bleeding was noted. After two hours, it will need to be removed. With suchinjury, the victim is injected intramuscularly with 12.5% "Etamzilat" and 1% "Vikasol". The tourniquet must not be covered with a gauze bandage
- If the skin is damaged, then they must be treated with iodine, and then apply an aseptic bandage.
- 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 such a fracture treated
In some cases, a hip replacement is performed. Since a pronounced pain syndrome is noted during an injury, the doctor often injects a local anesthetic into the damaged area to relieve discomfort. In addition, the patient is prescribed non-narcotic painkillers, as well as non-steroidal anti-inflammatory drugs. The tactics of therapy in this case depends on the integrity of which tissue was violated, whether large vessels, muscles and ligaments were damaged.
A victim with a fracture in the hip joint is compared with parts of the bone, and then skeletal traction is applied. In this position, the patient should lie for 1 to 2 months. When carrying out such therapy, the amount of cargo is gradually reduced. After that, a plaster bandage is applied to the victim. This allows you to move around with crutches. The motor mode of the patient is gradually expanding. However, it is strictly forbidden to focus on the damaged lower limb. In the process of rehabilitation, patients with such an injury are prescribed massage and physiotherapy. Apart fromThis is indicated by exercise therapy for a fracture of the hip joint.
It is worth noting that full physical activity on the injured limb is shown only after 3 months. If the elderly patient does not have any diseases in which the introduction of general anesthesia is not allowed, then the doctor may perform a surgical intervention. Indeed, in some situations, hip prosthetics are required. In addition, the operation allows you to reduce the duration of bed rest, which is very important.
In certain situations, hip arthroplasty is prescribed. Recovery after surgery is much faster. It is worth considering that bone replacement in this area is a high-tech and complex operation.
Rehabilitation process after prosthetics
Is hip arthroplasty well tolerated? Rehabilitation after surgery can be carried out in the department of physiotherapy exercises or physiotherapy. From the first day after surgery, exercise therapy is performed under the strict supervision of an instructor or attending physician. After a few days, the patient is allowed to move around with crutches. In addition, after surgery, drug therapy is carried out. Patients after arthroplasty, as a rule, are prescribed vasoconstrictors, 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 afterfracture
Open or closed fracture of the hip joint - this injury, after which a long period of rehabilitation is required. In this case, special therapy is carried out. She is appointed from the very first days of bed rest. Its main direction is the prevention and elimination of congestive processes, as well as postoperative complications.
Special belts are located above the patient's bed. With their help, he can gently change the position of the body. This avoids the formation of bedsores. In addition, the rehabilitation specialist should regularly carry out breathing exercises and various exercises with the patient, which allow filling the tissues with oxygen and preventing the development of congestive pneumonia.
Is there a diet
As far as nutrition is concerned, patients with such injuries should follow a specific diet, which includes foods with a high content of vitamins and calcium. Vegetables and fruits can improve the functioning of the digestive tract, as well as avoid the occurrence of persistent constipation. In addition, a patient with such an injury should not forget about spa treatment.
