Fracture of the leg in the femoral region has a favorable prognosis in the case of early reposition of fragments or the imposition of traction.
Depending on the location, distinguish:
- trauma of the upper edge;
- fracture of diaphysis;
- fracture of distal or proximal meta-epiphysis.
The last damage is characterized bycertain difficulties in treatment. Data of the injury result from falls from high altitudes. The impact in this case is directly on the site of a large trochanter, provoking fracture of the leg.
Symptoms manifest themselves in the form of soreness inhip joint, the patient is difficult to tear off the heel from the horizontal plane. In addition, the lower limb is shown and slightly rotated outwards. In this case, a large spit in a trauma with displacement is located higher than the Rosel-Nelaton line. Specification of the degree of displacement of fragments and the nature of the fracture is carried out by means of X-ray study.
Medial (cervical) injury of the femur, andalso epiphyseliasis of the head refer to intraarticular lesions. Lateral injury is a lesion of the periarticular, but in a number of cases, penetration of the plane of the fracture into the joint cavity is noted.
Fracture of the leg in the femoral neck and traumaticepiphysiolysis of the head with absent displacement implies a prolonged immobilization on the outgoing bus or a cast bandage with a belt on the pelvic region superimposed in the position of internal rotation and retraction. The immobilization period is from two to three months, followed by (within four or six months) by unloading.
Fracture of the leg in the thigh area with displacement of bone fragments suggests the use of skeletal traction as therapeutic measures.
The most common complication is the formation of aseptic necrosis in the head of the femur. In the case of ineffectiveness of conservative measures, fracture of the leg involves treatment operatively.
Isolated fracture, the causes of which are injurieswhen falling and hitting, is localized in the region of the large trochanter of the hip bone. This damage is characterized by limited pain during palpation and movement, as well as local traumatic swelling. As a rule, such a fracture of the foot is accompanied by a slight violation of limb function.
As treatment, immobilization is prescribed in the gypsum longus for three to four weeks.
The most common injuries of the femoralbones include a fracture of the diaphysis. Lesions with localization in the middle third can be caused by both indirect and direct trauma. As a rule, this fracture of the leg happens when falling from a height or when moving games.
Given the level, distinguish between low and high diaphyseal injuries, as well as injuries of the middle third. In accordance with the character, the oblique, transverse, comminuted and helical fractures are determined.
In many respects, the displacement of bone fragments is associated with the degree of the acting force, the level of damage, and also the reduction of the corresponding muscle groups.
Fracture of femur bone in proximal partis characterized by the retracted position of the fragment, external rotation and flexion due to the reduction of the iliac and gluteus muscles. Displacement of the distal fragment is carried back, inside and up.
A fracture of the middle third is characterized by the samethe relationship of debris. At the same time, anterior deviation and retraction of the proximal fragment is less pronounced with a likely significant displacement of the distal fragment along the length and back.
Correct treatment of femoral damage ensures fusion without shortening.
After the immobilization period, the load on the limb is allowed no earlier than two or three weeks. The accelerated recovery is facilitated by the use of warm baths and therapeutic exercise.