Anatomically, the femoral head is held by an annular articular fossa. The femur is considered the largest in the body, and therefore, it has a complex structure and performs a large number of motor functions. It is not easy for a person far from medicine to understand this, but to understand the causes and characteristics of the course of femoral diseases, it is necessary.
Femur anatomy
The femur has an important role in the human body, as it is the largest tubular bone tissue in the skeleton. She, like other tubular type bones, has two ends and a body. It is connected to the pelvis using the head, which ends in the upper proximal section.
The transition of the neck to the bone body ends with tubercles - skewers. The bone body ends with a large skewer. On its medial surface there is a small depression. A small trochanter is located on the back side of the lower edge of the neck. The large one is connected to it by an intertrochanteric crest, which runs along the back side of the bone.
Hip function
The entire lower limb is very important for a person, as it takes part in all movements of the body. In addition, the structure of the femur helps a person to be in an upright position, while bearing all the static loads. Thanks to the femur, a person has the opportunity to walk, run, jump, play sports and perform more difficult actions.
The main lesions of the femur
The main and most common injuries and lesions of the femur are: fracture of the greater trochanter of the femur, fracture of the minor trochanter, bursitis, trochanteritis, teninosis.
Types of trochanteric fractures
Helicopter fractures are characteristic of elderly people who are diagnosed with a common disease such as osteoporosis. The most common trochanteric fractures are:
- Extravagant simple and comminuted. With such a fracture, the direction of the bone fracture line coincides with the one that connects the greater and lesser trochanters.
- Intertrochanteric. For such a fracture, it is characteristic that the damage line crosses the line that connects the major and minor trochanters.
Such injuries are punctured and not punctured, here is the clinical picture.
Thanks to muscle traction, simple fractures bring fragments closer together. This facilitates bone fusion and reposition. Fractures with many fragments are fused worse, and they require a stronger fixation.
Intertrochanteric fractures are characterized by the fact that the work of the muscles around does not contribute to fusion, but vice versa. This explains the importance of rigid fixation.
Fracture of the greater trochanter
This type of lesion of the femur occurs directly with a direct force on the area of the greater trochanter. In children, this is usually apophyseolysis with diaphysis shift. In this case, 2 or 3 fragments of the greater trochanter can completely fragment.
The most common femur lesions in older people are trochanteric and femoral neck fractures. In fracture of the greater trochanter, bone displacement can be directed upward or backward. This is due to the fact that over the years, bone strength decreases, and normal loads on the musculoskeletal system may already be traumatic.
With a trochanteric fracture, the patient feels a sharp pain in the affected area, with palpation, a small joint mobility can be detected. In addition, a small crisp sound is characteristic of a fresh fracture. The functional part of the thigh is broken during a fracture, especially with regard to its retraction. With a fracture of the large trochanteric bone, a load on the affected leg is possible, but lameness will be felt.
A patient with such a fracture can freely bend and straighten the leg in the knee joint, however, attempts to turn the leg cause severe pain to the patient. If he can lift the extended leg up, then this means that there is no fracture of the femoral neck. It is worth noting that it is impossible to take the leg to the side with a fracture of the femur due to sharp pain in the affected area.
Tendinosis of large skewers
This disease is a fairly common pathology. Characteristic for people overloading the hip joint. This category includes mainly athletes.
With tendinosis in the region of the greater trochanter, the inflammatory process begins in the ligaments and tendons, subsequently spreading to the tissues. The process originates at the place where the bone connects to the ligament. If a person does not pay attention to this, while continuing to strain the joint, the inflammation becomes chronic.
Provoking factors include the following:
- Joint Injury
- Failures in metabolic processes.
- Congenital dysplasia of the joints, which affects not only the articular surfaces, but also the entire ligamentous apparatus.
- Violations of the endocrine system.
- Aging of the body, in which the structure of bones and ligaments changes.
- Systematic loads associated with the monotony of work.
- The spread of infection into the surrounding tissue.
- Inflammatory processes in the joints.
The clinical picture:
- Pain on palpation and limb movement.
- During movement, the bones begin to crackle.
- The skin at the lesion changes color and turns red.
- Local temperature increase at the site of injury.
- A joint cannot perform its direct functions.
Inflammation
Skewer bursitis is an inflammation between the broad femoral fascia and the greater trochanter. It is located on the outside of the femur in its upper part. At the same time, fluid is collected in the bag, its walls expand, pain appears. This disease is very dangerous for its complications, including complete immobilization of the joint.
Pain sensations that occur at the site of the protrusion of the femur of the greater trochanter are the most basic sign of the beginning of the development of pathology. During walking and with any effects on the joint, the pain intensifies. At a later stage, the inflammatory process caused by bursitis begins to spread to the lower thigh, thereby causing lameness in the patient. Even if the load on the affected limb does not decrease, then after some time the pain may begin to manifest itself at rest.
Diagnostics
To diagnose a fracture of the greater trochanter of the femur, an x-ray is taken, if necessary, the doctor decides to send the patient for computed tomography. Tendinosis is diagnosed by palpation, radiography, magnetic resonance imaging and ultrasound of the affected area.
Fracture Treatments
In case of fracture of the greater trochanter of the femur, the patient, as a rule, is given a gypsum circular dressing for 3 weeks in the abduction position. After the prescribed period, the gypsum is removed, and the patient is prescribed a massage course on the affected area. During this period, the patient can move around with crutches, since such a load does not cause him any discomfort or pain.
But in some cases, doctors have to resort to open reduction using bone holders specially designed for such procedures, that is, bone fragments are juxtaposed, which provides them with better adhesion. This procedure is carried out if it is not possible to straighten the bone fragments during abduction of the leg.
Tendinosis Therapy
The treatment of this pathology is carried out by complex measures. Depending on the location of the lesion and on what stage the disease is at, the doctor prescribes the optimal therapy. To relieve pain, the patient is prescribed painkillers and ice packs that need to be applied to the affected area.
Using elastic bandages or bandages, the affected joint is limited in movement. In addition, physiotherapeutic procedures are used to treat tendinosis. A good effect, for example, is provided by magnetic therapy, laser, ultrasound, and applications from therapeutic mud and a bath with mineral salts also help. As recovery, the patient should begin to perform a course of exercise therapy. Classes help improve joint mobility, elasticity and muscle strength.
Surgery for tendinosis is an extreme measure of treatment for this disease and it is used in very rare cases. Doctors try to dispense with conservative methods of therapy.
What to do with bursitis?
Treatment of bursitis should begin with simple procedures. Very rarely, such a disease requires surgical intervention. Patients under thirty years of age are recommended to reduce the load on the affected joint and undergo a course of rehabilitation therapy, which includes exercises for stretching the muscles of the thighs and buttocks.
Therapy for inflammation of the greater trochanter of the thigh involves the use of anti-inflammatory drugs. With the help of such drugs, swelling of the affected joint and pain are effectively removed. The use of cold, ultrasound, warming and UHF helps to get rid of pain and relieve swelling.
One of the most convenient methods of exposure at home is the use of heat or cold. It is important to remember that cold is used immediately after an injury, and heat is used in inflammatory processes that take place in a chronic form. An experienced physiotherapist will be able to give useful recommendations, using which you can completely restore all the motor functions of the joint. If fluid accumulates in a skewer bag, then the patient is recommended to have a puncture in order to pump out all the water and send it to the laboratory for analysis.
During this procedure, a small dose of steroid hormones, such as cortisone, is injected into the spit bag, but this can only be done if the patient has no infectious diseases. The hormonal drug quickly relieves inflammation. The effect of the procedure can last for 6-8 months.
A timely visit to a doctor will help to cure all existing violations in the femur in a short time. If any of the pathologies in this part of the human body acquires a chronic course, then the pain syndrome stops only for a while.