Hip joint: fracture and its consequences. Hip replacement, rehabilitation after surgery

Not everyone imagines what a hip joint is. 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 the 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 interverticular region - the upper outer part of the femur. In this case, the fracture can be full or partial.

Classification

Hip fracture is classified as follows:

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

In this case, a violation of the integrity of the tissues of the femoral neck is divided into categories. It all depends on the fracture lines:

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

Classification of simple and complex fractures

Simpler fractures exist. These include:

1. Fracture of the posterior wall.
2. Fracture of the posterior column.
3. Violation of the integrity of the front wall.
4. Fracture of the front column.
5. Transverse fracture.

More complex injuries include:

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

Fracture symptoms

How to determine if the hip joint is damaged? Bone fracture in this area is usually accompanied by characteristic symptoms. Among them it is worth highlighting:

1. Pain in the groin. They may be mild at rest. However, when trying to move a damaged leg there is a sharp pain.
2. Hematoma. This symptom is not early, as it can occur only a few days after the injury.
3. In case of a fracture, the foot lies with its entire outer edge on a horizontal surface.
4. Lack of active internal rotation of the lower limb. With a hip fracture, a person cannot rotate a damaged leg and turn its foot inward. It is for this reason that the foot remains constantly in the outward position.
5. The lower limb becomes shorter by about 3-4 centimeters.
6. Symptom Girgolova. 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 not able to lift and hold his leg in an elevated position.

Why does a fracture occur?

Not everyone is safe from injuries and is able to maintain the integrity of the hip joint. Fracture in young people is a disorder 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, a fracture of the hip joint 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 ailment often develops after the onset of menopause. Osteoporosis often occurs in men in old age, but to a lesser extent.

It is worth noting that a fracture of the hip joint often occurs as a result of a fall. Risk factors for impaired integrity include impaired vision, neurological or oncological disease, decreased physical activity, and unbalanced nutrition. After reaching the age of 50, the risk of injury increases significantly. Each year, around 1.6 million hip fractures occur in the world.

Effects

Is the hip joint fully restored? The 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 tissues needs immediate hospitalization. For patients in the trauma unit with such fractures, bedsores are dangerous. Most often they form on the buttocks and in the sacral region. This is primarily due to violations of trophic tissue.

Thrombosis and stagnation

Thrombosis of the vessels of the lower extremities, as well as venous congestion, is a great threat to the health and life of the patient. Prolonged bed rest often leads to circulatory disorders. In elderly patients, pulmonary thromboembolism may occur. This violation often leads to death. In addition, respiratory failure and congestive pneumonia can occur.

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

Hypodynamia often leads patients to depression. In such situations, support from loved ones is very important. In addition to the above, aseptic necrosis of the very head of the bone and cavity may occur in patients with an acetabular injury. In some cases, coxarthrosis develops.

First aid

How is first aid given for a hip fracture? In such injuries, care must be taken. The procedure is as follows:

1. First of all, the victim with a violation of the integrity of the bones of the hip joint must be soothed and laid on his back.
2. 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. It can be analgesics or Ketorol.
3. The transportation of the victim with such an injury should only be carried out on a stretcher.
4. In no case should you try to return the damaged lower limb to its original position.
5. 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 in case of additional damage

Hip fracture, the treatment of which should be carried out in a hospital, is a serious injury that may be accompanied by a violation of the integrity of the soft tissues. What to do with such damage?

1. If blood vessels are damaged, then a tourniquet should be applied above the place where bleeding was noted. Two hours later, it will need to be removed. With such an injury, the patient is injected intramuscularly with 12.5% ​​Ethamsylate and 1% Vikasol. The tourniquet must 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 dressing.
3. If the victim has a pain or post-traumatic shock, then urgent resuscitation measures should be taken, which are aimed at maintaining the basic functions of vital systems.

How is such a fracture treated

In some cases, a hip joint prosthesis is performed. Since a pronounced pain syndrome is noted during an injury, it is not uncommon for a doctor to inject a local anesthetic into the damaged area to relieve unpleasant sensations. In addition, non-narcotic pain medications, as well as non-steroidal anti-inflammatory drugs, are prescribed to the patient. The tactics of therapy in this case depends on the integrity of which tissue was broken, whether large vessels, muscles and ligaments are damaged.

The victim with a fracture in the hip joint compares parts of the bone, and then skeletal traction is applied. In this position, the patient should lie for 1 to 2 months. When conducting such therapy, the amount of cargo is gradually reduced. After this, a plaster cast is applied to the victim. This allows you to move with crutches. The motor regime in the patient is gradually expanding. However, it is strictly forbidden to focus on a damaged lower limb. In the process of rehabilitation, patients with such an injury are prescribed massage and physiotherapy. In addition, exercise therapy for hip fracture is indicated.

It is worth noting that the full physical load on the injured limb is shown only after 3 months. If an elderly patient does not have any diseases in which the introduction of general anesthesia is not allowed, then the doctor can perform a surgical intervention. Indeed, in some situations, prosthetics of the hip joint is required. In addition, the operation reduces the duration of bed rest, which is very important.

In certain situations, hip arthroplasty is prescribed. Rehabilitation after surgery is much faster. It is worth considering that bone replacement in this area is a high-tech and complex operation.

The rehabilitation process after prosthetics

Is hip arthroplasty easy to tolerate? Rehabilitation after surgery can be carried out in the department of physiotherapy or physiotherapy. From the first day after surgery, exercise therapy is carried out 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 performed. After endoprosthetics, patients are usually prescribed vasodilators, iv infusion, low molecular weight heparins for the prevention of thrombosis, analgesics and antibiotics. After surgery, the patient should be in the hospital for at least 5 days.

Rehabilitation after a fracture

An open or closed hip fracture is a trauma after which a long rehabilitation period is required. In this case, special therapy is performed. She is appointed 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 are special belts. With their help, he can gently change the position of the body. This avoids the formation of pressure sores. In addition, the rehabilitologist should regularly conduct breathing exercises and various exercises with the patient, which can fill the 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 digestive tract, as well as avoid persistent constipation. In addition, the patient with such an injury should not forget about the spa treatment.