False joint: signs, causes of education, treatment of congenital and acquired false joint

In this article you will learn symptoms and treatment of a false joint.

Content

The false joint is a pathology of bone integrity and the formation of mobility in an uncharacteristic area for it. The disease has another name - pseudo -arthrosis. A distinctive feature It is - the maneuverability of the tubular bone in the wrong place. Perhaps violation of the limb.

If the pathology is formed in one of the paired bones - mobility may not be observed. With this violation, you can notice deformation of the limb, a change in its usual size. Pain sensations are rarely accompanied by this violation. Usually it is detected - if the false joint is formed in the lower limb.

The causes of the false joint

There are congenital and acquired false joints.

The congenital false joint is formed during pregnancy at the time of the formation of the skeleton in the embryo - neurophysiological disorders and anatomical disorders occur. Pathology is found during the first steps of the child. This type of disease is rare and is formed, as a rule, in the area of \u200b\u200bthe lower leg and its lower part. The false joint with a fibrous anomaly occurs due to the presence of the formation of malignant tissues of the bone that do not have the opportunity to perform support actions.
In post -traumatic education - the false joint acts in the form of a form of incomplete bone restoration. The inhibited association is conditionally distinguished - it is not observed during diagnosis of bone fusion within the normal range. In this case, after the fracture, a double average term may pass, which is necessary for its fusion, but there will be no signs of the connection. With this diagnosis, the complete fusion of the bone is impossible and surgical intervention is required.
The causes of the false joint are caused by local and general factors.

Local reasons are divided into groups:

The first group includes the occurrence of pathology as a result of improper treatment - an erroneous combination of bone parts, weak fixation of the limb when fused the fracture, insufficient removal of damaged tissue.
The second group includes reasons related to the degree of complexity of damage - the occurrence of a false joint when the large part of the bone or suppuration is lost, extensive damage to the muscle zone.
In the third group, violations are considered due to poor blood supply to the bone - a decrease in the density of bone corns, deviations in the process of bone tissue.

The appearance of a false joint can provoke a number of such causes as: deficiency of fat -soluble vitamins for vitamin deficiency, chronic diseases and impaired nervous system, hormonal deviations.

Congenital false joint

Congenital false joint - The result of a rare and complex intrauterine disease, such a pathology has 0.5% of other orthopedic deviations.

Pathology is divided into groups: false joints based on a fibrous anomaly, hereditary or congenital deviations. The disease is expressed in two types: a true false joint and hidden.
With a true false joint, angular curvature, maneuverability of fragments, the damage zone are shortened. Asymmetry and visual difference between the length of the limbs is visible - up to 10 cm.
Defects lead to insufficient development of the small bervice and ankle joint. Latent is characterized by curvature with signs of sclerosis in the lower third of the bone.
At first, the bone, at the birth of a child, is a whole, then a fracture forms in the place of pathological destruction - as a result, a false joint occurs at the fracture site. X -ray allows you to identify false tight or moving joints.

If the false joint is tight, hypertrophied parts with a phenomenon of sclerosis and osteoporosis are observed above or below this zone. In the case of a movable false joint - a bone at the ends sophisticated with signs of osteoporosis, in the area of \u200b\u200bsclerosis is manifested at a minimum level.
In two forms of pathology, angular curvature in the affected area is possible. When false joints are shook, their mobility is clearly manifested. For tight false joints, minor swaying movements are characteristic.

Acquired false joint

It occurs as a result of complication and improper fusion of the bone.

The formation of pathology increases in the presence of soft tissue bones between the fragments, if the distance between the parts is increased, in case of violation of the bone fixation and insufficient immobilization, early loads during the rehabilitation period.
The gap between the parts of the bone is filled with connective tissue. The structure of the false joints changes with a long existence - cartilage is formed at the ends of the bone. The mobility of parts increases.
In the slotting gap, a joint cavity is formed covered with a shell and filled with synovial fluid. The diagnosis is established when an X -ray passes in a direct and lateral projection. Sometimes an x \u200b\u200b-ray of oblique projections is required for a more accurate diagnosis. At the same time, it is found that there is no bone callus, the ends of the fragments are rounded and smoothed out, closed cavities formed at the ends of fragments of the tubular bone.

The X -ray also shows the narrowed ends of the fragments with the atrophic false joint, the shape of the gap is observed in the hypertrophic false joint, the ends of the fragments are thickened. When identifying a true false joint, the ends acquire a different shape from each other - convex and concave. The disease appears, first of all, when the integrity of the vessels appears - the access of nutrients to the ends of the bone fragments stops, after which necrosis forms in the fracture zone. The false joint can form with an anomalous fracture. In standard fractures, a common complication is a non -unhoice with the formation of a false joint in a scaphoid bone, then - the neck of the thigh.
It is not easy to diagnose, especially if the small bones are damaged and in the area of \u200b\u200bthe true joints, a violation of the integrity of one of the bones of the forearm or lower leg, while the other bone remains intact. The diagnosis of the false joint implies - the exclusion of traditional treatment and the appointment of surgical intervention.

Treatment of a false joint

The occurrence of a pathology of the false joint is more often found in middle and elderly people and extremely rarely in childhood.

With an innate false joint

Congenital false joint is not amenable to conservative methods of treatment. It has a predisposition to relapses, which leads to numerous operations.

Treatment may not give effective results and then experts are forced to resort to amputation of the damaged limb - according to statistics in half of cases, such a disease has such an outcome. Efficiency in the treatment gives the use of the method of submersible and external bone compound: so with a low mobile violation to the Ilizarov apparatus, the bone stretching applies to straightening the curvature until its disappearance is installed.
In the case of shuttered false joints, bilocal osteosynthesis is prescribed: it includes several stages of treatment - the connection of fragments and the plastic surgery of the bone. Despite the effectiveness, the recovery procedure is one of the complex in the treatment of pathology, has disappointing statistics and is designed for a long period up to 2 years.
Treatment should take place in the complex: surgical intervention, physiotherapeutic procedures, the use of medications. This contributes to the normalization of blood flow and tissue nutrition in the pathology zone.

With the acquired false joint

It needs exclusively in the operational method of treatment. In the presence of an inflammatory process, anti -inflammatory drugs are prescribed.

The scar region is eliminated in the joint zone - by transplanting the full part of the skin. Further, in the absence of contraindications, an operation on the bones is carried out: the ends of the bones are connected using knitting needles fixed crossroads in the Ilizarov apparatus.
Suppose a temporary connection of bone fragments using special devices that allow the patient to move freely, based on the limb. Fixation is carried out by the same Ilizarov apparatus and allows you to eliminate the displacement of bone parts during movement.
With a complication of pathology, it is recommended to excise the ends and the implementation of the bone plastic surgery. To avoid the development of a false joint, it is necessary to adhere to the doctor’s recommendations, reliably fix the fracture site. Do not remove gypsum earlier and do not make excessive loads on the area of \u200b\u200bdamage.