False joint is a common disorder in which connective tissue appears at the fracture site. Because of this, the damaged area acquires pathological mobility, which causes serious discomfort for the patient.
This problem can be either primary or secondary. Most often, it occurs against a background of malnutrition during intrauterine development. With an acquired false joint, pathology develops due to an abnormally fused fracture.
The most important classification of false joints is to determine the nature of its appearance: it can be acquired and congenital. It is possible to recognize a congenital form of pathology only after the child begins to move actively.
Congenital pseudarthrosis is rarely diagnosed, in the vast majority of cases occurs in the lower third of the leg. The acquired form of pathology occurs when the broken bone is improperly fused.
The following groups of reasons can provoke this phenomenon:
- Errors made during the treatment – incomplete combination of fragments or elimination of tissue clamped by fragments, improper immobilization;
- The severity of the injury – the formation of a false joint occurs with the loss of part of the bone, suppuration, crushing of a piece of muscle tissue;
- Anatomical and physiological features – disturbances in blood circulation and trophism adversely affect the strength of tissues, interfere with healing.
Lack of vitamin complexes in the body can provoke the development of an acquired false joint. Vitamin D deficiency negatively affects the speed of bone repair. The risk of a false joint increases significantly with a fracture in pregnant women and people with hormonal disorders or a nervous system disorder. It is very important to conduct an extended diagnosis and determine the cause of such a pathology.
The exact signs of a false joint depend on where it is located. However, such a neoplasm can be recognized by general manifestations that are characteristic of any area. You can diagnose the deviation by:
- Impaired gait;
- Pain at the fracture site;
- Deformation of a damaged limb;
- Impaired functioning;
- Unnatural bending of the arm or leg;
- Decreased muscle tone, tissue atrophy;
- Inability to hold an item in one position with both hands;
- Swelling of the damaged area;
- Limited mobility;
- The increase in the amplitude of motion;
- Lack of discomfort during palpation.
The easiest way to diagnose the acquired form of a false fracture is when a person immediately notices changes and consults a doctor. It is possible to identify this pathology in children only after they begin to move actively.
In order to choose the most suitable tactic for treating the pseudarthrosis, it is necessary to conduct an extended differentiation. First of all, it is necessary to determine the reasons for this change. Depending on this parameter, congenital and acquired false joints are distinguished. The latter are divided into traumatic and pathological.
The most important classification is the division of neoplasms according to symptoms. Allocate a false joint:
- Emerging – it is possible to diagnose it until the full formation of a false joint. An X-ray examination clearly defines the boundaries of the fracture and bone marrow. It differs by the appearance of pain during palpation.
- Fibrous – at the ends of the damaged bone, fibrous tissue accumulates, which is clearly visible on CT. This condition can be recognized by the limited mobility of the joints.
- Necrotic – occurs after injuries or fractures that are highly likely to develop necrosis. Most often occurs with damage to the femur or talus.
- Pseudoarthrosis of bone regenerate – occurs with the development of tibia osteotomy, its insufficient immobilization or muscle strain.
- True – is formed on one bone due to its excessive mobility. Hyaluronic cartilage forms at the tip, and with time a periarticular bag with flu >
When assessing the course of degenerative processes, uncomplicated and infected false joints are distinguished. In the first case, the disease proceeds without the formation of pus and the inflammatory process, in the second – the infection joins, there are signs of infection of the body.
Features of congenital false joints
The false joint in children is a rare phenomenon that occurs in 1 child per million. Such a complex disease requires immediate correction. The cause of this pathology is a violation of the development of the bone skeleton during development in the womb. Congenital pathology can be of two forms:
- True – diagnosed immediately after birth during the first examination.
- Latent – signs of pathology are hidden, symptoms of sclerosis appear after birth. Over time, a portion of the bone is broken, a gradual formation of a false joint occurs.
Dislocation of the hip joint can contribute to the manifestation of pathology. The first signs of a latent form of deviation occur after the child begins to move actively. As the load on the bone skeleton increases, such a joint breaks, which leads to serious complications. Recognize the symptoms of a congenital false joint by:
- Excessive mobility of the limb;
- Manifestations of atrophy of muscle tissue in a specific place;
- The transfer of body weight on one leg, since the child cannot fully step on the pathological limb;
- Disproportionality of limb size.
Unambiguously determine the false joint will allow only an extended diagnostic examination. With its help, the specialist will accurately say what provoked the deviation. After that, he will prescribe an effective and safe treatment.
With an integrated approach, diagnosing a false joint is quite simple. To do this, contact a qualified traumatologist. He will collect a detailed history, after which he will send the patient for an extended diagnostic examination. First of all, he needs to find out if the patient has fractures, how long they healed, how long the bones were restored. If the pseudoarthrosis was diagnosed before the moment of complete formation, getting rid of it will be much faster.
To confirm the diagnosis, the patient must undergo direct and lateral radiography. In especially advanced cases, an additional study of the joint in oblique projections is prescribed.
On an x-ray, a specialist will be able to determine the smoothing and rounding of bone fragments, the absence of corns. It is possible to diagnose a false joint by the formation of a locking plate in a pathological place. With a detailed study of such a formation, the specialist determines the narrowing of the bone fragments, as well as the thickening of the fragments. With proper bone fusion. One fragment becomes concave, the other convex.
To get rid of the pseudoarthrosis, it is necessary to comprehensively approach the solution of the problem. All procedures should be prescribed only by a qualified attending physician. It will help restore the continuity of bone tissue, save a person from the deformations that have occurred. Thanks to this limb will be able to return its physiological functions. In determining the tactics of therapy, it is necessary to take into account the nature of the formation, as well as the individual characteristics of the body.
It is important that the treatment includes the following activities:
- General therapeutic actions – allow you to restore muscle tone, help strengthen the entire body. They are necessary for the accelerated healing of a damaged limb. They consist of various physiotherapeutic procedures: acupuncture, mud therapy, waxing, magnetic therapy, UHF, exposure to currents, massage.
- Local influences – promotes activation of recovery processes, accelerates the regeneration of the skin and the healing of a fragment. The use of medications contributes to the normalization of blood circulation, the prevention of purulent complications. This helps to reduce the rate of degenerative processes.
- BWW – helps to reduce the distance between damaged fragments, to get r >
The choice of certain tactics for treating a false joint depends on the type of lesion.
If the formation has managed to fully form, then it is impossible to do without surgical intervention. Such operations are not performed in childhood, since bone tissue is actively growing during this period. Typically, interventions are prescribed after the age of 14 years, as growth may require additional surgery to replace the metal plate. With an integrated approach and following the doctor’s recommendations, getting rid of the pseudoarthrosis will turn out without surgical intervention.
For successful treatment of the disease, you need to consider some features:
- When a periarticular bag appears, BWW is performed;
- If the pseudoarthrosis occurs on the femur, intramedullary osteosynthesis is prescribed to the patient;
- With pseudarthrosis of the tibia, a closed type of compression-distraction osteosynthesis is prescribed;
- Pathology on the radial bone requires hardware traction and bone grafting;
- When the radius of the forearm is damaged, hardware distraction and bone grafting are performed.
Therapy of the false joint involves a long rehabilitation period. It is necessary for restoration of blood circulation, normalization of tissue nutrition, as well as accelerated healing of damaged tissues. Of the greatest importance are the following procedures:
- Therapeutic gymnastics – allows you to return the body to its usual activity, contributes to the gradual increase in muscle tissue.
- Massage – accelerates blood circulation, so the recovery process proceeds faster.
- Physiotherapeutic procedures – allow you to speed up the recovery process, relieve soreness and discomfort.
- Herbal medicine – treatment with medicinal herbs. The use of various decoctions and infusions favorably affects the entire body, contributes to a more rap >
When organizing recovery in the elderly, the number of physiotherapeutic procedures and exercise therapy is reduced – it is important not to overstrain the body. Accelerate healing will help the intake of various vitamin complexes. They improve blood circulation, increase trophism and nourish the body with useful trace elements.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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