Traumatic injuries of bones metatarsals and phalanges of the foot
Hock is a part of the foot between the tarsus and the phalanges of the toes. In humans, it consists of five bones. They have a base, body and head.
Fractures and dislocations of the metatarsal bones are found at up to 2%. They occur most often due to direct trauma: a blow to the foot, drop a heavy object on the stack. Chance and indirect mechanism of injury: a fall from a height on foot, tucking the foot. Metatarsal bones are connected by very strong ligaments, so that a fracture or dislocation of one of them leads to a dislocation of the rest.
There are fractures of the bones of the base, their body or head. Trauma is considered to be severe. It is accompanied by significant bleeding, swelling and changes in the shape of the foot. Further consequences of fracture or dislocation of the metatarsal bones affect the function of distance. If the dislocation of metatarsal bones remained nevpravlennym, the patient will disturb the constant movements of the foot pain.
When fractures and dislocations of bones metatarsal pain in a patient concerned about the foot, the violation of the foot support, inability to stand up to "socks." In the area of the fracture edema and hemorrhage. Clarify the diagnosis with X-ray examination, with special packing of the patient.
Treatment of fractures of the metatarsal bones and dislocations
Performed anesthesia. When fractures and dislocations of bones metatarsus conservative treatment is ineffective, since there is always the danger of bias. Only stable injuries, which are bundles of the gap between the bones of the paw, treated by applying a circular plaster cast.
Use a closed mapping (reduction), metatarsal bones and fixing them by means of spokes, which are inserted through the skin. If it is impossible to compare fragments or right dislocation, surgical treatment is carried out. Timing of surgical treatment – 1-2 weeks, but no later than 1.5 months after injury. This deadline is necessary in order to reduce the swelling of tissues in the area of injury.
Reveal the fracture zone, compare fragments, reduce a dislocation, and fixation is carried out by means of spokes or screws. Then a plaster bandage for up to 6 weeks. Stepping foot on the affected patient is prohibited. After 6 weeks of starting to walk, and the cast is modified. This is called a cast with the "heel". After 3 months of the spokes removed, and after 4 months of the screws. After that, we recommend wearing orthopedic shoes and orthopedic insoles. Sometimes there is a fracture of the fifth metatarsal bone at a distance of 5 cm from its base. The mechanism of injury – a blow to the side of the foot of the little finger. This change is called a fracture Jones.
Treatment of fracture is the imposition of the cast from the toes to the middle third of the leg for 7-8 weeks. Stepping on the damaged leg the patient is prohibited. When tucking the foot can occur inside the gap between the base of the fifth metatarsal bone due to enhanced propulsion short peroneus longus, which is attached to it. This change is called psevdodzhosovskim fracture. Treatment of fracture similar to Jones. With a significant displacement of the fragments perform surgery or removal of fragments.
Fractures of the phalanges of the foot often occur as a result of direct trauma – impact on the fingers, a heavy object falling on his fingers. These fractures are often open. There are fractures of the nail, the middle or main phalanges. Fractures of the nail and middle phalanges do not affect the function of the foot.
Fractures of the phalanges at their core adhesion of the wrong lead to degenerative processes in the metatarsal-phalanx joint pain, stiffness of their appearance, followed by pain and difficulty walking. Separately isolated fractures of the phalanges of the thumb, which occur most frequently. Patients complain of pain, swelling, bleeding in the affected finger. Movement of a finger sharply painful. The pressure along the axis of the finger causes pain. When fractures of the nail phalanx of subungual hemorrhage usually occurs with the formation of hematoma and severe pain. Refine the diagnosis of X-ray examination.
Treatment of fractures of the phalanges. Spend the fracture analgesia. If the bias is not found on the foot plantar plaster splint is applied for up to 8 weeks. If you hold a closed shift mapping of fragments with subsequent fixation of Kirschner spokes.
Fractures of the nail phalanx usually do not require special treatment, since the bone fragments are usually well fixed nail plate. Their record with the patch to the adjacent phalanx, after removing the subungual hematoma by perforation of the nail plate.
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