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False joint – the pathological state which is followed by violation of a continuity of a tubular bone and emergence of mobility in departments unusual for it. The false joint can have the congenital and acquired (post-traumatic) character. Often it has a malosimptomny current, is shown by existence of mobility in the unusual place and pain at a support on the affected extremity. The false joint by results of a radiological research is diagnosed. Treatment is generally surgical. Operation of an osteosynthesis is performed, and at its insufficient efficiency - bone plasticity.

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False joint

False joint – the pathological state which is followed by violation of a continuity of a tubular bone and emergence of mobility in departments unusual for it. The post-traumatic (acquired) false joints develop after 2-3% of changes, are most often formed on a tibial, beam and elbow bone, is more rare – on humeral and femoral. The congenital false joint is localized on shin bones, makes 0,5% of all congenital anomalies of the musculoskeletal device.

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Classification

On an etiology:
  • acquired;
  • congenital.
By the form:
  • fibrous false joints without loss of bone substance;
  • true (fibrous );
  • false joints with bone defect (loss of bone substance).
As formation:
  • normotrofichesky;
  • atrophic;
  • hypertrophic.
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Reasons

The acquired false joint – the complication after a bone fracture caused by violation of process of an union of otlomk. The probability of development of pathology increases at introduction of soft fabrics between otlomka, considerable distance between bone fragments, insufficient or early the stopped immobilization, premature loading, local violation of blood supply and suppuration in the field of a change. The risk of developing of pathology increases at metabolic disorders, endocrine and infectious diseases, violations of blood circulation owing to shock or blood loss, multiple fractures, the severe combined injury, violations of an innervation in a change zone.

At the acquired false joints the crack between bone fragments is filled with connecting fabric. Structure it is long the existing false joints gradually changes. The ends of otlomk become covered by a cartilage, become more mobile. In the field of a crack the articulate cavity covered with the capsule and filled with sinovialny liquid is formed. Violation of food and innervation of the corresponding segment of an extremity in the pre-natal period is the reason of development of congenital false joints. The struck area is filled not until the end of the created bone tissue which cannot sustain load of an extremity.

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Symptoms

The acquired false joint arises on the place of a change, is followed by more or less expressed mobility of a bone in the unusual place. If the false joint is formed on one of two bones of a segment of an extremity (for example, on a beam bone at whole elbow), symptoms can be absent or be poorly expressed. The palpation is, as a rule, painless, considerable loading (for example, the support on a false joint of the lower extremity) usually is followed by pain. The congenital false joint is characterized by more expressed mobility. Pathology comes to light when the child learns to go.

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Diagnostics

The diagnosis is exposed by the traumatologist on the basis of the anamnesis, a clinical and radiological picture, and also time which passed from the moment of a trauma. If there passed the average term necessary for an union of this type of a change, speak about the slowed-down consolidation. In case the average term of an union is exceeded in two and more times, the false joint is diagnosed. Such division in traumatology is rather conditional, but, at the same time, is of great importance at the choice of tactics of treatment. At the slowed-down consolidation there is a chance of an union. When forming a false joint the independent union is impossible.

For confirmation of the diagnosis the X-ray analysis in two (direct and side) projections is carried out. In certain cases do roentgenograms in additional (slanting) projections. In pictures lack of a bone callosity, smoothing and a curve of the ends of bone fragments, emergence of a switching plate on the ends of otlomk comes to light (closing of a cavity in the center of a tubular bone). On the roentgenogram of an atrophic false joint conic narrowing of the ends of bone fragments, in a picture of a hypertrophic false joint – a thickening of the ends of otlomk and uneven contours of a crack is defined. At a true false joint the end of one otlomk becomes convex, and another concave.

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treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!

Conservative therapy is inefficient. Operation of the choice is low-traumatic compression an osteosynthesis (imposing of the device of Ilizarov). In the absence of result carry out bone plasticity or a resection of the ends of bone fragments with their subsequent lengthening. Treatment of a congenital false joint complex, includes operation in combination with fizio-and the medicamentous therapy directed to improvement of food of fabrics in the field of defeat.

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False joint - treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!

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