Hip contracture — symptoms, treatment and complications
Motion limitation or a contracture of the hip joint
Hip contracture – restriction of mobility in the hip joint.
The mechanism of development of contractures main cause is cicatricial contraction of the tendons, joint capsules. Skin retraction is possible due to the formation of burn scars.
The contraction of the subcutaneous tissue occurs due to prolonged inflammatory it purulent processes. Long wearing cast, it may cause atrophy of the muscles and myogenic contractures.
With the defeat of the nerves perhaps the appearance of neurogenic disorders. In chronic inflammation it progresses gradually.
The reasons why there is a contracture of the hip joints (TZB):
- the decrease in the length of the muscles of the joint;
- loss of elasticity of ligaments;
- the presence of bone deformation of the joint due to arthritis or arthrosis;
- damage and inflammation that cause destruction.
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Types of violations:
- congenital — usually the result of hereditary defects;
- acquired — occurs under the influence of unfavorable external environment.
If there is any form of lesion contracture can cause complete immobility.
Position dependent, which remains the foot as a result of movement restrictions, isolated flexor, extensor, adductor, abductor and rotational contracture of the TZB.
Basically, the most frequently observed societally contractures.
Symptoms and diagnosis
The beginning of the development of the lesion goes unnoticed for the patient, because it does not manifest itself. And with existing contracture there is pain in the region of the diseased joint, feeling some of the obstacles when moving.
Constant and emblematic of the articular variances is a decrease in muscle volume. Also, on later stages the lesions may occur deformation of the damaged joint.
The limitation of hip joint in infants is manifested by shortening of the patient’s feet.
The diagnosis is based on measurement of range of motion.
Certainly x-rays is assigned to the corresponding part.
Other additional studies depend on the nature of the violation that triggered the restriction of movement. Passive contractures of the patient sent for MRI or CT of the joint.
Neurogenic is necessary to consult a neurologist, may exercise electromyography and other tests. If you suspect inflammation appointed visiting surgeon, rheumatologist, etc.
The features of pathology of newborns
This deviation is characterized by failure of formation of parts of the joint, as well as the underdevelopment of its individual parts. Congenital disorders of formation of the hip joint brings together a wide range of conditions from dysplasia to dislocation of the hip.
Illiterate and untimely treatment of disorders of the hip joints in children can cause severe consequences and even disability.
In children with a hip dislocation, even when medical treatment greatly increases the risk of coxarthrosis, contractures, avascular necrosis and other disorders, the treatment of which required surgery.
The occurrence of congenital lesions is associated with immaturity of the connective tissue of the joint and the imbalance of maturation, characteristics of childbirth and the postpartum period, as well as with the sex of the child.
The main task of the doctor as early as possible to identify a violation and to begin treatment. It must begin from the first days of life.
The sooner treatment is started, aimed at the full development of the joints of the hips, the less it will last. Not be discounted that if left untreated can become redviva subluxation and dislocation, treatment without surgery is impossible.
If the inspection revealed adductor contracture, and ultrasound confirms subluxation and dislocation, it is recommended to start treatment using Pavlik’s stirrups.
These children may have arthritis, pain in the operated joint, the girls in the future will have problems in childbirth.
Any load may cause problems in the joint, lameness, contractures, reduction, or limitation of motion of the hip joint.
In any case, the baby is disabled since childhood, the risk of complications will affect the whole of his subsequent life.
The treatment of contractures
The main goal of physicians is to neutralize the swelling, inflammation, and normalize the movement of the joint. Successful treatment is possible with timely treatment to the doctor.
This violation requires conservative and surgical treatment. During conservative treatment is carried out:
- drug blockade;
- manual therapy;
- drug treatment with hormones, and analgesics;
- physical therapy;
- therapeutic massage;
The main stages of development:
- In the early days of samoregulyacii allowed wiggle in the joints of patients within the acceptable range with a small force, gradually increasing the amplitude of oscillations.
- Enhanced development of contractures should start a month after the beginning of samoregulyacii.
- Wounds and trophic ulcers on the extremities is not a reason for refusal of the development.
- Development in the limbs comes from the larger joints to the smaller ones.
- Hip joints work out all possible freedom of movement, over time, achieving the maximum amplitude.
By the time the enhanced development of the legs should be restored trophism, blood flow. It is desirable to remove the plates that were used for fusion, since the plates themselves can provoke the compression of muscle fibres and provoke a disease.
Chronic patients the activation process can cause torn ligaments and even broken bones.
Excessive rotational movement in the hip joints may cause hip fractures in people with osteoporosis.
Exercises for the hip joint:
- Lying on the back, holding hands tied to the headboard of the bed cord. The transition to semi-sitting and sitting position. Slowly (6 times).
- On the back. Motion in a circle straight leg. Slowly (8 times).
- On the back, holding hands on the bed: lifting direct feet one at a time; slowly (8 times); the circular movements of the right and left leg. Slowly (5 times).
- On the side, leg on top. The splaying of the legs. Slowly (8 times).
- Standing sideways to the bed, drawing on her hand: the rise of the feet forward and bringing back. Slow (10 times).
- Standing, toes together. Tilt forward, trying to reach the floor with your fingers or palms. With the average speed (16 times).
Consequences and complications
Without timely proper treatment of such lesions of the joints leads to its immobility. Disease this stage is eliminated only by surgery.
If the lesion is not treated, it can cause stiffness and even ankylosis. Often the process involved adjacent joints.
Contracture has very serious consequences in diseases and injuries of the joints.
Indeed, in these cases, often there is a loss of the soft tissues around the sore joint. If the contracture occurred in childhood, NEGP may lag in growth.
Thus, the most likely result of contractures, neglected, — disability.
To carry out the prevention of the joint contracture easier than to treat it. The main preventive measures are:
- the correct position of the leg and the joint in the restraint;
- any competent treatment of the joint damage;
- the use of splints and orthoses if necessary;
- development of the knee after a leg injury.
The prognosis for treatment depends on the nature of pathology and its type, the time from the moment of occurrence, age and condition of the person, the usefulness of the treatment.
Early treatment helps to achieve significant results.
Comprehensive treatment using the achievements of medicine at the dedication of the patient may give positive results.