Investigation of sanogenesis in hip fracture-dislocation
Keywords:fracture, dislocation, hip joint, sanogenesis, study
Background. The background of the injured hip joint is determined by the course of the reparative process, which, in turn, depends on the changes occurring in the body of the injured at the local and systemic levels as a result of trauma and further therapeutic measures. The purpose of the work is to identify the directions of sanogenesis of fracture-dislocations in the hip joint, which determine the changes resulting from trauma in the victim’s body and influence the choice of treatment tactics, the course of the reparative process in the damaged joint, the content and results of complex restorative treatment. Materials and methods. There were examined 180 patients with hip fracture-dislocations using the clinical, radiological, laboratory methods, methods of conceptual and mathematical modeling, statistical method. Results. The planning of treatment tactics should be approached from the standpoint of analyzing different mechanisms of pathogenesis after traumatic arthrosis by determining the factors of destruction and their role in the sanogenesis of traumatic injuries of the hip joint. Based on the study of biomechanical changes, the characteristics of the immune status and metabolic processes in the body of the victims, their relationship with the clinical, radiological, and morphological changes in the area of damage, a conceptual position regarding the treatment are proposed. The most significant factors that determine the course of the recovery processes are highlighted: structural damage to the cartilage covering, acetabular subchondral bones and the head of the femur; damage to the articular bag of the hip joint; damage to the muscles of the pelvic girdle; changes in the stress-strain state in the hip joint; violation of the stability of the damaged hip joint; local post-traumatic osteoporosis; reactive inflammation in the damaged joint; regeneration of the connective tissue in the damage focus; pathogenic factors due to treatment. The priority directions for solving the problem are to improve the diagnosis of fracture-dislocations in the area of the hip joint and to study pathological changes in the body of victims in different periods after trauma to substantiate the criteria for a differentiated approach to the choice of treatment tactics. The directions and content of pathogenetic treatment of hip fracture-dislocations depend on the type of damage to the hip joint and the duration of the injury. Conclusions. The main points of the treatment program for fresh injuries are the elimination of hip dislocation, restoration of stability of the hip joint, optimization of the mode of functional unloading of the joint, functional rehabilitation treatment, drug correction of the reparative process.
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