DISTORTION (Latin. distortio curvature) — stretching, a partial rupture of the copular device of a joint.
Belongs to the closed injuries of joints and arises owing to the indirect appendix of the injuring factor at the sudden and sharp movement in the increased volume or the direction, unusual to this joint. More often one of segments of an extremity carries out a role of the lever, the effort, napr is made for Krom, the sole weight of a body, and other segment of an extremity at this moment is in strictly fixed situation. At such mechanism of an injury the copular device of a joint perceives big loading, on size the cut also depends a damage rate of sheaves — on simple extension with a partial rupture of fibers to a complete separation, is frequent with a separation of a bone tissue at the place of an attachment of a sheaf.
Are most subject side ligaments of joints since the volume of their movements, as a rule, always insignificant. Meets preferential in large joints, especially lower extremity — knee and talocrural, is more rare in joints of an upper extremity — elbow and radiocarpal. Represents a widespread type of a home and sports injury.
Is the main reason for D. podvertyvany extremities at the awkward movement, napr, feet or shins on a slippery surface, forearms or brushes during the falling arm-distance.
Is followed by injury of small nerves and vessels with moderate hemorrhage in surrounding soft tissues and a cavity of a joint with development hemarthrosis (see) in cases of simultaneous damage of the capsule of a joint.
The clinical picture
is characteristic Of D. the puffiness of tissues of the injured joint which is most expressed in an affected ligament, morbidity at a palpation, the active and passive movements and also instability of a joint.
Diagnosis it can be put only after a X-ray analysis of a joint for an exception of other damages. In particular, make pictures with violent reduction or assignment of an extremity for an exception of a complete separation of sheaves. Sometimes the contrast research of a joint helps. Should differentiate from a bruise of a joint, a complete separation of sheaves and a change.
Is carried out an immobilization of the injured joint. Depending on D.'s localization apply different soft bintovy bandages to an immobilization, in hard cases — longetny or circular plaster bandages. The immobilization proceeds from 1 to 3 week depending on localization and a damage rate. In the presence of a hemarthrosis the puncture of a joint with removal of the streamed blood is shown.
After the termination of an immobilization carry out massage, physical therapy and to lay down. gymnastics for recovery of function of the injured joint. For reduction of hemorrhage and hypostasis and removal of pains use bandages, the novocainic blockade, ethyl chloride cooling lotions or bubbles with ice, a cold water. Extremities give sublime situation.
Sometimes after D. for quite long time instability of a joint remains that is connected with weakening of the copular and muscular device. In these cases the joint is strengthened bandaging by an elastic roller or elastic cuffs. Apply also massage of the next muscles and special gymnastics. Of separate joints — see articles according to names of joints (e.g., Ankle joint , Knee joint etc.).
Bibliography: Ya. G. Posobiye's oak groves on traumatology, M., 1973, bibliogr.; Kaplan A. V. The closed injuries of bones and joints, M., 1967, bibliogr.; Mironova 3. Page and Heifetz L. 3. Prevention and treatment of sports injuries, M., 1965; About d and N about in D. E. and Shabanov of A. N. Hirurgiya of the ambulatory doctor, M., 1973, bibliogr.; Watson-Jones R. Fractures of bones and injury of joints, the lane with English, M., 1972.
E. Ya. Dubrov.