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The national textbook in accordance with the curriculum approved by the Ministry of Health of Ukraine and the Ministry of Education and Science of Ukraine covers modern views on etiology, development mechanisms, principles of diagnostics and treatment of injuries and diseases of the apparatus of movement support. There is presented a modern view on the pathogenesis of traumatic disease, bone tissue regeneration, common complications, methods for prevention and treatment. Taking into account changes in the structure of injuries, special attention is paid to the issues of combat damages, the organization of stage care for polytrauma, spine, pelvis, limb injuries, and restorative treatment of patients with musculoskeletal injuries. Details include widespread congenital deformities, degenerative-dystrophic, inflammatory and tumor diseases of spine and joints.
The publication is intended for students of higher medical educational institutions, interns, clinical residents, doctors in sports medicine, traumatologists-orthopedists and surgeons.
Національний підручник підготовлений відповідно до навчальної програми, схваленої Міністерством охорони здоров’я України та Міністерством освіти і науки України охоплює сучасні погляди на етіологію, механізми розвитку, принципи діагностики і лікування травм і захворювань апарату руху та опори. У підручнику представлено сучасний погляд на патогенез травматичного захворювання, регенерацію кісткової тканини, поширені ускладнення, методи профілактики та лікування. Враховуючи зміни у структурі травм, особлива увага приділяється питанням бойових ушкоджень, організації стадій догляду при політравмах,травмах хребта, таза, травмах кінцівок та відновлювальному лікуванню хворих з травмами опорно-рухового апарату. Детально розглядаються поширені вроджені деформації, дегенеративно-дистрофічні, запальні і пухлинні захворювання хребта та суглобів.
Видання призначено для студентів вищих медичних навчальних закладів, інтернів, клінічних лікарів, лікарів спортивної медицини, травматологів-ортопедів та хірургів.
CONTENT Introduction ....................................................................5
List of abbreviations.....................................................6
The history of development of traumatology and orthopaedics..........................................................7
The establishement of traumatology and orthopaedics as part of general surgery ...........8
Traumatology and orthopaedics as independent surgical discipline......................... 10
1. The introduction to the specialty. The features of clinical examination of traumatic and orthopaedic patients. Ligaments, tendons and muscles injuries. Traumatic dislocations... 17
1.1. Methods of clinical examination in traumatology and orthopaedics............... 17
The procedure of examination of patients with musculoskeletal system traumas........ 18
Procedure of examination in orthopaedics diseases and musculoskeletal trauma consequences....................................................... 24
Features of examination of children with traumas and orthopaedic diseases............... 42
Additional methods of investigation in traumatology and orthopaedics................... 45
Diagnosis establishment.................................. 50
1.2. Injury of ligaments, tendons and muscles 51
1.3. Dislocations.......................................................... 57
Tasks and tests............................................................. 69
2. Traumatic disease. Multitrauma. Modern principles of medical aid supply during fractures.......................................................... 73
2.1. Multitrauma.......................................................... 73
Clinical presentation.......................................... 74
Estimation of the trauma severity................. 78
Treatment.............................................................. 80
2.2. Modern principles of aid in fractures.......... 87
Classification of the fractures.......................... 87
Clinical signs of fractures ................................. 88
Methods of treatment of fractures.............102
Open fractures...................................................109
Gunshot fractures of long bones.................110
Compartment syndrome of the extremities126
Traumatic osteomyelitis.................................129
Tasks and tests...........................................................133
3. Amputations of the extremities. Rehabilitation and prosthetics of disabled persons with defects of the extremities. Treatment of traumatological and orthopedic patients in outpatient conditions..........................137
Indications for amputation............................137
Methods and techniques of amputations138
Rehabilitation and prosthetics of the disabled patients with defects of thier extremities............................................................. 139
Prosthetics of upper extremities.................143
Lower extremities prosthetics......................145
Treatment of traumatological and orthopedic patients in outpatient conditions......................147
Tasks and tests...........................................................149
4. Injury of bones and joints of the upper extremity ...........................................152
Fractures of the scapula..................................152
Fracture of the clavicle....................................154
Dislocation of clavicle......................................156
Shoulder dislocations......................................158
Fractures of the humerus...............................161
Dislocations of the forearm...........................169
Fracture-dislocations of the forearm bones173 Fracture of radius in a typical site................174
Tasks and tests...........................................................180
5. Injuries of the spinal cord and pelvis............184
5.1. Injuries of the spinal cord..............................184
Causes and mechanisms of spinal injuries 184
Сlassification of spinal injuries.....................185
Traumatology Orthopedics Injuries of the cervical part of the spine....188
Injuries of the thoracic and lumbar parts of the spine..........................................................190
Diagnostics of spinal injuries........................190
Treatment of spinal injuries...........................193
5.2. injuries of the pelvis........................................198
Classification and mechanogenesis of pelvic injuries.................................................198
Diagnostics of pelvic injuries........................200
Treatment of the pelvic injuries...................202
Tasks and tests...........................................................207
6. Injuries of bones and joints of the lower extremity .....................................................................211
Fractures of the proximal part of the femoral bone ......................................................211
Hip luxation.........................................................219
Injuries of knee joint menisci and ligaments223 Rupture of the knee joint ligaments..........228
Shin luxation.......................................................232
Shin bones fractures........................................234
Tasks and tests...........................................................254
7. Degenerative-dystrophic diseases of joints and spine....................................................257
7.1. degenerative-dystrophic diseases of joints257 Osteoarthritis......................................................257
Avascular necrosis............................................280
Cystic restructuring of the articular bones..286
7.2. Degenerative-dystrophic diseases of the spine.................................................................288
Osteochondrosis...............................................288
Deforming spondylosis and spondyloarhtrosis.............................................297
Spondylolisthesis..............................................299
Spinal stenosis....................................................302
Tasks and tests...........................................................304
8. Congenital deformations of the spine, bones and joints. Scoliosis.................................................308
8.1. congenital defects and deformations of the musculoskeletal system............................308
Congenital myogenic torticollis..................308
Congenital myogenic clubfoot....................312
Developmental dysplasia of the hip joint 317
Congenital hip dislocation ............................319
8.2. Posture and its impairments........................325
8.3. scoliotic disease (scoliosis)............................328
8.4. kyphotic deformation of the spine............334
Tasks and tests...........................................................336
9. Inflammatory, tumorous and tumor-like diseases of the musculoskeletal system ..........340
9.1. Tumorous and tumor-like diseases of the musculoskeletal system............................340
Benign bone tumors........................................343
Malignant bone tumors..................................349
Tumor-like bone diseases..............................352
9.2. Inflammatory diseases of the musculoskeletal system.........................................355
Tasks and tests .........................................................381
Key answers................................................................385
Attachments...............................................................386
References...................................................................399