Injuries. Crucial moment. Terrible injuries that cost players their careers

Traumatology is the science of damage to human organs and tissues. She is engaged in the study of injuries, its prevention, the organization of trauma care and the treatment of injuries of the musculoskeletal system.

Injury, or damage, is a sudden impact of environmental factors (mechanical, thermal, chemical, etc.) on tissues, organs or the body as a whole, leading to anatomical and physiological changes, accompanied by a local and general reaction of the body.

Damage, depending on the application of force, is divided into direct and indirect. They are isolated - with damage to one anatomical and functional formation of the musculoskeletal system; multiple - with damage to two or more anatomical and functional formations or damage to blood vessels and nerves in various segments of the limbs; combined - damage to internal organs in various cavities with trauma to the musculoskeletal system - and combined - the simultaneous presence of two etiologically heterogeneous injuries in the victim (for example, a fracture of the humerus and body burns).

The mechanical factor can manifest itself as pressure, stretching, tearing, torsional moment of application of force or counter-blow. At the same time, the force of the impact of an external factor on tissues and organs is directly proportional to the direction (directly or at an angle), speed and duration of exposure, which leads to varying degrees of injury severity. The most common injuries include bruises, wounds, dislocations, bone fractures, limb avulsions, burns, frostbite, electrical injuries, etc.

To bruises(contusio) include mechanical damage to tissues or organs, often without violating the integrity of the skin. In this case, the subcutaneous fatty tissue is destroyed, and hemorrhages occur with impaired arterial, venous circulation and lymph flow. Soft tissue edema, local temperature increase, skin redness (reactive hyperemia) occur. With bruises in the limbs involving muscles, tendon-ligamentous apparatus, joints, the musculoskeletal function is disturbed, with bruises of organs (heart, lung, brain, etc.), functions specific to these organs are violated. The severity of the bruise depends on the strength of the external impact and the localization of damaged tissues and organs.

compression(compression)- damage to organs or tissues caused by pressure from outside or from neighboring organs or tissues. A serious danger to life is the compression of the brain (hematoma, edema, tumor), heart (hemopericardium), lungs (hemothorax, pneumothorax). Long-term compression of the soft tissues of the extremities, less often of the trunk, is identified as a separate nosological group, with the syndrome of prolonged compression (crushing) or crash syndrome occurring. In its development, the main role is played by traumatic toxicosis caused by decay products and impaired metabolism of compressed or crushed soft tissues.

The severity of the condition of the victims is aggravated by the development of acute renal failure.

Wound(vulnus)- any violation of the integrity of the skin or mucous membranes under the influence of external mechanical impact or internal impact - a bone fragment. Distinguish superficial wounds and deep - with damage to large vessels, nerves, internal organs.

Dislocation(luxatio)- complete separation of the articular ends of the bones, with subluxation, partial contact of the articular surfaces remains, but with deformation of the contours of the joint and joint space (excessive expansion, uneven narrowing, etc.). Distinguish fracture-dislocation (intra-articular fracture of the dislocated end of the bone) and dislocation of the bone with an extra-articular fracture. A dislocated bone is considered distally located. A dislocation is considered fresh up to 3 days from the moment of injury, stale - up to 3 weeks, chronic - more than 3 weeks. According to the etiological basis, dislocations are divided into traumatic, habitual, congenital and pathological. traumatic dislocations occur more often with indirect trauma with forced violent movement in the joint, exceeding the amplitude of its normal movements. Habitual dislocation occurs mainly in the shoulder joint after an undertreated or improperly treated primary traumatic dislocation. Repeated dislocations can occur with varying frequency due to minimal external violent influences and even normal movements in the joint with a large amplitude. Congenital dislocation is formed as a result of dysplasia (underdevelopment) of the joint. The predominant lesion of the hip joint has been and remains a serious orthopedic problem. Pathological dislocation is the result of the destruction of the joint by some pathological process (arthrosis, tuberculosis, osteomyelitis, tumor).

fracture(fractura ossis) is called damage to the bone with a violation of its integrity. Most fractures occur under the influence of a mechanical force that exceeds the strength of normal bone. Less commonly, a fracture occurs from minor efforts (from the weight of a limb, body) and is considered pathological (in the area of ​​a tumor, cyst, inflammatory process). More often, fractures are closed, less often (1:10) - open (the fracture area communicates with the wound). If the wound arose from external violence, then the fracture is considered primary open. If the skin is perforated by a bone fragment (fragment) from the inside, then the fracture is considered secondary open. This division is of fundamental importance, since in a primary open fracture, soft tissue destruction and microbial aggression can significantly affect the surgical tactics and method of fracture treatment.

traumatism- a social phenomenon, as a result of which certain groups of residents who are in the same working and living conditions are injured. There are the following types of injuries.

I. Industrial injuries.

1. Industrial.

2. Agricultural.

II. Non-productive injury.

1. Household.

2. Outdoor:

a) transport;

b) non-transport.

3. Sports.

III. Intentional injury (murder, suicide, self-mutilation).

IV. Military injury.

V. Children's traumatism.

1. Generic.

2. Household.

3. Street.

4. School.

5. Sporty.

6. Other accidents.

work injury arises as a result industrial accident when workers are exposed to various production factors. All employees are subject to compulsory social insurance against accidents and occupational diseases.

The causes of accidents at work are divided into objective and subjective. To objective reasons conditionally include technical and sanitary-hygienic, to subjective - organizational and psychophysiological.

To technical reasons include equipment failure; uncoordinated inclusion of electricity and other energy sources; lack of fencing of the danger zone, etc.

To sanitary and hygienic reasons include poor lighting; air pollution; increased radiation, etc.

organizational reasons are the wrong organization of work; poor-quality briefing on labor protection issues; admission of unskilled workers to work of increased danger.

psychological reasons are fatigue and inattention during monotonous work; weakening of self-control; arrogance; unjustified, unjustified risk.

Up to 80% of accidents occur due to erroneous or belated actions of workers. The main cause of accidents and injuries is the risk factor. The risk is legitimate (permissible) and illegal (unacceptable).

Investigation and accounting of accidents. All accidents that occurred at work are subject to investigation:

• during the performance of labor duties, as well as actions in the interests of the enterprise without instructions from the employer;
• at the workplace, on the territory of the enterprise or in another place of work during working hours, including the established breaks;
• when putting in order the tools of production, clothing before or after the end of work, as well as for personal hygiene;
• during the journey to or from work, including on their own transport used in the interests of production;
• during accidents (fire, explosion, collapse) and their elimination at production facilities.

About an accident, as a result of which the employee, according to the medical report, lost his ability to work for one day or more, or it became necessary to transfer him to another, easier job for a period of at least one day, an act is drawn up in the form H-1.

The head of the enterprise, having received a message about the accident, by order appoints a commission of investigation in the following composition: head (specialist) of the labor protection service (chairman of the commission), head of a structural unit or chief specialist, representative of a trade union organization, sanitary and epidemiological supervision specialist (acute poisoning), authorized labor team on labor protection issues.

The owner of the enterprise approves five copies of the act in the form H-1 within 24 hours. One copy of the H-1 act, together with the materials of the investigation, is kept for 45 years at the enterprise where the accident was registered. Copies of the act are kept until the implementation of all measures to eliminate and prevent a hazardous production factor.

The fight against injuries is usually carried out in three directions:

1) prevention;

2) organization of trauma care;

3) qualified and specialized treatment.

This problem still remains one of the most acute problems in traumatology, since injuries annually claim a significant number of human lives, turn even more victims into disabled people, and thereby cause enormous moral and material damage to the state.

Traumatology and orthopedics. N.V. Kornilov

Traumatic brain injuries rank first among all injuries (40%) and most often occur in people aged 15–45 years. Mortality among men is 3 times higher than among women. In large cities, every year, out of a thousand people, seven receive head injuries, while 10% die before reaching the hospital. In the case of a minor injury, 10% of people remain disabled, in the case of a moderate injury - 60%, and a severe one - 100%.

Causes and types of traumatic brain injury

A complex of damage to the brain, its membranes, bones of the skull, soft tissues of the face and head - this is a traumatic brain injury (TBI).

Most often, participants in road accidents suffer from craniocerebral injuries: drivers, passengers of public transport, pedestrians hit by vehicles. In second place in terms of frequency of occurrence are domestic injuries: accidental falls, bumps. Then there are injuries received at work, and sports.

Young people are most susceptible to injuries in the summer - the so-called criminal injuries. The elderly are more likely to get TBI in the winter, with falling from height becoming the leading cause.

Statistics
Residents of Russia most often get TBI while intoxicated (70% of cases) and as a result of fights (60%).

Jean-Louis Petit, a French surgeon and anatomist of the 18th century, was one of the first to classify traumatic brain injuries. Today there are several classifications of injuries.

• by severity: light(concussion, slight bruising) average(serious injury) heavy(severe brain contusion, acute compression of the brain). The Glasgow Coma Scale is used to determine severity. The condition of the victim is estimated from 3 to 15 points, depending on the level of confusion, the ability to open the eyes, speech and motor reactions;
• type: open(there are wounds on the head) and closed(there are no violations of the skin of the head);
• by type of damage: isolated(damages affect only the skull), combined(damaged skull and other organs and systems), combined(the injury was received not only mechanically, the body was also affected by radiation, chemical energy, etc.);
• according to the nature of the damage:
• shake(minor injury with reversible consequences, characterized by a short-term loss of consciousness - up to 15 minutes, most victims do not require hospitalization, after examination, the doctor may prescribe a CT scan or MRI);
• injury(there is a violation of the brain tissue due to the impact of the brain on the wall of the skull, often accompanied by hemorrhage);
• diffuse axonal brain injury(axons are damaged - processes of nerve cells that conduct impulses, the brain stem suffers, microscopic hemorrhages are noted in the corpus callosum of the brain; such damage most often occurs during an accident - at the time of sudden braking or acceleration);
• compression(hematomas are formed in the cranial cavity, the intracranial space is reduced, foci of crushing are observed; emergency surgical intervention is required to save a person's life).

It's important to know
Brain injury most often occurs at the site of impact, but often damage occurs on the opposite side of the skull - in the zone of impact.

The classification is based on the diagnostic principle, on its basis a detailed diagnosis is formulated, in accordance with which treatment is prescribed.

Symptoms of TBI

The manifestations of traumatic brain injury depend on the nature of the injury.

Diagnosis « brain concussion» based on history. Usually the victim reports that there was a blow to the head, which was accompanied by a short loss of consciousness and a single vomiting. The severity of the concussion is determined by the duration of the loss of consciousness - from 1 minute to 20 minutes. At the time of examination, the patient is in a clear state, may complain of headache. No abnormalities, except for the pallor of the skin, are usually not detected. In rare cases, the victim cannot remember the events that preceded the injury. If there was no loss of consciousness, the diagnosis is made as doubtful. Within two weeks after a concussion, weakness, increased fatigue, sweating, irritability, and sleep disturbances can be observed. If these symptoms do not disappear for a long time, then it is worth reconsidering the diagnosis.

At mild brain injuryand the victim may lose consciousness for an hour, and then complain of headache, nausea, vomiting. There is twitching of the eyes when looking to the side, asymmetry of reflexes. X-ray can show a fracture of the bones of the cranial vault, in the cerebrospinal fluid - an admixture of blood.

Dictionary
Liquor - liquid transparent color, which surrounds the brain and spinal cord and performs, among other things, protective functions.

Moderate brain injury severity is accompanied by loss of consciousness for several hours, the patient does not remember the events preceding the injury, the injury itself and what happened after it, complains of headache and repeated vomiting. There may be: violations of blood pressure and pulse, fever, chills, soreness of muscles and joints, convulsions, visual disturbances, uneven pupil size, speech disorders. Instrumental studies show fractures of the vault or base of the skull, subarachnoid hemorrhage.

At severe brain injury the victim may lose consciousness for 1–2 weeks. At the same time, gross violations of vital functions (pulse rate, pressure level, frequency and rhythm of breathing, temperature) are detected in him. The movements of the eyeballs are uncoordinated, the muscle tone is changed, the process of swallowing is disturbed, weakness in the arms and legs can reach convulsions or paralysis. As a rule, such a condition is a consequence of fractures of the vault and base of the skull and intracranial hemorrhage.

It is important!
If you or your loved ones assume that you have received a traumatic brain injury, it is necessary to see a traumatologist and neurologist within a few hours and carry out the necessary diagnostic procedures. Even if it seems that health is in order. After all, some symptoms (cerebral edema, hematoma) may appear after a day or even more.

At diffuse axonal brain injury a prolonged moderate or deep coma occurs. Its duration is from 3 to 13 days. Most of the victims have a respiratory rhythm disorder, different horizontal pupils, involuntary movements of the pupils, arms with hanging hands bent at the elbows.

At brain compression two clinical pictures can be observed. In the first case, a “light period” is noted, during which the victim regains consciousness, and then slowly enters a state of stupor, which is generally similar to stunning and stupor. In another case, the patient immediately falls into a coma. Each of the conditions is characterized by uncontrolled eye movement, strabismus, and crossed paralysis of the limbs.

long head compression accompanied by soft tissue edema, reaching a maximum 2-3 days after its release. The victim is in psycho-emotional stress, sometimes in a state of hysteria or amnesia. Swollen eyelids, impaired vision or blindness, asymmetric swelling of the face, lack of sensation in the neck and back of the head. Computed tomography shows edema, hematomas, fractures of the bones of the skull, foci of brain contusion and crushing.

Consequences and complications of TBI

After suffering a traumatic brain injury, many become disabled due to mental disorders, movements, speech, memory, post-traumatic epilepsy and other reasons.

Even a mild TBI affects cognitive functions- the victim experiences confusion and decreased mental abilities. In more severe injuries, amnesia, impairment of vision and hearing, speech and swallowing skills can be diagnosed. In severe cases, speech becomes slurred or even completely lost.

Disturbances of motility and functions of the musculoskeletal system expressed in paresis or paralysis of the limbs, loss of sensation of the body, lack of coordination. In the case of severe and moderate injuries, there is failure to close the larynx, as a result of which food accumulates in the pharynx and enters the respiratory tract.

Some TBI survivors suffer from pain syndrome- acute or chronic. Acute pain syndrome persists for a month after the injury and is accompanied by dizziness, nausea, and vomiting. Chronic headache accompanies a person throughout life after receiving TBI. The pain can be sharp or dull, pulsating or pressing, localized or radiating, for example, to the eyes. Attacks of pain can last from several hours to several days, intensify at moments of emotional or physical exertion.

Patients have a hard time with the deterioration and loss of body functions, partial or complete loss of working capacity, therefore they suffer from apathy, irritability, and depression.

TBI treatment

A person with a traumatic brain injury needs medical attention. Before the arrival of the ambulance, the patient should be laid on his back or on his side (if he is unconscious), a bandage should be applied to the wounds. If the wound is open, cover the edges of the wound with bandages, and then apply a bandage.

The ambulance team takes the victim to the traumatology department or intensive care unit. There, the patient is examined, if necessary, an x-ray of the skull, neck, thoracic and lumbar spine, chest, pelvis and limbs is taken, ultrasound of the chest and abdominal cavity is performed, blood and urine are taken for analysis. An EKG may also be ordered. In the absence of contraindications (a state of shock), a CT scan of the brain is done. Then the patient is examined by a traumatologist, a surgeon and a neurosurgeon and a diagnosis is made.

The neurologist examines the patient every 4 hours and assesses his condition on the Glasgow scale. If consciousness is disturbed, the patient is shown tracheal intubation. A patient in a state of stupor or coma is prescribed artificial ventilation of the lungs. Patients with hematomas and cerebral edema regularly measure intracranial pressure.

The victims are prescribed antiseptic, antibacterial therapy. If necessary - anticonvulsants, analgesics, magnesia, glucocorticoids, sedatives.

Patients with hematoma require surgical intervention. Delaying surgery within the first four hours increases the risk of death by up to 90%.

Recovery prognosis for TBI of varying severity

In the case of a concussion, the prognosis is favorable, provided that the victims follow the recommendations of the attending physician. Complete recovery of working capacity is noted in 90% of patients with mild TBI. In 10%, cognitive functions remain impaired, a sharp change in mood. But these symptoms usually disappear within 6-12 months.

The prognosis for moderate and severe forms of TBI is based on the number of points on the Glasgow scale. An increase in scores indicates positive dynamics and a favorable outcome of the injury.

In patients with TBI of moderate severity, it is also possible to achieve a complete restoration of body functions. But often there are headaches, hydrocephalus, vegetative vascular dysfunction, coordination disorders and other neurological disorders.

In severe TBI, the risk of death increases to 30-40%. Among the survivors, almost one hundred percent disability. Its causes are pronounced mental and speech disorders, epilepsy, meningitis, encephalitis, brain abscesses, etc.

Of great importance in the return of the patient to an active life is the complex of rehabilitation measures rendered to him after the relief of the acute phase.

Directions of rehabilitation after traumatic brain injury

World statistics show that 1 dollar invested in rehabilitation today will save 17 dollars to ensure the life of the victim tomorrow. Rehabilitation after a head injury is carried out by a neurologist, a rehabilitation doctor, a physical therapist, an ergotherapist, a massage therapist, a psychologist, a neuropsychologist, a speech therapist and other specialists. Their activities, as a rule, are aimed at returning the patient to a socially active life. The work to restore the patient's body is largely determined by the severity of the injury. So, in case of a severe injury, the efforts of doctors are aimed at restoring the functions of breathing and swallowing, at improving the functioning of the pelvic organs. Also, specialists are working on the restoration of higher mental functions (perception, imagination, memory, thinking, speech), which could be lost.

Physical therapy:

• Bobath therapy involves stimulating the patient's movements by changing the positions of his body: short muscles are stretched, weak ones are strengthened. People with movement limitations get the opportunity to learn new movements and hone the ones they have learned.
• Vojta therapy helps to connect brain activity and reflex movements. The physical therapist irritates various parts of the patient's body, thereby inducing him to make certain movements.
• Mulligan therapy helps to relieve muscle tension and pain relief.
• Installation "Exarta" - suspension systems with which you can relieve pain and return atrophied muscles to work.
• Training on simulators. Classes are shown on cardio simulators, simulators with biofeedback, as well as on a stabiloplatform - for training coordination of movements.

Ergotherapy- the direction of rehabilitation, which helps a person to adapt to the conditions of the environment. The ergotherapist teaches the patient to take care of himself in everyday life, thereby improving the quality of his life, allowing him to return not only to social life, but even to work.

Kinesiology taping- the imposition of special adhesive tapes on damaged muscles and joints. Kinesitherapy helps to reduce pain and relieve swelling, while not restricting movement.

Psychotherapy- an integral component of high-quality recovery after TBI. The psychotherapist conducts neuropsychological correction, helps to cope with the apathy and irritability characteristic of patients in the post-traumatic period.

Physiotherapy:

• Medicinal electrophoresis combines the introduction of drugs into the body of the victim with exposure to direct current. The method allows you to normalize the state of the nervous system, improve blood supply to tissues, and relieve inflammation.
• Laser therapy effectively fights pain, swelling of tissues, has anti-inflammatory and reparative effects.
• Acupuncture can reduce pain. This method is included in the complex of therapeutic measures in the treatment of paresis and has a general psychostimulating effect.

Medical therapy It is aimed at preventing brain hypoxia, improving metabolic processes, restoring active mental activity, and normalizing the emotional background of a person.

After craniocerebral injuries of moderate and severe degree, it is difficult for the victims to return to their usual way of life or come to terms with forced changes. In order to reduce the risk of developing serious complications after TBI, it is necessary to follow simple rules: do not refuse hospitalization, even if it seems that you feel fine, and do not neglect various types of rehabilitation, which, with an integrated approach, can show significant results.

Which rehabilitation center after TBI can I contact?

“Unfortunately, there is no single rehabilitation program after traumatic brain injury that would allow with a 100% guarantee to return the patient to his previous state,” says a rehabilitation center specialist. - The main thing to remember is that with TBI, a lot depends on how soon rehabilitation measures begin. For example, "Three Sisters" accepts victims immediately after the hospital, we provide assistance even to patients with stoma, bedsores, we work with the smallest patients. We accept patients 24 hours a day, seven days a week, and not only from Moscow, but also from the regions. We devote 6 hours a day to rehabilitation classes and continuously monitor the dynamics of recovery. Our center employs neurologists, cardiologists, neurourologists, physical therapists, occupational therapists, neuropsychologists, psychologists, speech therapists - they are all experts in rehabilitation. Our task is to improve not only the physical condition of the victim, but also the psychological one. We help a person gain confidence that, even after suffering a severe injury, he can be active and happy.”

Every day we experience many events. Some of them are significant, others are passing. Some of them are pleasant: we rejoice, making sure that we are on the right path. But it is the incidents that cause a negative reaction that really affect us. Such events can cause complexes or psychological trauma.

Sometimes experiences are so strong that a person cannot come to terms with what happened and move on. Such an experience is "encapsulated" and goes into the unconscious part of the psyche. Memory rejects the experience, but it remains in the form of a painful imprint. In the future, we will try to do everything we can to avoid a recurrence of such situations.

Trauma turns life into existence

It turns out a confusing situation: the negative experience and its pain are denied by the conscious part of the psyche, but the subconscious part keeps it and tries to avoid everything in life that even slightly reminds of the traumatic story.

Moreover, the earlier the injury occurred, the stronger the imprint. Childhood traumas are experienced especially strongly, although we seem to not remember them and disguise them with stories of a happy childhood. The causes of trauma are relationships with parents, hospitalizations, dog attacks, relationships with peers.

An injured person does not choose new opportunities, does not take risks, does not listen to his feelings.

Of course, psychological trauma can be obtained not only in childhood. Common examples of trauma at a conscious age are assault, violence, separation, divorce. It is very important that the fear of recurrence of the trauma begins to control the choice and life of a person. His behavior narrows down to sustainable scenarios, the quality of life decreases, and inner peace is lost.

But the worst thing is that the injured person is ready for significant sacrifices. He lives on half of his strength and resources, just not to touch the past painful experience. At the same time, it seems to him that the events that occurred earlier have no influence on him and do not bother him.

A traumatized person does not choose new opportunities, does not take risks, does not listen to his feelings. For a woman after divorce or violence, it may be the fear of starting a family. For a child once abandoned, it is an obsession to be always in a relationship, and their quality does not matter - just so as not to be left alone. And the one who was overprotected in childhood may simply not trust people, fearing that they will manipulate him. This is expressed in panic attacks or the desire to constantly control a partner.

How can you tell if you've had an injury?

Emotional signs:

• dependence on a partner;
• difficulty in managing emotions and feelings (irritability, outbursts of anger, guilt, shame, anxiety, fears and feelings of depression);
• isolation, difficulties in contacts with other people;
• lack of trust in the world;
• difficulty learning and concentrating;
• you do not feel like a whole person, you are lost;
• relationship building problems.

Physical signs:

• fatigue, lethargy;
• muscle hypertonicity, especially in the calves and back;
• headache;
• inability to relax and rest;
• sleep disturbance;
• psychosomatic diseases (according to various estimates of psychologists, from 80 to 100% of psychosomatic diseases develop due to trauma).

When to start working on trauma?

Many people are afraid to work with trauma, thinking that it can lead to withdrawal into negative emotions. "I'm not ready now, sometime later." It is important to understand that it is the trauma that dictates our usual strategy: to put it off until later, to pretend that this is not there and everything is not so bad.

Under the influence of trauma, our potential is curtailed. Our faith in our own strength is undermined. We become hostages of the past. Fear or unwillingness to contact a painful memory not only strengthens its power over us, but also creates internal tension, leads to anxiety and depressive states. Until we have worked through the trauma, we do not live.

First step: disidentification

It is very important not to try to "freeze" or switch, driving the injury even deeper. The following steps will help:

• It is necessary to be “in contact” with the experience, to burn it out. Cry, speak out, allow yourself to receive support from loved ones.
• Help others. Often such help allows you to mobilize, find strength for your own recovery.
• Recognize and name your emotions. This allows you to disidentify with the experience, to look at it from the outside. When we remain at one with the problem, we feel helpless.
• Put your pain and feelings on paper. It is advisable to perform this exercise for at least 30 minutes. Prescribing sensations, we begin to work with them, becoming a subject, not an object.
• The same effect is given by drawing your feelings. Take paper and draw what you feel, naming this feeling. The artistic component is not important here. It can be just colors, shapes - whatever you want. The main thing is not to limit yourself.

Second step: contacting a specialist

Even the best psychotherapists, when traumatized, turn to colleagues without trying to get out of the hole on their own. This is due to the fact that the pain becomes native, and it is too difficult to completely separate it from yourself. Therefore, it is advisable to leave the second step to a specialist.

There are many different paths to releasing the burden of trauma. But the only way that works is to start working on yourself.

One of the effective methods of working with trauma is related to body therapy and is based on deep immersion in oneself. You lie on the couch, experiencing vibrations similar to the swaying of babies.

It has been scientifically proven that a special oscillation frequency balances the impulses of the right and left hemispheres of the brain and, as a result, there is a connection with intuition and the unconscious. In the process, you relax, immerse yourself in your own body, having a bodily experience and gaining a resource.

After the first session, you gain the ability to see the incident in a new light, having a mature understanding of what really happened. And, most importantly, why did it happen. The result of the work is felt immediately: the “core” of the trauma disappears, as well as its emotionally negative color.

What will happen after?

After a long time spent side by side with endless experiences, we get used to them. And get used to the feeling of guilt. We justify our impotence. And when all this monstrous burden leaves, there is a feeling of freedom. This is a lightness that can only be felt by someone who has been carrying immeasurable burdens for years, and then threw them off.

There are many different paths to releasing the burden of trauma. But the only way that works is to start working on yourself. Separate from the injury, see a specialist. To spread my wings and start living again.

About the expert

Psychologist, body therapist, meditation practice instructor, author of the Rapid Change Therapy methodology, formed on the basis of psychosynthesis (a method of psychotherapy and self-development), bodily and meditative techniques. More details on the website.

Injuries, according to statistics, account for 9% of total deaths worldwide. This is one of the most common reasons for hospitalization of patients and seeking medical help. A significant proportion of patients who survive after severe injuries receive a temporary or permanent disability.

Sudden short-term or long-term impact on tissues / organs, resulting in anatomical and physiological changes of varying degrees, is called trauma. This impact, depending on the type of damaging factor, can be different, in particular, mechanical, chemical, etc. The causes of injuries are diverse. For example, a mechanical factor can be pressure, rupture, stretching, etc. Electrical injury occurs as a result of tissue contact with electric current, and as a result of interaction with open fire or high-temperature liquids. Separately, it is worth noting chemical burns, which can be obtained by contact with aggressive chemicals. The severity of the injury depends on the speed and duration of the external impact. Many injuries require emergency medical attention, and the prognosis for patients depends on the timeliness of the treatment started.

What is trauma?

Injury is a term that implies the degree of prevalence of various types of injuries among certain groups of people who are in approximately the same conditions, both at home and at work. According to statistics, among the male population, injuries most often occur between the ages of 20-49, and among the female population between 30 and 59 years. At the same time, at any age, men are more prone to injury than women. Injuries are the third leading cause of death and primary disability. It is also worth noting that in terms of the frequency of mortality, injuries rank first among people of working age.

Huge efforts are currently being made to study the causes of injuries and the causes of its occurrence, the frequency of various types of injuries, their nature, as well as the characteristics of the existence of certain groups of people. According to generalized data, approximately 6% of the population is exposed to various injuries per year.

There are different types of injuries:

• industrial injuries, divided into industrial and agricultural;
• non-production, including street, household and sports;
• intentional injuries arising against the background of unlawful actions of one person in relation to another with the aim of injuring him or depriving him of his life;
• military injuries, the name of which speaks for itself and implies injuries due to military operations or in the service;
• children's, including birth (injuries received during childbirth), street, household, school, sports and injuries associated with various accidents.

Accidents at various enterprises are often the cause of industrial injuries. That is why social insurance at manufacturing enterprises is mandatory for each employee. Such insurance covers various industrial accidents and so-called occupational diseases. Causes of injury at work can be:

• Objective, in particular technical and sanitary-hygienic.

The former include the faulty condition of the equipment used, an unexpected power outage, improper arrangement of the working area, etc. Among the sanitary and hygienic reasons, it is worth noting poor lighting and polluted air at the enterprise, an increased level of radiation, etc.

• Subjective.

These include mainly organizational and psychological causes of injuries. The organizational reasons for which an industrial injury may occur are the illiterate distribution of the work process, the absence or non-compliance with established rules, and the involvement of unskilled employees in especially dangerous work. Psychological causes are purely individual. These include the arrogance of employees, the weakening of self-control, inattention, fatigue, etc.

According to statistics, in about 80% of industrial injuries are the result of erroneous and untimely actions of employees. The negligent attitude of the management of the enterprise and its employees themselves creates dangerous working conditions and increases the likelihood of injury. Officially investigated cases that occurred:

• during working hours directly at the enterprise itself or in another place where the employee fulfills work obligations;
• in the performance of duties assigned by the employer;
• when bringing in the proper form of work equipment, overalls, as well as during the establishment of personal hygiene before and after the start of working hours;
• on the way to work or home;
• in case of accidents at work or in the liquidation of their consequences.

Occupational injury is one of the most important problems in modern traumatology, taking many lives or causing disability from year to year. The main methods of combating industrial injuries are the prevention of its occurrence, the organization of qualified trauma care, as well as professional treatment for employees.

Types of injuries: classification

According to the nature of the impact, all types of damage are usually divided into:

• Mechanical, arising against the background of a sharp mechanical effect on the tissue. These types of injuries can vary in severity. Mechanical damage also includes operating, birth and accidental injuries.
• Thermal, occurring when tissues are exposed to excessively low or high temperatures. So, they include both burns and frostbite.
• Electrical, arising from exposure to the body of electric current discharges, domestic or natural.
• Chemical, appearing upon contact of body tissues with alkalis, salts of heavy metals, acids and other aggressive chemicals. Chemical types of injuries can lead to local damage or, being absorbed through the skin, poison the body.
• Radiation, which is the result of prolonged exposure to ionizing radiation. This type of injury does not always have an immediate manifestation, since the protective functions of the body are not activated immediately during radiation exposure.

In addition to the above types of injuries, mental and biological traumas are distinguished. The latter are the result of exposure to the body of microbes, viruses and other pathogens, as well as toxic substances of various origins. Mental trauma occurs against the background of exposure to nerve centers, visual and auditory analyzers of stress factors and stimuli.

According to the nature of the impact, all types of possible injuries are usually divided into:

• isolated, implying various kinds of damage to one organ or anatomical department;
• multiple - similar in terms of damage to various parts of the body, lower and upper limbs or head;
• combined, including damage to one or several organs at once, parts of the musculoskeletal system, as well as brain injuries;
• combined, caused by the action of mechanical, as well as one or several non-mechanical traumatic factors at once.

According to statistics, one of the most common causes of death and disability, in particular among young people, is traumatic brain injury. The main risk group is citizens under the age of 50 years. The frequency of TBI is approximately 300-400 cases per 100,000 people annually. On the territory of Russia, about 400 patients per 100,000 people are annually diagnosed with a traumatic brain injury. At the same time, approximately 50 thousand people out of the above number of patients die or become disabled. The most common causes of TBI in Russia are domestic and industrial accidents, as well as traffic accidents (traffic accidents).

This type of injury is damage to the bones of the skull, blood vessels, brain and other intracranial formations. There are other options for TBI:

• severe trauma, due to which the bones of the skull retain their integrity, and intracranial structures are damaged;
• violation of the integrity of the skull with minimal brain injury.

Among the main causes of TBI are falls from a height, traffic accidents, domestic, industrial and sports accidents. The severity of TBI and the individual prognosis for the patient depends on the degree of brain damage.

What is a head injury?

According to the type of impact, head injuries are divided into:

• acceleration injuries accompanied by diffuse brain damage;
• local injuries arising from a blow to the head with an object with a certain force;
• compression damage.

Different types of injuries have their own characteristics of occurrence, clinical picture and prognosis for the patient. There are different types of TBI:

• closed head injuries, including bruises, concussions, compression, as well as damage to the skull, provided that the integrity of the soft tissues surrounding it is preserved;
• open - injuries in which skull fractures are accompanied by a violation of the integrity of soft tissues, bleeding of varying intensity or liquorrhea (outflow of cerebrospinal fluid).

It should be noted that open brain injuries are divided into penetrating (accompanied by damage to the hard shell) and non-penetrating (respectively, without it).

According to the type of injuries received, the patient can be diagnosed with:

• isolated head injury - an injury not accompanied by other extracranial injuries;
• combined craniocerebral injury, in which damage to the internal organs and bones of the skeleton is also noted;
• combined TBI - damage that occurs against the background of exposure to the body not only mechanical, but also one or more non-mechanical factors.

Specialists distinguish three stages of TBI according to its severity. So, patients can be diagnosed with mild, moderate and severe stages of traumatic brain injury.

Taking into account the form and nature of TBI, the age of the patient and his state of health, as well as a number of other factors, acute, intermediate and remote periods of its course are distinguished.

In addition, there are primary and secondary TBI. Primary occurs under the influence of mechanical factors that are not caused by any cerebral disorders. The cause of secondary TBI is falls and mechanical blows to the head, for example, in people diagnosed with epilepsy, stroke and a number of other diseases.

Secondary brain injury is the result of a severe head injury. Its frequency is approximately 20% of all patients with this diagnosis. Secondary trauma is a particular danger to the health and even life of the patient. Among the main causes of this pathology, it is worth noting cerebral hypoxia, which develops due to the lack of oxygen supply through the respiratory tract, arterial hypotension and a sharp increase in intracranial pressure.

Severe head injury

The consequences of a severe head injury for the health and life of a patient depend on the quality and timeliness of the medical care provided. With this type of damage, the victim may experience a number of characteristic signs, in particular:

• repeated vomiting that cannot be overcome;
• prolonged loss of consciousness;
• confusion and memory loss;
• an overwhelming desire to sleep and double vision;
• convulsions and bleeding from the nose, etc.

The patient's condition with a severe head injury is deteriorating rapidly. To provide first aid for a head injury, you must:

• put the patient in a room with subdued light, providing him with complete peace;
• put something soft under the head and shoulders, while slightly lifting the victim;
• try to stop bleeding from an open wound on the head (pressing a bandage or a clean cloth to the wound, you can not put pressure on it if there is a possibility of a skull fracture).

All these actions must be performed by first calling an ambulance. Before the arrival of doctors, it is important to monitor the consciousness and the presence of breathing in the victim. If there is no breathing, start cardiopulmonary resuscitation.

The main actions in the diagnosis of TBI include interviewing the victim, collecting an anamnesis, examining and assessing his condition. If a person has lost consciousness, it is necessary that doctors receive information about the incident from eyewitnesses and employees of the ambulance team that arrived at the scene. When assessing his condition, it is important to verify the presence or absence of violations of the integrity of the soft tissues and to perform a neurological examination.

One of the most informative instrumental diagnostic methods is computed tomography. Using it, specialists can assess the degree of damage to the bones of the skull, brain and other intracranial structures, the presence of pathological processes and the nature of their course. CT can be used for injuries of any severity. Such a study makes it possible to do without a number of previously used diagnostic procedures, in particular, craniography, cerebral angiography, echoencephaloscopy, etc.

If it is not possible to immediately conduct a CT scan, magnetic resonance imaging is used for diagnosis. Before MRI, craniography is mandatory to exclude the presence of metallic foreign bodies.

In some cases, echoencephaloscopy is used, which allows the most accurate assessment of the displacement of intracranial structures. When examining children and patients with defects in the bones of the skull, ultrasound can also be used. Less accurate than computed tomography is craniography (X-ray examination without the use of contrast agents). When examining a patient with a head injury, it must be performed in several projections at once. Such a study allows to determine fractures of the skull bones, radiopaque foreign bodies, as well as pneumocephalus.

eye injury

Quite vulnerable to various damages is the main organ of the visual system. It would seem that minor eye injuries can lead to deterioration or complete loss of vision. The cornea, vitreous body or lens are most susceptible to injury. In severe eye injury, the retina and optic nerve may be damaged. According to statistics, eye damage is 10% of the total number of pathologies of the organ of vision.

Among the main causes of eye injuries are penetrating (accompanied by a violation of the integrity of the membranes of the organ) and non-penetrating injuries, as well as blunt injuries, exposure to high and low temperatures, and various chemicals. According to statistics, in about 90% of cases, damage to the main organ of the visual system is microtrauma and blunt trauma. The total number of penetrating injuries is approximately 2%, and approximately 8% of eye injuries are thermal burns. Let's take a closer look at the main types of eye injury:

Penetrating injuries are injuries in which a foreign body can violate the integrity of various parts of the main visual organ. Foreign body particles can remain in the eye, causing severe pain and profuse lacrimation, photophobia, and a sharp decrease in visual acuity. With a penetrating wound on the eyeball of the victim, you can see the wound itself and the bloody spot around it. Such damage to the eye can lead to destruction of the eyeball and lens, as well as partial or complete blindness.

Non-penetrating injuries are usually the result of bruises and so-called blunt blows. Blunt trauma is the result of damage to the eyeball by various objects. There are three degrees of severity of such an injury. In this case, the injury of the I degree is mild, the most severe is the III degree. Such injuries can be characterized by intraocular hemorrhage, retinal detachment, violation of the integrity of the vascular membrane of the organ and retina, as well as the development of traumatic cataracts.

Various parameters are used to classify damage to the main organ of vision. According to the field of activity of people prone to certain types of injuries, injuries can be industrial (obtained at work), agricultural (possible in the performance of work and domestic duties), household (injuries received at home, on the street, etc.) , sports or combat origin. The latter is by far the rarest. The main reasons leading to damage to the main organ of vision include:

• small objects, for example, sand, motes, midges, etc .;
• various chemicals, in particular, household chemicals, building compounds, cosmetics, etc.;
• a wide variety of sharp objects, for example, metal shavings in production or when performing household repairs;
• blunt blows that occur when a stone or snowball hits the eye, for example, when punched or falling from a height;
• thermal effect, implying eye contact with hot liquids, objects, etc.

In order to avoid the negative consequences of an injury and preserve a person’s vision, it is important to provide him with competent assistance in time. So, first aid for eye injuries should be to eliminate the irritating factor, if any.

Treatment of injuries of the organ of vision

Any damage to the main organ of the visual system requires immediate medical attention. Only a qualified specialist using the appropriate equipment will be able to determine the extent of damage and its nature. At the first examination of the victim, the ophthalmologist examines the fundus using a special mirror or ultrasound, assesses the condition of the retina. If the injury is penetrating, radiography is used to assess the patient's condition, which allows to determine the presence of a foreign body in the wound. Also, with such injuries, it is important to assess the state of the optic nerve in the injured eye and predict the possibility of maintaining vision when using a certain tactic for treating the injury.

The choice of tactics for the treatment of injuries should be carried out exclusively by a specialized doctor and may depend on various factors. Its selection is the task of an experienced ophthalmologist. For example, if the integrity of the walls of the orbits and eyelids is violated, the victim needs urgent surgical treatment of the damage. It may also be necessary to restore bone structures and surgical closure of wounds. If the injury is the result of blows and contusions, anti-inflammatory treatment is required, as well as the use of therapy aimed at resorption of hematomas and prevention of hemorrhage. First aid for injuries resulting from a blow requires the immediate application of cold to the affected area. If the injuries are penetrating wounds and a foreign body remains in the organ, the treatment of injuries requires surgery.

Most eye injuries occur due to the ingress of foreign bodies of various sizes and types, which can be very diverse. Basic first aid for injuries of this type can be provided to the victim, as they say, on the spot. The first thing to do is not to let the victim rub his eyes, because this can only aggravate the situation. A small foreign body should be removed with a clean piece of tissue (for example, a handkerchief). To carefully remove an object that irritates and injures the eye, you should pull down the lower eyelid or try to slightly twist the upper eyelid. If you cannot do this yourself, you should immediately contact a specialist.

Spinal injury

The causes of spinal injuries can be very diverse. As a rule, various injuries are caused by strong mechanical impacts as a result of a fall from a height, an accident, impacts, heavy objects falling on a person, etc. Traumatic factors in such situations, for the most part, determine the type of damage received. For example, injuries to the spine of passengers staying in cars involved in an accident most often represent injuries of the cervical spine - the so-called whiplash injuries. The reason for their occurrence is a sharp bending of the neck forward and the same sharp tilting of the head back, which is typical for sudden braking of transport. According to statistics, whiplash injuries are much more common (about 2.5 times) in females who have poorly developed cervical muscles. Also, damage to the cervical spine is often observed in divers who do not adhere to the basic rules of immersion in water. For people injured as a result of a fall from a height, a combined fracture of the spine with damage to the lower thoracic or pelvic region, as well as the heel bones, is characteristic.

Spinal injuries account for approximately 1% of all types of injuries. Such a pattern of damage includes lesions of the spine and spinal cord. Depending on which area is affected, spinal injuries can be:

• damage to the vertebrae in various parts of the spinal column
• violation of the integrity of the transverse process
• damage to ligaments, which is their sprain or rupture
• traumatic dislocation
• intervertebral disc damage

There are also uncomplicated and complicated injuries. Uncomplicated are injuries in which there is no violation of the integrity of the spinal cord and its roots.

Allocate closed and open injuries of the spine. The former are more common. With closed injuries, the integrity of the skin and soft tissues that cover the vertebrae is not violated. There are also stable and, accordingly, unstable traumatic injuries. The former include bruises, ruptures of the spinal ligaments that are not accompanied by displacement, whiplash injuries (injuries to the cervical region), as well as fractures of the transverse and spinous processes. Unstable injuries mean various injuries that lead to the appearance of pathological mobility of the damaged spine at the time of injury or the progression of pathological deformity in the long-term period after injury. These specialists include dislocations, spondololisthesis, injuries associated with shifts and sprains, etc.

Depending on the type of damage, their symptoms may differ, as well as the consequences of injuries for patients. So, the signs of stable spinal injuries may look like this:

• bruises of the spine are characterized by diffuse pain in the area of ​​the injury, swelling and hemorrhage, slight limitation of movement;
• distortions are accompanied by sharp pain, tenderness on palpation and restriction of movement;
• a fracture of the spinous processes causes severe pain, and, in addition, the damaged process is often distinguished by palpation;
• fractures of the transverse processes, which are more common, are characterized by a number of symptoms, including Payr's symptom, the so-called stuck heel symptom, diffuse pain in the area of ​​the damaged area, etc .;
• whiplash injuries of the cervical region are accompanied by headache, pain in the neck, memory impairment, neuralgia and numbness of the extremities are also possible.

Symptoms of damage depend not only on the type of injury itself, but also on which part of the spine is affected.

Consequences of spinal injuries

The type of injury, its severity, localization of the affected area are the main factors that determine the prognosis of treatment and the consequences of injury for the patient. According to statistics, severe spinal injuries are the most common and lead to disability in almost half of the cases. If injuries of the spinal column are combined with a violation of the integrity of the spinal cord, their consequences for patients are almost always quite serious and in about 80-95% of cases lead to disability.

The most dangerous are injuries of the cervical spine, combined with damage to the spinal cord. They often lead to respiratory arrest and blockage of blood circulation, which causes almost instantaneous death of a person. In addition, with such an injury, the death of the victim is possible as a result of the development of hypostatic pneumonia, urological pathologies and bedsores, leading to blood poisoning.

The most promising in terms of treatment are spinal injuries in children, including injuries received during childbirth. This is due to the fact that the child's body is most susceptible to adaptation after various spinal injuries.

What will be the consequences of injuries depends not only on their type, but also on the timeliness and quality of assistance provided to the victim. If help is provided to a person incorrectly, this can only aggravate his condition and make the prognosis for treating injuries less favorable.

Treatment of spinal injuries is a long and complex process. As a rule, its implementation is the task of such specialists as a traumatologist, a rehabilitation specialist and a neurosurgeon.

The causes of leg injuries are varied. These can be both strong blows and falls, accidents, excessive physical exertion, etc. These include:

• Bruises or injuries resulting from compression.

Bruises can cause cracks and even fractures of bones, damage to the joints. At the site of bruises, as a rule, a hematoma occurs. It is also possible the formation of edema.

• Dislocations, which can be congenital (obtained during fetal development) or acquired as a result of various leg injuries.

The main symptoms of a dislocation are severe pain, limitation of joint mobility and the adoption of an unnatural position by it.

• Sprain or complete rupture of the ligaments is a leg injury that involves damage to the ligamentous apparatus of the ankle or knee joints, as well as damage to the menisci.

These injuries are usually caused by excessive stress on the ligaments. At the site of injury with this type of injury, a hematoma forms and edema appears, and there is also a sharp unrelenting pain.

• Fractures are injuries of the lower extremities, which can be closed and open, accompanied by complications or proceed without them.

The causes of such injuries can be excessive loads on the legs, accidents, falls, etc. Signs of fractures are pain, rapid formation of edema, hematoma in the area of ​​the affected area, its deformation, a characteristic crunch during movement, limited movement. An open fracture is an injury in which, without special diagnostic methods, you can see the damaged bone.

Knee injury

People of all ages are susceptible to various types of knee injuries. Even with normal walking, such damage is possible if certain factors accompany it. For example, natural wear and tear as a result of aging, as well as a number of diseases, such as arthritis or osteoporosis, can increase the likelihood of knee joint injuries. Most often, a leg injury in the knee area occurs in athletes. But people are also often exposed to it during active entertainment (skiing, roller skating, etc.). No less likely is industrial and domestic injury.

The knee joint is the largest joint in the human body. Between its upper, called the femur, and the lower (larger and fibula) bones, cartilaginous formations are localized, called the menisci. The main legs are connected to each other with the help of ligaments, tendons and muscles. Inside, the joint is covered with the so-called articular hyaline cartilage, which ensures the smoothness of its movement and is an elastic tissue with a smooth surface. Knee injuries most often represent damage to one or more of the structures listed above.

Acute knee injuries often occur as a result of a sudden direct blow to the knee, unnatural bending, twisting of the lower limb, or falling and hitting the knee. Such damage is accompanied by an almost instantaneous occurrence of pain, swelling and bruising. Acute injuries can damage nerves and blood vessels. Victims may notice numbness in the area of ​​injury, coldness, weakness, pale skin and blueness at the site of injury, as well as slight trembling in the knee. Among the main varieties of leg injuries in the knee area are:

• damage to ligaments and tendons, in particular their sprain;
• meniscus tear;
• cracks in the patella, greater and fibular bones in their upper part, the femur in its lower part;
• dislocation of the patella, most common in girls 13-18 years old;
• dislocation of the knee joint - an injury that can occur as a result of a blow of great force.

Excessive exercise can also cause injury to the knee, leading to irritation and inflammation of the knee joint. Such damage occurs due to repeated actions or prolonged heavy loads. Among the consequences of such influences, it is worth noting:

• bursitis, which is an inflammatory lesion of synovial bags;
• tendinitis, which is an inflammatory lesion of the tendons, as well as tendinosis;
• Plick's syndrome, which consists in twisting and thickening of the knee ligaments, etc.

The applied treatment for knee injuries should include immediate medical attention, complete rest for the injured limb, professional splinting, various physiotherapy procedures, medication, and in some cases surgery. The choice of treatment method depends on various factors, in particular, on the area of ​​the lesion, the type of injury and its severity, the age of the patient, his state of health and his usual lifestyle.

Among the main injuries of the hip are fractures and dislocations. The former are a particular danger to human health and full mobility. These types of injuries include:

• fracture of the upper part of the femur, accompanied by a violation of the integrity of the femoral neck, trochanteric fracture;
• fracture of the lower part of the femur;
• diaphyseal fracture.

The main risk group for hip fracture is the elderly. To a greater extent, female representatives are susceptible to such an injury, often suffering from osteoporosis and weak muscle tone. The main cause of injury to the upper thigh is a fall, a sharp blow, an accident, etc. Elderly people can get such an injury from a direct blow or a fall on the hip joint. Also, a fracture of the femoral neck in elderly people can be with an unsuccessful fall, when a person stumbles and abruptly transfers his body weight to one leg.

The symptoms of a hip fracture are:

• Sharp and pronounced pain in the hip joint, radiating to the groin. With an intra-articular fracture, pain may be mild at rest and increase with movement. There is also pain on palpation.
• Inverted position of the lower limb. If a hip fracture is accompanied by displacement, the injured leg appears to be significantly shorter than the healthy leg. With an impacted fracture, this feature is not observed.
• A fracture of the upper thigh makes it impossible to lift and straighten the leg in a supine position.
• If the fracture is trochanteric, the soft tissues around the injured area swell and bruise.

Separately, it should be said about open fractures, in which a strong one is possible.

With an injury such as a fracture of the femoral neck, blood circulation is disturbed in it and in the femoral head, which greatly complicates the process of bone tissue fusion. The consequences of such an injury depend on the location of the fracture. So, the higher its location, the less favorable is the prognosis for the patient.

hip dislocation

Hip dislocation is a fairly common injury today. The causes of its occurrence are direct strong impacts, falling from a height, compression as a result of landslides, road accidents, etc. Hip dislocations can be anterior and posterior. More common is a posterior dislocation resulting from sudden rotation or flexion of the hip towards the inside. In this case, the posterior part of the joint capsule is damaged by the head of the femur. Depending on the location of the dislocated articular head, iliac and ischial dislocations are distinguished.

Anterior dislocation is rare. With such an injury, the head of the femoral bone is displaced downward, as a result of which the joint capsule is torn. Anterior dislocations are divided into obturator and pubic. Also, such an injury can be congenital, due to defects that have arisen during fetal development.

With a dislocation of the hip, there is a visible deformity of the lower limb. In this case, patients feel severe pain. With a posterior dislocation, the limb bends with the knee to the inside and turns out. With strong flexion, there is a high probability of ischial dislocation. Anterior dislocation is accompanied by an outward twisting of the knee. With such an injury, flexion of the lower limb in the region of the hip and knee joint, as well as complete limitation of movement, is observed.

First aid for an injury, which is a dislocation of the hip, consists in the introduction of an anesthetic and immediate hospitalization of the victim. It is important to provide the victim with complete rest and immobilize the injured leg.

When treating an injury of this kind, it is important to correctly set the joint. This procedure is performed using anesthesia, which will help the muscles surrounding the injured joint to relax as much as possible. The reduction of dislocations can be done in various ways. The most in demand today are the methods of Depre-Bigelow, Janelidze-Kollen and Kefer-Kocher. After reduction of the dislocation, the patient needs to apply a special retractor splint, which must be worn for about one month. After removing the overlay splint, with a favorable course of the applied treatment, the patient is recommended to undergo a special rehabilitation course. Sometimes it may be necessary to use crutches to reduce the load on the injured leg during movement. Among the complications of hip dislocation, it is worth noting the development of degenerative changes in the damaged joint, called coxarthrosis.

A closed craniocerebral injury can have the most unfortunate consequences for a person, which is why timely diagnosis and treatment are so important. Rehabilitation after TBI can be done at the Three Sisters Center.

According to inexorable statistics, up to 50% of all injuries are skull injuries, and in 20% of cases this is a severe injury, often leading to death or disability of the victim. Up to 60% of those who have received severe craniocerebral injuries die within 2-3 years after the injury due to a cause one way or another associated with it.

As is known from the ICD-10 code, craniocerebral injuries are classified into open and closed. The former are characterized by a violation of the integrity of the skin of the head, skull bones, aponeurosis and, often, damage to the medulla (in the latter case, the wound is defined as penetrating). With closed injuries, either there is no damage to the integument (for example, concussion), or injury to soft tissues or bone is observed, but without ruptures of the aponeurosis. In this case, you should not usually be afraid of sepsis, since the intracranial cavity retains its "closedness". However, closed injuries should not be underestimated - sometimes they are more dangerous than open ones and, not least, because they are not given due importance and treatment is delayed.

Causes and consequences of CBI and concussions of the brain

The factors that cause TBI can be of various kinds: road accidents and other accidents, falls, blows to the head, mechanical damage caused by another person (intentionally or accidentally). The consequences of such injuries can be extremely severe, even fatal. There are frequent cases of paresis of the limbs, pinched nerves, loss of cognitive functions of the brain.

Symptoms of closed TBI of various types

Doctors distinguish between the symptoms of traumatic brain injury, which occur immediately after injury, and "delayed", which can be noticed only after a few hours or even days. Even if there are no visible signs of injury (such as an open wound), injury can be suspected by the following symptoms:

• Loss of consciousness is the most striking sign. It can last from several minutes to several days. It is observed with concussion, bruise (contusion), compression (hematoma) of the brain.
• Nausea and vomiting are common symptoms of a concussion.
• Dizziness, headaches - a sign that can be observed both in trauma and in stroke or other disorders of the brain.
• Paleness or redness of the face is observed with bruises and contusion of the brain.
• Photophobia may indicate traumatic subarachnoid hemorrhage.
• Speech impairment indicates a focal brain lesion (hematoma, hemorrhage).
• Hematomas on the skin (usually around the eyes and behind the ear), as well as the outflow of blood or cerebrospinal fluid from the ears, are a sign of a fracture of the vault or base of the skull. Strictly speaking, this injury is more of an open injury, but some classifications include it in a closed injury.

Three periods of traumatic brain injury are distinguished: acute (sometimes the most acute is considered separately - within an hour or two after injury), intermediate and remote. First aid measures should be taken immediately, and treatment should be started without waiting for the end of the acute period.

Diagnosis and treatment of closed craniocerebral injuries

Various diagnostic methods are used to confirm the diagnosis according to the medical history: examination by a neurologist, traumatologist or neurosurgeon, computed and magnetic resonance imaging, echoencephalography, lumbar puncture (if cerebral compression is suspected), craniography.

Depending on the received data on the severity and nature of the injury, the doctor prescribes treatment in a hospital.

In severe injuries, take measures to maintain breathing. If necessary, urgent surgical intervention is performed (for hematomas and hemorrhages). It is important to immobilize the patient, to prevent convulsive seizures, which can aggravate the condition of the injured.

A complex of drug therapy is also carried out, including:

• dehydration drugs: lasix, furosemide (with prolonged administration, potassium chloride, panangin are additionally prescribed);
• glucose solution, magnesium;
• analgesics: baralgin, analgin, etc.;
• coagulants: calcium gluconate, ascorutin, etc.;
• sedatives;
• anticonvulsants;
• if necessary - antibiotics, antipyretics;
• after the end of the acute period, vitamins of group B are prescribed.

The duration of conservative treatment is determined individually and depends on the speed of recovery of the patient. During the entire stay in the hospital with the patient, additional therapy is carried out: massage, passive and then active gymnastics, breathing exercises.

Come to Three Sisters and we will make sure that you are healthy.