Cruciate ligaments are located in the cavity of the knee joint. To tear them prohibitive lead the movement of the knee. Anterior cruciate ligament starts from the inner surface of the caudineural external condyle (bone protrusion) of the femur, crosses the knee joint cavity and attached to the front of the anterior fossa of the tibia intercondyloid also in the joint cavity.
This ligament stabilizes the knee and lower leg does not move forward too, and keeps the outer condyle of the tibia. Posterior cruciate ligament of the knee joint begins peredneverhney part of the lateral condyle surface of the inner thigh, crosses the knee joint and attaches to the back intercondyloid fossa of the tibia. It stabilizes the knee joint and keeps the tibia from the backward movement.
Anterior cruciate ligament rupture can occur during the action of force directed forward, the back surface of the knee in a bent and turned inward leg. It often occurs not isolated cruciate ligament rupture, and the so-called "poor triad" or triad Turner. This rupture anterior cruciate ligament rupture external (tibial collateral) ligament and the lateral gap of the internal (medial) meniscus.
Cruciate ligament ruptures may be accompanied by fractures of the bony plates loose in places of attachment of ligaments or a fracture intercondyloid elevation. Which greatly complicates further treatment. Very often breaks cruciate ligament in athletes occur during a football game, with skiing, the wrestlers. Posterior cruciate ligament is torn with a sharp leg unbending at the knee or a direct attack on the front of the leg when she bent at the knee joint.
Ligament are often combined. The most severe damage to both cruciate ruptures is considered, and both sides of the joint capsule. This leads to laxity of knee and walking opportunities in the loss of his foot. When you break a cruciate ligament there is a sharp pain. There is a bleeding into the joint (hemarthrosis). Joint increases in size. Revealed a symptom of "balloting" patella. However, for some patients the very moment of injury may go unnoticed. Later there is a feeling of instability, laxity of the knee.
The main symptom of rupture cruciate ligament is a symptom of "drawer". Using special techniques the doctor moves the patient's lower leg forward or backward. When you break the anterior cruciate ligament tibia move forward excessively - a symptom of "front drawer," and in the posterior cruciate ligament rupture leg moves easily back - a symptom of "posterior drawer."
In old torn ligaments symptom of "drawer" can become confusing because of the development around the site of rupture of fatty tissue, which partially stabilizes the knee joint. Refine the diagnosis of X-ray examination. Sometimes you have to resort to the introduction of contrast into the cavity of the knee or to the computer, or magnetic resonance imaging. If necessary, arthroscopy: a probe introduced into the joint cavity and inspect the joint from the inside. As a first-aid to numb the injury, immobilize the knee joint by bus and brought the victim to travmopunkt.
Treatment of cruciate ligament rupture knee. Puncture is performed knee to remove blood from the joint cavity. After removing the blood into the joint is injected novocaine. After that, making sure that the motion of the knee meniscus tear and retained joint not to impose a leg plaster cast. The leg is somewhat bent at the knee joint.
The duration of immobilization of up to one month. Then the plaster is removed and assigned exercise therapy, massage and physiotherapy. Usually right after the injury surgically restore the integrity of cruciate ligaments do not produce as well as possible complications in the form of knee joint contractures. However, if there was a tear fracture a bone fragment and has its offset, performed an emergency surgery. The bone fragment is fixed to the bone.
The indications for delayed reconstruction of the ligament laxity is a joint dysfunction of walking. Calibration is done 5-6 weeks after injury. Ligaments do not sew, it is futile. Performed cosmetic reconstruction. To do this, take the graft from the patellar tendon. Sometimes resort to the endoprosthesis ligament with artificial material.
However, artificial ligaments life is limited. Surgery may be performed by open, across a wide cross-section and opening the joint cavity, half-open - after minimal incision or endoscopic method. Endoscopic cruciate ligament plasty method is the least traumatic. Motion in the joints begin within a few days after surgery, but the heavy loads on the joints are not recommended for 1.5 years.