Ivannikov SV Fracture

the most severe damage to the ankle and up 7% of all skeletal injuries 4. Results: Ankle previously regarded as a cylindrical helical hinge. Bending foot, as it were come unscrewed from the plug with simultaneous ankle supination her, and bringing a small rotation inside. When straightening foot, on the contrary, as if the plug is screwed into the joint, at the same time it is pronation, abduction and slight external rotation. It is known that the ankle is shaped like a truncated cone with the base directed toward the fibula. The imaginary axis of the cone is rotated by about 10 degrees relative to the proximal articular surface of the talus, and 25 degrees relative to the frontal plane. For practice, it is important that the imaginary axis of the ankle goes from the lower edge of the inner ankle to the lower edge of the outer ankle 1. Pylons fractures called fractures of the distal tibia metaepiphysis arising from the effects of axial forces of high-energy, which leads to position of the foot during the injury, the direction and magnitude of traumatic force.

Also, damage to the ankle depends on the direction of traumatic force which may be of 3 types: adduction, abduction, rotation. Hikmet Ersek takes a slightly different approach. During supination external Ligamental structures are strained. With a gap of enhanced external adduction ligament tear or fracture podsindesmozny outer ankle, and the talus clicks the inner ankle, resulting in a fracture occurs and the vertical plane. If supinate stop the load is rotated outward, in addition to the external voltage lateral ligaments stretched anterior ligament syndesmosis. If the force continues its impact, then there is an oblique or spiral fracture nadsindesmozny chrezsindesmozny or outer ankle. Rotating astragalus may pull back a bunch of syndesmosis, breaking it, or removing a bone fragment posterior margin of the tibia.

Its destructive effect of the rotating talus fracture completes the inner ankle or torn deltoid ligament. When pronatsionnom position of the foot stretched internal structures. If there is a rigid abduction, can be torn deltoid ligament tear or inner ankle (with the horizontal fracture). Then continuing Violence breaks both syndesmosis ligament tears or bone fragments in them. Then the autopsy results in a fracture of the fibula at or above the syndesmosis. If at the initial position of the foot she pronatsionnom rotated laterally, there is a gap deltoid ligament or transverse fracture of the inner ankle. With the continuing rotation of the outer talus anterior ligament rupture occurs tibiofibular syndesmosis or separation of the bone attachment 2, 3. Conclusions: The mechanism of the pylon fractures depends on the direction of the damaging efforts and position of the foot at the time of injury. References 1. Oganesyan OV, Ivannikov SV, Korshunov AV Recovery form and function of the ankle joint hinge-distraction apparatus. – Moscow: BINOM. Laboratory knowledge. – Medicine. – 2003. – S. 12-13 2. Shabanov AN, Kay I., Sartan VA Atlas fractures ankle and their treatment. – M.: Medicine. – 1972. – S. 44-67. 3. Kao KF, Huang PJ, Chen YC, et al. Postero-medial-anterior approach of the ankle for the pilon fracture / / Injury. – 2000. – Vol. 31. – P. 71-74. 4. Topliss CJ, Jackson M., Atkins RM: Anatomy of pilon fractures of the distal tibia / / JBJS. – 2005. – Vol. 87 – P.692-697. Tekt article is copyrighted


For that reason we see that the greater concentration of people with this problem is concentrated in the great cities. One thinks that it could have an influence of particles of the diesel engine of the cars, on the structure of pollen, so that it would increase his capacity alergnica. The allergy, abnormal answer of the immune system, exists under four aspects possible: Immediate: It depends on the IgE antibodies (in the urticaria and edema of Quincke). Cytotoxic: The antibodies act of the IgG type. Immune complex: tie to the IgG through complexes immunes. Slowed down: Ligature to a cellular inflammation, for example the eczema. It is fundamental, whenever it is possible, to avoid the allergens.

the environmental Smog, micromoulds, pollens, acaruses (in mattresses and carpets), dandruff and hair of the mascots. we do not have to think that the dust is the true person in charge, but the excrements and organic rest of acaruses and insects that proliferate in him, and are fed on dandruff, skin and hair of animal and human beings. Evitar the habit of the tobacco. Between the prophylaxis forms they are the cleaning, to avoid closed and very humid atmospheres, and the specific vaccination against the allergens in the allergic people. In the respiratory allergy (rinitis, asthma) Immunotherapy can be used, that is the allergy vaccine or hyposensitization. In this treatment the dose becomes congested slowly via subcutaneous a purified extract of allergens, increasing so that the organism is become accustomed itself the allergen.

In Europe one does not admit that allergens of different classes are mixed and they are not due to administer more than three different allergens at the same time. Several types of Immunotherapy exist or allergy vaccines, generally are administered initially of weekly form and later, it is followed monthly. The treatment usually lasts between 3 to 5 years, since its curative effect is slow and progressive. Swiss investigators proved the effectiveness and the associated risk to inject the allergen within the lymphatic ganglia, concluding that improved the security, the effectiveness, and the duration of the treatment and the used doses fell significantly. Also they exist in Europe bovine oral (sublingual) very controverted at the moment and of an important risk for the health, in case of badly being administered. These vaccines do not contain any medicine as antihistamine or corticoesteroides. The treatment can last between 3 and 5 years. Confortyrelax.