Joint injuries include bruises, sprains and ruptures of ligaments, tendons, capsules, menisci, cartilage damage, joint dislocations, intra-articular bone fractures. We tell you which injuries are the most common and what to do if you are injured.
Classification of joint injuries
Due to the occurrence of joint injuries there are:
- production;
- not related to production.
In turn, production is divided into industrial, agricultural, construction, transport and others.
Non-industrial ones can be household, street, road, non-road transport, sports, school and others.
By damage mechanism:
- direct – the damage is localized where the force was applied (for example, a blow to the knee);
- indirect – the injury is located far from the area where the force is applied (for example, a twisted leg during an unsuccessful landing after a jump).
Depending on the duration of the injury, there are:
- acute – one-time trauma to the joint;
- chronic – long-term microtraumatization.
By time of patient’s request:
- fresh;
- obsolete.
The timeframes differ for each type of joint injury. The time of transition to an old injury can range from several days to several months. Sometimes intermediate forms are distinguished: for example, subacute injury.
Based on the presence of a wound on the skin, trauma can be:
- closed – without damaging the skin;
- open – with a wound on the skin, for example, an open bone fracture.
Depending on the number of damaged joints and other tissues, trauma can be isolated, combined (several joints) and combined (damage to joints and other anatomical structures).
By severity: mild, moderate, severe injury, and some classifications also distinguish an extremely severe degree.
Depending on the presence of complications, joint trauma can be complicated or uncomplicated. Complications are different for each trauma.
Symptoms and diagnosis of joint injuries
The main universal signs of joint injury:
- pain;
- edema;
- deformation;
- limitation of mobility.
Individual injuries may have specific symptoms, but in general, a diagnosis based on clinical signs is not always possible. Sometimes additional instrumental diagnostic methods are used: CT and X-ray are better suited for diagnosing bone fractures, while MRI is considered the best option for diagnosing soft tissue injuries, including ligaments, tendons, cartilage, menisci, and joint capsule.
Knee joint injuries
Rupture of the anterior cruciate ligament. Most often, it is torn completely. This is one of the most common injuries in sports. To treat it, you have to do an operation with a subsequent long recovery. And if you do not do the operation, chronic instability of the knee develops and the risk of osteoarthritis increases.
Meniscus tear. Along with ACL tear, one of the two most common knee injuries. Menisci are cartilaginous pads inside the knee joint. When they tear, they usually do not heal due to lack of blood supply. In some cases, a torn meniscus can be stitched, but more often the damaged fragment has to be removed. At Dr. Waqas Javed’s Clinic, this surgery is performed using a minimally invasive arthroscopic method, with a recovery period of about one and a half months.
Other common knee injuries include:
- rupture of the lateral ligaments: more often the internal one, less often the external one;
- rupture of the posterior cruciate ligament (rarely isolated);
- intra-articular bone fractures;
- ruptures of cartilaginous fragments;
- damage to the joint capsule.
Ankle Injuries
Ligament injuries. The most common type of injury. There are many ligaments in and around the ankle that can be damaged as a result of a twisted ankle. The most frequently injured is the talofibular ligament. A complete rupture leads to a dislocation of the talus. The lateral collateral ligaments are also often torn.
Ankle fractures. They account for 60% of all tibia fractures. The main mechanism of injury is the outward rotation of the foot. Subluxation or dislocation of the foot is possible. Often, the deltoid ligament is torn at the same time, as well as the anterior tibiofibular ligament (partial rupture of the tibiofibular syndesmosis).
Other possible ankle injuries:
- fracture and dislocation of the talus;
- damage to the cartilage of the talus;
- tendon ruptures.
Shoulder joint injuries
Shoulder dislocation. The shoulder joint is the most mobile and has almost no ligaments. Therefore, it is the most frequently dislocated joint. Primary dislocation can become habitual due to damage to the anatomical structures that provide stability to the shoulder joint.
Bone fractures. They are supratubercular (fractures of the head, anatomical neck), infratubercular (transtubercular, fractures of the surgical neck), and also include fractures and avulsions of the greater tubercle of the humerus.
Biceps tendon rupture. Most often occurs against the background of degenerative changes, in men over 40 years old. Usually the tendon ruptures when lifting weights on the biceps (with a bent elbow).
Rotator cuff tears also occur, but they are usually degenerative rather than traumatic. Joint capsule damage is possible, but this is an adjunct to shoulder dislocation rather than an independent injury.
Elbow joint injuries
Bone fractures. Fractures of the bones that form the elbow joint account for 20% of all bone fractures. They can be intra-articular and extra-articular. Intra-articular fractures include fractures of the head, neck of the radius, olecranon and coronoid process.
Dislocation. Occurs when falling on a bent arm. The radius and ulna are behind the humerus.
Ligament ruptures. The most common are ruptures of the lateral and ulnar ligaments, which become an addition to the elbow dislocation.
Causes of joint injury
Sports injuries to joints are divided into two groups according to the cause of their occurrence: direct and indirect, which are associated with the characteristics of the human body.
Direct causes include poor organization of the training process (weather, footwear, equipment, etc.), excessive loads and lack of medical supervision.
Indirect causes include poor physical fitness, poor athletic skills, hidden and established diseases (contraindications to exercise), moral, volitional, disciplinary and other reasons on the part of the athlete.
How to recognize a joint injury
It is not difficult to recognize a joint injury: if the joint suddenly begins to hurt as a result of a blow, a twisted leg, or the impact of any other one-time factor, and this pain does not go away within a few minutes, then there is anatomical damage in the joint.
Some are serious, do not go away on their own, and require surgery, while others heal on their own without long-term effects on joint function. Some joint injuries take you out of your daily routine and training for just a few days, while others can take months.
First aid for joint injury
First aid includes:
- rest (no movement or no stress on the sore joint);
- cold (ice packs);
- pain relievers (non-steroidal anti-inflammatory drugs);
- pressure on the wound in case of bleeding.
It is necessary to immediately consult a doctor, as the patient may require reduction of the dislocation, repositioning of bone fragments, evacuation of blood from the joint cavity, or other emergency procedures.
Treatment of joint injuries
Treatment can be conservative or surgical.
The main procedures and operations used for joint injuries are:
- joint puncture;
- reduction of dislocation;
- closed or open reposition of bone fragments;
- immobilization;
- meniscus resection or suture;
- arthroscopic treatment of habitual shoulder dislocation;
- arthroscopic reconstruction of torn ligaments or tendons;
- osteosynthesis (bone augmentation).
There are no universal procedures that apply to all types of injuries to any joints. Treatment is personalized, depending on the type, nature of the injury, its duration, requirements for the functional result and many other criteria.