The meaning of the Roser-Nelaton line in medical terms. Fractures of the neck of the femur See the meaning of Roser - Nelaton Line in other dictionaries
Nelaton line) a line drawn by the superior anterior iliac to the ischial tuberosity; serves as a guide in recognizing the displacement of the femur, since when the hip is flexed at an angle of 135 °, the greater trochanter is normally located on this line.
1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.
See what the "Roser - Nelaton line" is in other dictionaries:
- (W. Roser, 1817 1888, German surgeon; A. Nelaton, 1807 1873, French surgeon; syn. Nelaton line) a line drawn from the superior anterior iliac spine to the ischial tuberosity; serves as a guideline in recognizing the displacement of the femur, because with ... Big Medical Dictionary
Big Medical Dictionary
ROSER-NELATO LINE- (proposed by surgeons - German W. Roser, 1817-1888, and French A. Nelaton, 1807-1873) - a conditional line connecting the upper anterior spine of the iliac wing with the most prominent part of the ischial tuberosity. Normally, when bent at an angle ... Encyclopedic Dictionary of Psychology and Pedagogy
- (A. Nelaton) see Roser Nelaton line ... Medical Encyclopedia
I The hip joint (articulatio sohae) is formed by the acetabulum of the pelvis and the head of the femur. A fibrocartilaginous lip runs along the edge of the acetabulum, due to which the congruence of the articular surfaces increases. T.… … Medical Encyclopedia
- (luxatio, singular) a persistent change in the correct anatomical relationships (congruence) of the articular surfaces, accompanied by a dysfunction of the affected joint. The term "dislocation" also refers to a violation of the relationship ... Medical Encyclopedia
HIP FRACTURES- honey. Hip fractures account for 6.4% of all fractures. Classification Fracture of the proximal femur Medial (cervical) fracture is valgus and varus Capital fracture (head fracture) Subcapital fracture (at the base ... ... Disease Handbook
- (18071873), French surgeon. G. Dupuytren's student. Described one of the signs of a fracture of the femoral neck (line Roser Nelaton), the clinic of the so-called sliding hernias of the bladder. He created a number of urological instruments and proposed ... ... Big Encyclopedic Dictionary
(W. Roser, 1817-1888, German surgeon; A. Nelaton, 1807-1873, French surgeon; syn. Nelaton line)
a line drawn from the superior anterior iliac bone to the ischial tuberosity; serves as a guide in recognizing the displacement of the femur, since when the hip is flexed at an angle of 135 °, the greater trochanter is normally located on this line.
Watch value Rosera - Nelaton Line in other dictionaries
Line- trait
Synonym dictionary
Line- and. trait; order, system or row; direction. straight line, the shortest connection of two points, it can be level, sheer, indirect; - curve, bow, bent, arc. border, ........
Dahl's Explanatory Dictionary
Line- lines, w. (from Latin. linea, letters. thread). 1. The boundary of a surface that has only one dimension (length) and is defined as the trace of a moving point or the intersection of two ........
Explanatory Dictionary of Ushakov
Line- -And; and.
1. A narrow strip, a line drawn on some kind of surfaces from one point to another. Draw a line. Wavy l. Mark points on the line. Intersecting........
Explanatory Dictionary of Kuznetsov
Budget Line — -
line on
chart showing all available options
choice.
Economic dictionary
Budget Line- - a graphical representation of all possible combinations of purchases of goods,
the amount of costs for which is determined
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Cash Flow Timeline— A line depicting the operating activities and cash flows of a company over a period of time.
period of time.
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Border (Limit, Line)— In insurance operations: a term originally used in the practice of Lloyds of London to denote the amount of risk liability (limit of liability), ........
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Moving Assembly Line- - a device for moving the manufactured product from one worker to another, each worker performs separate specific tasks.
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Mortgage Credit Line — -
mortgage loan linked to a revolving line of credit
the borrower can raise funds throughout the life of the loan.
Interest rates........
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Red line- The boundary separating the territories of blocks, microdistricts and other elements of the planning structure from streets, driveways and squares in urban and rural settlements. st.........
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Short Term Support Line— A bank line of credit to provide the firm with financial resources during the period of replacement of American commercial bills issued by it with European commercial bills.
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Credit line- an agreement between the borrower and the bank, according to which the bank undertakes to provide the borrower, within a certain period, with a loan on demand within ........
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Credit Line— 1 The bank's consent to provide the client, at his request, with loans not exceeding a certain total amount. It is usually drawn up in the form of a formal contract, according to which ........
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Credit Line On Demand— Credit
line to be opened
bank and giving
client
right to
borrowing money on a daily basis or
on demand.
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Credit line secured by your own home— A line of credit offered by banks and brokerage firms that allows the homeowner to receive
loan in accordance with
the value of your home. Like........
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Leasing Credit Line- (lea e line) is essentially similar to a bank line of credit, when opened by the landlord L.k.l. the tenant gets the opportunity to supplement the list of leased property........
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Line- a specialized section in mass production.
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Line 45 Bisector- - in a graphic representation
economic growth models - a straight line indicating
equality of pace
growth
factor and its result. In particular,........
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Line 45° (bisector)- in the graphic representation of the economic growth model - a straight line, indicating the equality of the growth rate of the factor and the result due to it. Particularly in the linear...
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Line Bankovskaya- Cm.
credit line
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Budget Constraint Line — -
an indicator of the combination of two goods that can be purchased at a given price level for these
goods and for a given amount of money
consumer's income.
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Line of Budget Constraints- in consumer theory
choice
line on
a graphic depicting
preferences and possibilities of the consumer, the buyer to acquire one or another quantitative ........
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Line In Insurance Recorded— the sum insured that the reinsurer agrees to accept when signing the slip.
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State Border Line- - a line on geographical maps and on the surface of the Earth, drawn on the basis of international treaties on borders or on the basis of the laws of states (for example, in relation to ........
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Deposit Line— LINE OF DEPOSITSee AVERAGE DEPOSIT ACCOUNT BALANCE
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Exchange Client Game Line- a graphical representation of the gains and losses of participants in exchange transactions when playing for an increase or
downgrade
course,
prices.
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Investment Product Line— The line of income required for investment projects as a function of beta (
non-diversifiable risk).
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Credit Line— LINE OF CREDITMaximum
amount, to-ruyu physical or legal.
person can take
bank in each individual
moment, or normal
loan limit. Dr. Name........
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Line Credit- providing
borrower legally
obligations of a credit institution to issue to it for some time
loans (open a credit ........
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Fractures of the proximal part of the femur are distinguished in relation to the hip joint (Fig. 1). As a rule, they occur in elderly and senile people, in women - twice as often as in men.
Rice. 1. Scheme of fractures of the proximal part of the femur: 1 - heads (type C); 2 - necks (type B); 3 - pertrochanteric (type A); 4 - subtrochanteric; 5 - joint capsule
Causes. Fractures of the femoral neck occur as a result of the impact of the greater trochanter on a hard surface during an uncoordinated fall of the patient (ice, wet floor, rubbed parquet, bath, etc.).
Signs. Complaints of pain in the hip joint, aggravated by an attempt to change the position of the leg rotated outwards.
The lateral edge of the foot almost touches the plane of the bed. Painful palpation of the hip joint and tapping on the greater trochanter and heel along the axis of the limb. Relative shortening of the limb, violation of the Roser-Nelaton line, She-maker, Briand's triangle are determined.
Roser-Nelaton line (Roser-Nekton) connects the anterior superior iliac spine with the most prominent part of the ischial tuberosity. Normally, with the hip bent at an angle of 135°, the greater trochanter is located on this line (Fig. 2).
Rice. 2. Roser-Nelaton line in normal (a) and in fractures of the femoral neck (b)
Line Shemyaker (Shoemaker) - normally straight, connecting the top of the greater trochanter with the anterior superior iliac spine, then crosses the middle axis of the body at the level of the navel or slightly higher. The displacement of the greater trochanter upward causes the line to deviate downward from the navel.
Rice. 3. Scheme of the Shemaker line in normal (AB) and in fractures of the femoral neck (VG)
Brian's triangle (Bryant) - a horizontal line is drawn through the greater trochanter in the cranial direction, on which a perpendicular is lowered from the anterior superior iliac spine. The top of the greater trochanter is connected by a line to the same awn. The resulting right triangle at a normal standing height of the greater trochanter has equal legs. The displacement of the greater trochanter upward or downward violates the isosceles triangle (Fig. 4).
Rice. 4. Briand's triangle in the norm (a) and with fractures of the femoral neck (b), c — scheme for constructing the Briand's triangle
With fractures without displacement and impacted fractures, most of these symptoms are absent, there are constant pains in the hip joint, aggravated by movement. The constancy of pain is explained by the stretching of the joint capsule by the blood accumulated in it. The capsule of the hip joint is inflexible, the joint cavity holds only about 20 ml of fluid. Therefore, impacted fractures of the femoral neck are often not recognized in a timely manner, sometimes even in the presence of radiographs. Radiography is performed necessarily in two projections - anteroposterior and axial.
Treatment. Non-operative treatment is acceptable for impacted fractures or in cases where surgical treatment is associated with a high risk for the patient.
Immobilization of the limb is performed with a circular hip plaster cast in the position of abduction and internal rotation for 4-6 months. and more (Fig. 5).
Rice. 5.
Skeletal traction must necessarily precede both the application of a plaster cast and surgical treatment. The traction pin is passed over the condyles of the femur.
In case of fractures with displacement of fragments, reposition is performed under local anesthesia with novocaine. The limb is pulled along the axis, rotated inwards and retracted.
From the very first days after the imposition of a system for traction or a plaster cast, patients are prescribed general and respiratory exercises to prevent congestive pneumonia, bedsores, atrophy of the muscles of the trunk and limbs.
The patient should use the Balkan frame to raise the upper body, help the attendants (relatives) make the bed, develop movements in the knee and ankle joints, and actively strain the quadriceps femoris muscle.
The outcome of the injury largely depends on the personal care of the patient, since patients, especially the elderly, quickly become inactive, cease to independently engage in exercise therapy, they develop bedsores, pulmonary heart failure, and they die.
Operative methods for the treatment of femoral neck fractures should be preferred. Although the operation itself is a serious test for the patient, it provides the necessary conditions for a favorable course of the fracture. During the operation, accurate reposition of fragments is ensured, their strong fixation with metal structures (Fig. 6), which allows early activation of patients.
Rice. 6. Osteosynthesis in fractures of the femoral neck: a — spongy cannulated screws; b — dynamic femoral screw with cancellous screw
The operation is performed under anesthesia, conduction (Fig. 7), local or spinal anesthesia.
Rice. 7. Conduction anesthesia of the lower limb (Pashchuk A. Yu., 1977): a, b - blockade of the sciatic nerve; c - blockade of the femoral (3) and external cutaneous (1, 2) nerves; g - blockade of the obturator nerve; e - blockade of the saphenous nerve of the lower leg (4), tibial (5) and common peroneal (6) nerves; f - conduction anesthesia in the lower third of the leg
After closed reposition, osteosynthesis is performed with three cannulated screws or a dynamic femoral screw. After surgery, in all cases, the leg should be straight, but slight abduction is possible, supported by a splint of soft molded material.
Physiotherapy. In all cases, immediately start training the quadriceps muscle, passive movements in the hip and knee joints with support, breathing exercises (geriatric patients).
Getting out of bed(depending on the general condition and age) from the 5-7th day using "walkers" or crutches (Table 1).
Table 1. Terms of loading on the operated limb after osteosynthesis of the femoral neck
X-ray control produce after 4, 8, 12-16 weeks.
Removal of a metal structure usually carried out after 12-18 months. In elderly patients, fixators can not be removed.
Ability to work is restored after 8-12 months.
In elderly and senile patients, unipolar or total hip arthroplasty is indicated (Fig. 8), which allows to accelerate their activation and prevent the development of such complications as hypostatic pneumonia, bedsores, etc.
Rice. 8.
After hip arthroplasty, partial load on the operated limb is possible immediately, and full load after 4-6 weeks.
Complications: aseptic necrosis of the head, osteoarthritis, contractures.
Traumatology and orthopedics. N. V. Kornilov
Determination of the correct relationship of bone protrusions detected on the patient's body during , various auxiliary lines and geometric shapes help.
Photo: Wikipedia Connects the ischial tubercle with the anterior superior spine; serves to detect pathology in the hip joint and femoral neck. Normally, when the leg is bent at the hip joint to an angle of 130-140 degrees, the apex of the greater trochanter is on that line, and in the presence of pathology (fracture of the femoral neck, dislocation in the hip joint, etc.) - above or below it.
Shemaker line
Shemaker line, connecting the top of the greater trochanter with the anterior superior spine, normally passes above the umbilicus. When the greater trochanter is displaced in the cranial direction (with a fracture of the femoral neck, a decrease in the cervical-diaphyseal angle in various diseases of this area, etc.), this line passes under the navel.
Briand's triangle
Briand's triangle. If we extend the longitudinal axis of the femur extended to 180 degrees in the cranial direction through the greater trochanter in the cranial direction and lower the perpendicular from the anterior spine to this continuation, then by connecting three points (the intersection of the perpendicular, the anterior superior spine and the apex of the greater trochanter), we get an isosceles right triangle with vertex lying at the point of intersection of the perpendicular with the continuation of the axis of the femur. If the greater trochanter is displaced as a result of any pathology (congenital dislocation of the hip, traumatic dislocation, etc.), the isosceles triangle is disturbed.
Guther's triangle
Guther's triangle. It is formed when the arm is bent at the elbow joint by three bony protrusions: the epicondyles of the humerus and the most protruding part of the olecranon. Normally, this triangle is isosceles, and its apex is the olecranon.
Potera Line
If the arm is fully extended in the elbow joint, then the mentioned bone formations form a straight line - potera line.
Marx's epicondyle line
Normally, the line connecting both epicondyles is perpendicular to the longitudinal axis of the humerus.
Guther's triangle and Marx's line violated in fractures with displacement of the condyles and epicondyles of the humerus, fractures of the olecranon, dislocations of the forearm, etc.
For bimalleolar supination fractures, along with swelling in the ankle joint, there is a distinct soreness with light pressure at the level of the lateral, medial malleolus, sometimes uneven edges are felt in the area of the fracture. Final Diagnosis
put after radiography of the ankle joint in two projections. An avulsion fracture of the outer malleolus and an oblique fracture of the inner are determined.
On anteroposterior X-ray, an important condition that helps to identify all damage in the joint in a pronation fracture is the laying of the lower leg with the foot rotated inside by 20° (see UKP AO/ASIF).
Treatment. The main treatment for ankle fractures is non-surgical. After anesthesia (local anesthesia, premedication with non-narcotic or narcotic analgesics, often in combination with antispasmodics, conduction anesthesia, anesthesia), one-stage manual reposition and immobilization with a dissected circular plaster bandage to the middle of the thigh are performed. For subsequent walking with support on the leg, a "heel" is attached to the bandage. After 4 weeks from the moment of the fracture, the bandage is shortened, freeing the knee joint.
Full comparison of fragments and elimination of diastasis in the area of the tibiofibular syndesmosis (expansion of the "fork") are a prerequisite for restoring the function of the ankle joint and preventing the development of post-traumatic deforming arthrosis.
To reposition a pronation fracture, the patient is placed on his back, the leg is bent at the knee joint. The assistant creates countertraction for the thigh, and the surgeon grabs the heel with one hand, and the rear of the foot with the other, and performs a slow but strong traction of the lower leg along the axis. Without stopping traction, the heel and talus are placed in a supination position and the entire foot is displaced inwards, thereby eliminating the external subluxation of the foot. The supinated talus brings the broken and displaced medial malleolus closer to the fracture site. In the presence of detachment and displacement of the posterior part of the articular edge of the tibia, the foot is placed in an extension position, and in case of a fracture of the anterior tibia, flexion. These techniques, by stretching the ligaments and the joint capsule, contribute to the reposition of displaced fragments. Additionally, pressure is applied to the area of bone fragments. In conclusion, both bones of the lower leg are compressed at the level of the ankle joint in the frontal plane to eliminate diastasis in the tibiofibular syndesmosis and restore the "fork" of the ankle joint (Fig. 154). The achieved position is fixed with a plaster bandage: first, lateral plaster splints are applied and fixed with circular passages of a soft bandage, after X-ray control, a circular plaster bandage is applied from the fingertips to the middle of the thigh, giving the limb a flexion position in the knee joint by 5-10 ° and fixing the foot at an angle 90-95°.
