Traumatology is a branch of orthopedics that specializes in trauma care. In this case, we are talking about both just received injuries and their delayed consequences. Injury is one of the most common causes of death and disability, which is why traumatology is receiving such close attention around the world.
Features of traumatology in Russia
In Russia, traumatology has achieved great success thanks to the use of the latest methods of surgical treatment, the availability of modern equipment. The specialists working in Russian clinics are known all over the world for their high professionalism and innovative approach to treatment. Russian doctors have at their disposal consumables that can be used to restore the integrity of bones and ligaments.
That is why many patients come to Russia who have received injuries, especially difficult ones, requiring surgical treatment and long-term rehabilitation. All the necessary traumatology services are provided in clinics and rehabilitation centers in Russia, while their prices are quite affordable. Treatment in Russia is a real opportunity to return to a full life even after receiving serious injuries.
Many people mistakenly believe that a traumatologist is exclusively engaged in the application of plaster, but his field of activity is much wider. This doctor helps to get rid of many ailments, with complaints about which they initially turn to other specialists, including a therapist. Treatment can take place on an outpatient basis or in a clinic. Conservative, physiotherapeutic, surgical methods of treatment are used.
What does a traumatologist treat?
The profession of a traumatologist combines two specialties - traumatology and orthopedics:
- Traumatology in most cases is used for emergency measures, since it was created specifically for the diagnosis and treatment of injuries of the musculoskeletal system.
- Orthopedics, as a rule, deals with planned treatment, since the field of activity of an orthopedist includes the study, diagnosis, treatment, choice of methods for the prevention of diseases and deformities of the musculoskeletal system - both congenital and acquired.
The list of diseases and deformities that a specialist deals with is quite impressive. The most frequent problems with which they turn to a traumatologist are fractures, sprains, flat feet, scoliosis, arthritis, arthrosis, hip dysplasia, hallux valgus, and intervertebral hernia.
When to see a trauma doctor
A highly qualified specialist recognizes and treats diseases and injuries at any stage, but it is in the patient's best interest not to delay the visit in order to avoid complications. Neglect of symptoms leads to problems that negatively affect the whole body, make it impossible to work, to fully rest. Timely started treatment reduces the time required for complete recovery and the patient's financial costs.
Where does a traumatologist work
A specialist can be found in an emergency room, clinic or hospital near your place of residence, as well as in commercial multidisciplinary medical centers.
How is an appointment with a traumatologist
In case of serious injuries complicated by blood loss, respiratory failure, loss of consciousness, instantly developing infections, cardiac arrest, the specialist acts as an ambulance doctor.
In all other cases, as a rule, they make an appointment with a doctor at a convenient time for themselves. However, if the symptoms are severe, then there is no need to delay the visit so as not to aggravate the situation.
At the doctor's appointment, first a conversation is held, in which the patient must talk about his health condition, express complaints. You don't have to try to diagnose yourself. Then an inspection is carried out. The doctor makes a preliminary diagnosis, directs for tests, prescribes an additional examination - most often X-ray images and MRI.
It should be borne in mind that the traumatologist treats both on an outpatient basis and sends to hospitalization, therefore, in the second case, you will have to take mandatory tests, including a coagulogram, an ECG, a general urine and blood test.
For the first visit to be fruitful, you need to bring with you an extract from the outpatient card, MRI or X-ray images of problem areas.
In medicine, traumatology and orthopedics go side by side, although for the layman these are different specializations. As the name suggests, many believe that a traumatologist should only be consulted in the event of an injury, while an orthopedic surgeon treats congenital deformities. Meanwhile, dysfunctions of the musculoskeletal system can occur as a result of various diseases, and injuries can be hidden. Therefore, the basic specialization of a doctor who treats injuries to bones, joints, ligaments, tendons and muscles sounds like an orthopedic traumatologist. In addition, the duties of a traumatologist include the treatment of post-traumatic syndromes, flat feet, curvature of the spine, and the application of a plaster cast or splint.
When do you go to an orthopedic traumatologist?
First of all, they come to a trauma specialist in case of injury. Moreover, even with a "simple" injury, you should not neglect a visit to a doctor, since you will not be able to independently determine whether a dislocation, fracture or rupture of ligaments is disguised as a bruise. If the pain does not stop at the site of the injury, there is redness and swelling, you feel stiffness in movements - see a doctor immediately! In the competence of a traumatologist:
Dislocations and fractures;
Bruises and sprains;
Burns, peeling and frostbite;
Pain in joints and limbs;
Incorrectly healed fractures;
Curvature of the joints of the spine and intervertebral hernia;
Varus and valgus deformities.
In addition to treatment immediately after injury, periodic consultation with an orthopedic traumatologist is necessary for any joint pathology - this is arthritis, spondylitis, arthrosis; bone diseases - osteoporosis, osteomyelitis, gout; congenital deformities of the feet; dysplasia.
Also, an appointment with a traumatologist should be made if:
In the joints, spine, lower or upper extremities, a stringy or sharp pain is felt for a long time;
There is swelling, redness, swelling of the limbs, and when walking, limping and braiding of the legs begins;
There was frostbite of the extremities and even if first aid was provided, you should still show the affected area to a traumatologist;
The curvature of the spine, of any limb became noticeable, or one shoulder rose higher than the other,
The main functions of an orthopedic traumatologist:
Treatment of bruises, sprains, dislocations;
Treatment of wounds, removal of foreign bodies;
Fracture reduction, plaster cast;
Diagnostics and treatment of joint pain syndromes.
In case of any damage to the musculoskeletal system, do not neglect a visit to a traumatologist - after providing first aid, the doctor will observe you during the entire rehabilitation period until complete recovery.
How is an appointment with a traumatologist?
At a consultation with a traumatologist, you will most likely have to do the following diagnostic tests, which will help the doctor more accurately determine the course of treatment after he has familiarized himself with the patient's complaints:
X-ray (will reveal the presence of all defects, fractures and damage to the bone);
MRI (magnetic resonance imaging, which allows you to examine the state of internal organs and tissues);
Biopsy (microscopic examination of an organ or a small piece of tissue to identify diseases of the body, often with latent symptoms);
Blood test;
Densitometry (measurement of bone density).
In the case when the injury is external and clearly visible, for example, an open hand fracture has occurred, the doctor immediately proceeds to provide assistance, and after the X-ray, the limb is adjusted and a plaster cast is applied to fix the damaged bone correctly. In case of internal injuries, the traumatologist will not be able to provide medical assistance until the patient undergoes the necessary examinations. Based on the results obtained, a diagnosis is made, treatment is prescribed and a complex of medical procedures is carried out. If a patient comes to see a traumatologist with inflammation, then the damaged area is anesthetized (usually by means of a mixture of anesthetics with glucocorticoids injected directly into the joint or into the periarticular tissues), and then treatment.
Traumatology and orthopedics in the clinic "Prima Medica", Moscow
The clinic is proud of its doctors - high-class professionals. The qualifications of doctors are confirmed by diplomas, scientific publications and personal achievements in the profession. All medical staff of the clinic strictly adhere to the principles of the Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation", according to which the main priorities for us are to respect the interests of the patient, respectful and humane treatment of him.
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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!
Traumatologist at the emergency room
Trauma center ( abbreviated emergency room) Is the place of emergency medical care for a person with injuries musculoskeletal system and orthopedic diseases. In other words, this is a kind of clinic department that provides emergency assistance. In turn, the emergency room can be for children or adults, as well as stationary or mobile ( assistance is provided in a specialized vehicle).In the trauma center, victims with injuries of the musculoskeletal system are provided with emergency traumatological assistance, after which the patient is redirected either to traumatologist at the place of residence, or in the presence of medical indications for hospitalization in a specialized department of traumatology and orthopedics. Prevention of tetanus and rabies is mandatory in the emergency room.
Specialized emergency trauma care includes:
- the imposition of plaster;
- reduction of dislocations;
- the imposition of external fixation for immobilization;
- anesthesia;
- prevention of tetanus and rabies.
The types of full plaster cast include:
- solid plaster cast- covers both the trunk and limbs;
- plaster corset- applied for spinal fractures;
- boot- is applied in case of ankle fractures;
- bandage on the thigh- with fractures of the hip joint;
- thoracobrachial plaster- with shoulder fractures.
The rules for applying plaster are as follows:
- at the time of applying the plaster, the person should be in a comfortable and relaxed position to avoid muscle tension;
- for the injured limb, on which the plaster is applied, special supports are used;
- a plaster bandage is carried out spirally without the slightest tension;
- the fracture site is strengthened with additional rounds of bandage;
- the fingers of the limb always remain open - they are an indicator of blood circulation.
First aid for trauma
A tourniquet is another first aid maneuver used before the patient is transported to the emergency room.The stages of applying the harness are as follows:
- initially, the limb is checked for fractures;
- the presence of a fracture is a contraindication for establishing a tourniquet and an indication for a splint;
- then the limb is raised and a tourniquet is applied 10 centimeters above the damage;
- the place of application of the tourniquet must first be wrapped evenly with a towel, or the tourniquet is applied to clothing;
- initially, a full turn of the tourniquet is made, after which that part of the tourniquet that is wrapped around the limb is dosed out.
- the effectiveness of establishing a tourniquet is checked by stopping bleeding or by the disappearance of the pulse in the arteries of the peripheral limb;
- a limb with an imposed tourniquet must be immobilized.
Trauma surgeon
A trauma surgeon is a doctor who mainly specializes in the surgical treatment of pathologies of the musculoskeletal system. Such a unit is rarely present in the staff of a polyclinic or trauma center, since traumatology itself is a surgical profile. This means that an ordinary orthopedic traumatologist is able to perform surgical procedures without additional specialization. However, sometimes surgeons can specialize separately in trauma surgery. In this case, their basic profile is surgery, but with a bias in the musculoskeletal system.Consultation with a traumatologist
Consultation with a traumatologist is a necessary step in the diagnosis and treatment of injuries of the musculoskeletal system. Like a consultation with another doctor, it includes an examination of the patient and the appointment of additional studies. A traumatologist's consultation can be either urgent or programmed. An urgent consultation of a traumatologist is needed for persons who have suffered from a traffic accident or who have simply received fractures, sprains and bruises. A programmed consultation with a traumatologist can be in the event that the patient addresses him with the consequences of previously received injuries. Where does the traumatologist see?
A traumatologist can conduct an appointment at a clinic, trauma center or specialized institution. The clinic usually employs orthopedic traumatologists who treat and prevent congenital and acquired diseases of the musculoskeletal system. Also in their competence is the treatment of the consequences of previously acquired injuries. In the emergency room, as a rule, first aid is provided - wound treatment, application of plaster. After providing emergency care at the trauma center, the patient is either hospitalized or sent to a polyclinic at the place of residence.Surgical treatment is carried out in specialized institutions or in general trauma departments of hospitals. This can be the imposition of fixators, prosthetics, reduction ( picking up) debris and their fixation.
Despite sometimes the obvious picture and "clarity" of the diagnosis, a thorough examination of the patient is necessary. The examination should follow the standard scheme - clarification of complaints, collection of anamnesis ( medical history) and examination of the patient, as well as the appointment of additional tests.
Consultation with a traumatologist includes the following steps:
- clarification of complaints;
- collection of anamnesis ( medical history);
- inspection;
- appointment of additional analyzes.
Trauma patient complaints
So, the main complaint of a patient at an appointment with a traumatologist ( traumatologist-orthopedist) is pain. It is important to find out the nature, intensity and irradiation ( Spread) pain syndrome.Pain in traumatology and orthopedics is divided into the following types:
- stupid;
- sharp;
- aching;
- shooting / shooting;
- burning;
- localized and not giving away pain;
- radiating pain ( giving away) to neighboring organs.
Taking anamnesis
An important part of the examination is the collection of anamnesis - that is, finding out the course of the disease. So, the doctor without fail asks when the symptoms disturbing the patient first appeared, what preceded them, how they developed subsequently, and so on.Mandatory questions in the study of medical history are:
- When did the first symptoms appear?
- When it comes to trauma, when and where did it occur?
- Date and hour of the injury?
- Was first aid provided and what was it like?
The nature of the assistance provided at the prehospital stage ( that is, at the scene of the accident - before the visit to the traumatologist) also plays an important role. Inadequate help ( improper application of a harness or tire) can lead to a disorder of peripheral circulation, which will significantly aggravate recovery. At the same time, the timely reduction of the dislocation significantly changes the nature of the patient's complaints.
Also, if the doctor knows the exact date of the injury, it greatly facilitates the diagnosis of further injuries. For example, the nature of the damage is influenced by the rate of edema formation. Severe edema a few hours after the injury is less harmful than edema that develops within a few days.
Examination by a traumatologist
Further, the traumatologist ( or orthopedic traumatologist) proceeds to inspection. Even if the patient has an obvious injury or a specific complaint, the examination should begin with a general examination of the patient's appearance. The general view is understood as consciousness, the nature of the physique, nutrition, skin.Assessment of the general condition of the patient
Next, the traumatologist proceeds to assess the patient's posture and gait. So, the pose can be relaxed or forced ( forced). Sometimes the patient can only be standing, without the ability to sit down. This is observed with pathologies of the sacrum, lumbar spine, pelvic fractures. The patient's gait is of particular importance.
The types of pathological gaits include:
- Sparing gait ( lameness) - when the patient avoids stepping on the leg, leaning on it only for a short time. In this regard, the body is thrown towards the healthy leg.
- Duck walk- observed with damage to the pelvic bones. It can be coxarthrosis, congenital dislocation of the hip and other pathologies. In this case, a swaying gait is noted, in which the body deviates in one direction or the other.
- Cock walk- occurs when the lower leg is affected with paresis of the peroneal nerve. It is characterized by the fact that due to the sagging of the foot, the patient raises the diseased leg higher than the healthy one.
- Spasmodic gait- characterized by severe stiffness in the muscles of the limb. Such a gait is fixed in case of injuries, followed by an increase in muscle tone. At the same time, the legs are so constrained that the patient hardly lifts his legs from the ground, dragging and shuffling them.
- Ankylotic gait- occurs with ankylosis ( total immobility) the knee joint. At the same time, due to the impossibility of flexing the joint, the patient describes an arc with the affected leg. The pelvis on the affected side is raised.
What examination methods can a traumatologist prescribe?
A traumatologist, like any other doctor, uses various analyzes and studies in his practice. Basically, these are additional diagnostic methods, less often laboratory tests. Research methods in traumatology include:
- puncture of the joint.
X-ray
The simplest and most common diagnostic method in traumatology. In the overwhelming majority of cases, X-ray is a mandatory examination method. Even if a fracture is visible, the study is carried out in order to assess the extent of the lesion - the presence of fragments, the length of the fracture, the condition of the surrounding tissues. When taking X-rays, it is important to consider the basic rules for this procedure.The rules for conducting X-rays in traumatology are as follows:
- X-ray is always carried out in two projections - lateral and anteroposterior;
- the damaged area should always be in the center of the image;
- when examining tubular bones, the x-ray should also include the adjacent joints.
Angiography
A method that allows you to explore and evaluate the movement of blood through the vessels, using contrast agents. In turn, the data on the blood supply tell the doctor about the condition of the soft tissues, periosteum and bones. Without these data, it is impossible to predict recovery and the consequences of fractures.The method takes place in two stages. The first is the introduction of a contrast agent ( mayodil, urografin). The second stage is directly taking pictures. In the darkened image, the vessels appear as light wriggling stripes. Obstruction sites - where the movement of blood is suspended - appear darkened. The method is especially informative for congenital anomalies of the musculoskeletal system.
Ultrasound procedure
Ultrasound examination or ultrasound examination is also a relatively simple and cheap method of examination. It also has the advantage of being mobile. Today there are portable ( portable) ultrasonic devices that can be used in emergency rooms in the accident area.In modern traumatology and orthopedics, ultrasound is used to examine ligaments, joints and muscles. Also, the method is informative in the diagnosis of tumors of the musculoskeletal system. In pediatric orthopedics, ultrasound is used to examine the hip joint.
The indications for ultrasound in traumatology are:
- stretching;
- damage to the menisci;
- popliteal cyst;
- the presence of fluid in the joint;
Scintigraphy
This diagnostic method is rarely used today, but, nevertheless, it has not lost its value. The method is based on the degree of distribution and further reflection on the film of the radioactive substance introduced into the body. The method also takes place in two stages - the introduction of a radioactive substance and further exposure in a special chamber. Technetium ( Tehnetium-99m-MDP), which is injected intravenously. After the introduction of the substance into the body, the patient under study should drink from 5 to 7 glasses of warm water. Two hours later, the skeleton is scanned in a special camera. Before scanning in the X-ray room, the patient must prepare - remove metal items from himself, empty the bladder ( go to the toilet). After that, it is placed in a special chamber in which the distribution of technetium throughout the body is recorded. The duration of the procedure varies from 15 to 60 minutes. Scintigraphy allows not only to identify the presence of pathology, but also to assess its extent and severity of changes in bone tissue.Indications for scintigraphy are:
- bone tumors;
- bone metastases;
- trauma;
- infectious lesions of bones and joints.
CT scan ( CT scan)
CT scan ( CT scan) - the same X-ray method, but more sensitive. The difference is that CT allows for thinner sections of 0.1 millimeter. Today, thanks to computer diagnostics, three-dimensional reconstruction of the studied image is also possible ( 3D image).Also, the advantage of computer diagnostics is that it allows you to consider intra-articular lesions, which is impossible with an x-ray.
MRI)
Magnetic resonance imaging ( MRI) Is the gold standard in the diagnosis of diseases of the musculoskeletal system. The method is based on the saturation of body tissues with hydrogen protons and their behavior in a magnetic field. Due to the high density of bone and muscle tissue, a large difference in signals from the tissues is obtained. This allows for a very accurate and informative picture. That is why this method is ideal for examining the musculoskeletal system.Indications for magnetic resonance imaging in traumatology are:
- tumors and bone metastases;
- microtrauma;
- contractures;
- congenital and acquired joint pathologies.
Puncture of the joint at the traumatologist
In addition to the above research methods, so-called invasive diagnostic methods are used in traumatology and orthopedics. Invasiveness refers to penetration into the body. Most often, orthopedic traumatologists resort to joint puncture. With this maneuver, a needle is inserted through the skin and other tissues into the joint cavity or cysts ( if any).Basically, puncture is used when there is fluid in the joint. This phenomenon is called hydrarthrosis in traumatology. In this case, blood can act as a liquid ( hemarthrosis), pus ( purulent arthritis) or just a large amount of synovial fluid ( synovitis). Subsequently, the liquid is examined for the presence of bacteria in it ( for this sowing is carried out), antibodies or blood elements. Thus, a puncture of the joint can be performed for the purpose of diagnosis and treatment. In the first case, the resulting fluid is examined in a laboratory to deliver a diagnosis, in the second, it is simply removed from the joint.
Invasive methods also include arthroscopy - an endoscopic examination of the joint. The method allows you to explore all structures of the joint using an endoscope ( special tube) and the video camera connected to it. In the course of this study, it is also possible to carry out a puncture - the collection of tissue pieces for further research.
Where ( in which clinic) can I get advice from a traumatologist and orthopedist?
In Moscow
In St. Petersburg
Clinic name |
Work experience over 40 years
Metro stations: m Krestyanskaya Zastava m Paveletskaya m Paveletskaya
Online registration The cost of admission is 2500 rubles.
Chief physician of the clinic. Doctor of the highest category. Specializes in the treatment of diseases of the musculoskeletal system of adults and children. From the relief of acute pain to the development of individual programs for non-surgical treatment of diseases such as osteoarthritis, heel spur, flat feet, clubfoot, torticollis, scoliosis, humeral periarthrosis and others, intra-articular blockade of any complexity. She has many years of experience working with young athletes and sports veterans and children. He is the author of the ALANTOPHOSPHONE medicinal cream-gel (relieving acute pain and inflammation).
Specialties: orthopedist, traumatologist
Work experience over 25 years
Moscow, st. Derbenevskaya, 1, building 5, entrance 53
Moscow, st. Bolotnikovskaya, 5, bldg. 2
Moscow, st. Kozhevnicheskaya, 10, building 1
Metro stations: m Varshavskaya m Kakhovskaya m Peasant outpost m Nakhimovsky prospect m Paveletskaya m Paveletskaya m Sevastopolskaya m Serpukhovskaya
Online registration The cost of admission is 1500 rubles.
Traumatologist-orthopedist, podiatrist. Specializes in accelerated pain relief and rehabilitation of injuries and diseases of the musculoskeletal system in adults and children. Extensive experience in posture correction and flat feet. He is engaged in the manufacture of individual orthopedic insoles, has developed an individual exercise therapy program.
Savchenko Sergey Vladimirovich
Candidate of Medical Sciences
Specialties: orthopedist, traumatologist
Work experience over 35 years
Moscow, st. Shkolnaya, 49
Metro stations: m Marksistskaya m Ilyich Square m Rimskaya
Online registration The cost of admission is 1800 rubles.
She is engaged in the treatment of diseases of the musculoskeletal system, conducts traumatological and orthopedic interventions and manipulations, intra-articular blockade of any complexity, drug blockade for pain syndrome. He also owns the methods of manual therapy and treatment of diseases of the spine.
Candidate of Medical Sciences
Specialties: orthopedist, traumatologist
Work experience over 33 years
Online registration The cost of admission is 1500 rubles.
Traumatologist-orthopedist. She is proficient in the treatment of diseases of the spine and joints using PRP (platelet-rich plasma). Awarded with certificates, diplomas of the Moscow Department of Health and the International Academy of Medical and Technical Sciences. Has a number of scientific publications in the central medical journals on traumatology and orthopedics. Does not accept pregnant women, does not treat patients with fractures or any injuries. Conducts rehabilitation, but not earlier than 6 months after undergoing treatment with a surgeon.
Specialties: orthopedist, traumatologist
Work experience over 24 years
Moscow, st. School, 11/3
Moscow, st. Garibaldi, 36
Metro stations: m Marksistskaya m Novye Cheryomushki m Ilyich Square m Profsoyuznaya m Rimskaya m Taganskaya m Taganskaya
Online registration The cost of admission is 1700 rubles.
Pediatric orthopedic traumatologist, surgeon. A general specialist in the diagnosis and treatment of diseases of the feet and spine, including torticollis, clubfoot, flat feet, osteoarthritis, heel spur, periarthrosis of the shoulder scapula, scoliosis.
Simanenkov Sergey Nikolaevich
Specialties: orthopedist, traumatologist
Work experience over 23 years
Moscow, Leninsky Prospect, 2a
Metro stations: m Dobryninskaya m Oktyabrskaya m Oktyabrskaya m Polyanka m Serpukhovskaya
Online registration The cost of admission is 1500 rubles.
Chief physician, traumatologist-orthopedist. Doctor expert of the Moscow City Fund of Compulsory Medical Insurance. An expert-level orthopedic surgeon who works with difficult elderly and senile patients. She has experience working with elderly patients with joint pathology, spinal diseases in combination with diseases of the cardiovascular system, diabetes mellitus and others. Does not accept pregnant women, does not treat patients with fractures or any injuries. Conducts rehabilitation, but not earlier than 6 months after undergoing treatment with a surgeon.
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