Many diseases of the feet go unnoticed by the patient, bringing the person further trouble. If there is pain in the sole, the main reason is often hidden in the wearing of uncomfortable shoes. That the pain is caused by the inflammatory process, a rare person thinks seriously.
Many patients suffer from plantar aponeurosis disease. The disease is equated to a pathology, often manifested by pain in the heel. The heel always has a large load during movement, an outgrowth on the heel tubercle begins to appear, provoking inflammation. Such a condition prevents the patient from living normally, the patient thinks about treatment.
Inflammation of the plantar aponeurosis often occurs when a foot sprain occurs. A person will earn a condition if he starts to walk incorrectly, the foot turns inward. There are other known causes of this violation:
- The disease develops in people wearing high heels. A complication occurs with prolonged wear, especially on uneven roads.
- The disease is considered a disease of runners.
- People with overweight are at risk, the legs have a large load. Hypertonicity of the calf muscles develops.
More often the disease occurs in middle-aged people, affecting mainly women. Men are exposed to the disease when playing sports.
In the risk group, people who have crossed the 40-year mark, the disease often develops at a specified age. It is believed that heavy loads on the legs, even aerobic exercise, can provoke the disease. To prevent this, it is quite possible to regulate the load.
The disease belongs to the category of professional, often occurs in people in professions where a large load falls on the legs. Sometimes factory workers who have to stand for a long time, teachers, salesmen suffer. The cause of the disease is often a thin sole on shoes.
Symptoms of the plantar aponeurosis
The disease is difficult to diagnose, the disease is often confused with other disorders. First of all, a person feels severe pain in the heel and in the sole. There are signs:
- It becomes difficult for the patient to move around, the pain subsides after rest. Identification of the disease can only be carried out by a doctor after a series of diagnostic measures.
- If the disease goes to a difficult stage, a growth called a spur begins to appear. Studying the cause of the manifestation, the patient is assigned an x-ray.
These symptoms confidently point to the plantar aponeurosis.
Complications of plantar aponeurosis
The main complication is the occurrence of a heel spur, if medication is started on time, the symptom is eliminated. The patient feels chronic pain, moreover, the phenomenon brings tangible discomfort and is not always stopped by painkillers.
Soon the patient begins to feel the development of difficulties with the knee and hip joints, there are difficulties with the spine. Ligament calcification in plantar aponeurosis is considered a severe complication. Pronounced spurs, developing, give the patient trouble.
The place of occurrence of violations becomes the site of attachment of the Achilles tendon. Old age is dangerous in terms of the development of such situations. Treatment is required without fail, preventing the development of a number of diseases. For example, chronic traumatic pain may develop when walking, an infection called gonorrhea develops, and rheumatism appears.
Treatment of plantar aponeurosis
Do not expect that the treatment will be quick. Healing takes several months. Much depends on the degree. The first symptoms require immediate medical attention. There is a chance to stop the inflammatory process, restore health with the help of physiotherapy, and do massages.
To restore the patient's health, it is necessary first of all to prepare for treatment, which includes a complex of injections. Consider the main types of treatment:
It is possible to get rid of the disease only at the initial stage. If the disease is advanced, individual symptoms persist for a long time.
Prevention of plantar aponeurosis
In order to prevent the disease, you should first of all constantly make baths for the legs, it is important to soften the skin of the feet. It is permissible to additionally use massage and medications. The doctor will prescribe treatment after a thorough diagnosis.
Remember, leg difficulties require an immediate response, the cause can hide deep in the human body. If the disease is not treated, it becomes possible to remain disabled for life. Therefore, health must be treated with attention, any deviations in the legs without leaving unnoticed.
According to the location of the abdominal muscles (mm. Abdominis) are divided into groups of muscles of the anterior, lateral and posterior walls of the abdomen. Muscles of the anterior wall of the abdomen Muscles of the lateral wall of the abdomen Muscles of the posterior wall of the abdomen Atlas of human anatomy
Muscles of the chest and abdomen)- Front view. deep plate of the thoracic fascia; deltoid(pulled to the side) big pectoral muscle(partially removed); serratus anterior; internal intercostal muscles; rectus abdominis; tendon bridges; transverse muscle... Atlas of human anatomy
Muscles of the chest and abdomen - … Atlas of human anatomy
Muscles of the lateral wall of the abdomen- are broad abdominal muscles and are arranged in three layers. The external oblique muscle of the abdomen (m. obliquus externus abdominis) forms the surface layer of the lateral wall of the abdomen. With bilateral ... ... Atlas of human anatomy
Aponeurosis- Aponeuroses of the anterior abdominal wall (indicated in blue) and the white line of the abdomen Aponeurosis (other Greek ἀπο ... Wikipedia
MUSCLES- MUSCLES. I. Histology. In general morphologically, the tissue of the contractile substance is characterized by the presence of specific differentiation in the protoplasm of its elements. fibrillar structure; the latter are spatially oriented in the direction of their contraction and ... ... Big Medical Encyclopedia
The vagina of the rectus abdominis muscles (vaginae mm. recti abdominis) on a transverse section of the anterior abdominal wall at its different levels- And the incision is above the arcuate line (above the umbilical ring). B incision below the arcuate line (in the middle between the umbilical ring and the pubic symphysis). A: white line of the abdomen; rectus abdominis; anterior plate of the sheath of the rectus abdominis muscle; ... ... Atlas of human anatomy
White line of the abdomen- Aponeuroses of the anterior abdominal wall (indicated in blue) and the white line of the abdomen ... Wikipedia
Internal oblique abdominal muscle- The internal oblique muscle of the abdomen, t. obliquus intemus abdominis, a wide flat muscle, is located medially from the external oblique muscle of the abdomen, in the anterolateral abdominal wall. Starts from the outer 2/3 of the inguinal ligament, intermediate line ... ... Atlas of human anatomy
External oblique abdominal muscle- External oblique muscle of the abdomen, t. obliquus externus abdominis, flat, wide, begins with 8 teeth from the lateral surface of the eight lower ribs. On the anterolateral surface chest the top five teeth are wedged between the bottom teeth... Atlas of human anatomy
transverse abdominis muscle- (lat. Musculus transversus abdominis), located under the internal oblique muscle of the abdomen, is a thin muscular-tendon plate with a transverse direction of muscle bundles. The muscle begins on the inner surface of VII XII ... ... Wikipedia
Aponeurosis
Aponeuroses of the anterior abdominal wall (indicated in blue) and the linea alba
Aponeurosis(other Greek. ἀπο- - a prefix with the meaning of removal or separation, completion, reverse or return, negation, termination, transformation + νεῦρον "vein, tendon, nerve") - a wide tendon plate, formed from dense collagen and elastic fibers. Aponeuroses have a shiny, white-silver appearance. According to the histological structure, aponeuroses are similar to tendons, but are practically devoid of blood vessels and nerve endings. From a clinical point of view, the most significant are the aponeuroses of the anterior abdominal wall, the posterior lumbar region, and the palmar aponeuroses.
Aponeuroses of the anterior abdominal wall
The aponeuroses of the muscles of the anterior abdominal wall form the sheath of the rectus abdominis muscle. The vagina has anterior and posterior plates, while the posterior wall of the vagina at the level of the lower third of the rectus muscle is absent, and the rectus abdominis muscles rear surface in contact with the transverse fascia.
In the upper two-thirds of the rectus muscle, the anterior wall of the vagina is formed by the bundles of the aponeurosis of the external oblique muscle and the anterior plate of the aponeurosis of the internal oblique muscle; the back wall is the posterior plate of the aponeurosis of the internal oblique muscle and the aponeurosis of the transverse abdominal muscle. In the lower third of the rectus aponeurosis of all three muscles pass to the anterior wall of the vagina.
Aponeuroses of the posterior lumbar region
The aponeuroses of the posterior lumbar region cover the longitudinal muscles of the lower back: the muscle that straightens the body (lat. m. erector spinae) and the multifidus muscle (lat. m. multifidus)
Palmar aponeuroses
Palmar aponeuroses cover the muscles of the palmar surface of the hands.
Skull aponeurosis
The supracranial aponeurosis, or tendon helmet (lat. galea aponeurotica) - aponeurosis located between the skin and the periosteum and covering the cranial vault; is integral part occipital-frontal muscle, uniting its occipital and frontal abdomen.
see also
Links
- // Encyclopedic Dictionary of Brockhaus and Efron: In 86 volumes (82 volumes and 4 additional). - St. Petersburg. , 1890-1907.
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Synonyms:See what "Aponeurosis" is in other dictionaries:
Aponeurosis... Spelling Dictionary
- (from Greek apo from, and neuron nerve, muscle). Connecting membranes that attach muscles to bones. Dictionary of foreign words included in the Russian language. Chudinov A.N., 1910. APONEUROSIS is a tendon membrane that attaches muscles to bones. ... ... Dictionary of foreign words of the Russian language
Connective tissue plate, with which the muscles are fixed. In humans, the aponeurosis is also called the fascia of the sole and palm penetrated by tendon threads ... Big Encyclopedic Dictionary
- (from apo ... and Greek neuron vein), a wide tendon plate of vertebrates, consisting of dense collagen and elastic fibers, through which some wide muscles are attached to bones or other tissues of the body. A. naz. also fascia, ... ... Biological encyclopedic dictionary encyclopedic Dictionary
APONEUROSIS- (aponeurosis) a thin, but strong enough lobe of dense, formed fibrous connective tissue, replacing flat leaf-shaped tendons in muscles that are attached to bones over a considerable distance (for example, external aponeurosis ... ... Explanatory Dictionary of Medicine
- (aponeurosis, PNA, BNA, JNA; Greek aponeurosis; ano + neuron vein, tendon, nerve; syn. tendon stretch) 1) a wide connective tissue plate, consisting of dense collagen and elastic fibers, which are located larger ... ... Big Medical Dictionary
G. G. Karavanov (1952) proposed a method of operation, which consists in closing the femoral ring with a “veil-septum”, which is formed from the aponeurosis of the external oblique muscle under the inguinal ligament at the level of the femoral canal. The aponeurosis flap is cut out with a width of 1-1.5 cm with a base at the superficial inguinal ring, and after moving the spermatic cord or round ligament of the uterus, it is captured with a forceps from the side of the thigh and brought to the thigh through the femoral canal. This flap is sutured to the lacunar ligament, to the pectineal fascia and muscle, and to the pupart ligament. At the same time, the lateral edge of the flap is sutured to the sheath of the vessels, which we consider unacceptable because of the possibility of injury to the vein and unjustified as a measure that strengthens the femoral ring. The gap in the aponeurosis after excision of the flap is sutured with knotted sutures.
P.Ya.Ilchenko (1955) fixes an aponeurotic flap 8-10 cm long and 1.5 cm wide in front of the inguinal ligament to the pectineal ligament, followed by suturing the remaining part of the aponeurotic flap to the inguinal ligament.
Currently, operations are not used in which the approach of the inguinal ligament to the upper branch of the pubic bone is carried out with U-shaped metal brackets (operation Roux, 1899).
The method of passing a bronze-aluminum wire through the inguinal ligament and specially drilled holes in the pubic bone to close the femoral ring (P. A. Herzen, 1904; A. P. Morkovitin, 1904) also did not become widespread.
Proposed by R. R. Vreden, the insertion of a flap of the aponeurosis of the external oblique muscle using a Deschamp needle or a curved forceps under the scallop muscle from the medial edge of the femoral vein to the medial edge of the scallop muscle, followed by suturing it to the pubic tubercle, is practically inapplicable due to the great trauma and technical complexity.
The proposals of V. N. Shevkunenko and N. F. Mikuli are similar. All these techniques, tested in the sectional, turned out to be complex and physiologically unreasonable. These also include the operation proposed by T. S. Zatsepin (1903), the essence of which is to fix the inguinal ligament with a silk thread, carried out around the horizontal (upper) branch of the pubic bone. After tying the two ends of the thread, the inguinal ligament should be pressed tightly against the bone and close the femoral ring.
The principle of T. S. Zatsepin was used by T. V. Zolotareva (1961), who proposed to carry out a flap of the fascia lata of the thigh through a hole made in the soft tissues that cover the obturator foramen. P. A. Herzen considered it not indifferent for the patient to operate behind the horizontal branch of the pubic bone with sutures through the bone or, even worse, under this bone through the obturator foramen.
These modifications were also tested in the dissecting room, and we were convinced of their anatomical groundlessness and extreme trauma.
Operations of femoral hernias by intraperitoneal route. With free uncomplicated femoral hernias, operations by the intra-abdominal route have not received distribution. The recommendation of the intra-abdominal approach is available from Zudek (1928). He also joins Eleker's demand to perform the elimination of the existing hernia in all laparotomies in the lower abdomen. However, A.P. Krymov believed that abdominotomy for intervention for femoral hernia has always been and will be more dangerous than simple hernia repair. We fully subscribe to the opinion of A.P. Krymov.
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The edges of the aponeurosis can be connected in the following ways:
1) using a marginal seam (Fig. 34);
2) "overlap" (Fig. 35);
3) with the formation of duplication (Fig. 36).
Rice. 34. Edge-to-edge connection of the aponeurosis.
Rice. 35. Connection of the edges of the aponeurosis "overlap".
Rice. 36. Formation of duplication from aponeurosis
Conditions necessary for suturing the aponeurosis
1. Preservation of the anterior and posterior layers of the fascia covering the corresponding surfaces of the aponeurosis. Fastening its fibers together, the fascial plates play a "cementing" role. After their removal, the elasticity and strength of the aponeurosis (in particular, the aponeuroses of the broad abdominal muscles, latissimus dorsi back, adductor major, etc.).
2. good review surfaces of the connected aponeurosis to exclude damage to the deeper vessels and nerves.
For good access to the surface of the aponeurosis, the classical technique of working with a grooved probe and a scalpel should be used. When highlighting the aponeurosis in a blunt way, it is recommended to use the edge of a tupfer or a gauze ball.
To prevent impaired blood supply to the aponeurosis, do not exfoliate tissues over a large area. At the same time, insufficient separation of tissues from the surface of the aponeurosis can contribute to an increase in the tension of the wound edges and eruption of the sutures.
Requirements for sutures placed on the aponeurosis
1. Simplicity and reliability.
2. Exclusion of defibration.
3. Ensuring maximum connection strength.
4. Mechanical fastening of the edges of the aponeurosis for a time sufficient to form a strong connective tissue scar.
Options for a circular suture applied to the aponeurosis
1. Interrupted circular sutures applied with non-absorbable material at a distance of 5-7 mm from each other.
Interrupted circular sutures located transversely with respect to the direction of the aponeurotic fibers can, when tightened, lead to their separation, tearing and even tearing. Therefore, it is necessary to place the injection and injection sites of the needle not in a linear order, but “chaotically”, excluding the possibility of such a complication (Fig. 37).
Rice. 37. Chaotic suturing of the aponeurosis
2. The use of U-shaped seams is the most rational, since they capture a large tissue area. As a result, the area of direct contact of the connected tissues increases and, accordingly, the tension per unit of this area decreases (Fig. 38).
Rice. 38. The imposition of U-shaped seams on the edges
To increase the strength of U-shaped seams, the following techniques are used:
the sutures should be oriented at some angle with respect to the course of the aponeurosis fibers;
to prevent the possibility of disintegration of the aponeurosis, the sutures are not applied in one line, but randomly (chaotically).
When performing a suture through the "tucked" aponeurosis of the external oblique muscle of the abdomen (inguinal ligament), it must be taken into account that under it on the border of the medial and middle third the lengths of the femoral vessels - artery and vein.
Rough stitching of the pupart ligament can lead to damage to the walls of these vessels with the development of bleeding. Therefore, when suturing, the needle must be visible through the aponeurotic fibers. This indicates the surface conduction of the threads and serves as a criterion for the correctness of the suture.
3. The edges of the dissected aponeurosis can be joined with a continuous twist suture.
However, the use of this option with a high degree of probability can lead to the formation of a rough postoperative scar.
When connecting the edges of the aponeurosis "overlap", nodal circular or U-shaped seams can be used according to the previously formulated rules.
The formation of a duplication from the aponeurosis is usually carried out with a two-row interrupted circular suture (Fig. 39).
