Sažetak | Ligamentarne ozljede koljena česta su problematika današnje medicine. Učestalost oz-ljeda koljena najveća je u mlađoj životnoj dobi, naročito u profesionalnih i rekreativnih sporta-ša i to zbog biomehaničkih čimbenika, grešaka u treningu, neadekvatnog zagrijavanja te sve ekstremnijih sportskih aktivnosti. Najčešće su ozljede u brzim sportskim disciplinama (skijanje) i u kontaktnim sportovima s naglim promjenama smjera (nogomet, rukomet). Tjelesna nespo-sobnost uzrokovana neadekvatnim dijagnosticiranjem i liječenjem navedenih ozljeda smatra se velikim problemom koji smanjuje kvalitetu života ljudi u najaktivnijim godinama. Važan je cjelovit pristup bolesniku gdje se već iz anamneze saznaje o mehanizmu ozljede, detaljnim kliničkim testovima potvrđuje sumnja, a radiološkim metodama – ultrazvukom, kompjuterizi-ranom tomografijom i magnetskom rezonancijom na kraju prikazuje lezija. Atroskopija koljena predstavlja zlatni standard u liječenju većine unutar zglobnih lezija meniska i ligamenata. O-mogućuje minimalno invazivni pristup, bolju vizualizaciju zgloba te lakši postoperativni opora-vak. Otvorene operacije su rezervirane uglavnom za prijelome kostiju odnosno ekstremne li-gamentarne lezije koljena. Osim operativnog liječenja koristi se i neoperativni pristup, imobili-zacija koljena ortozom ili gipsom, za liječenje nepotpunih ruptura ligamenata ili kod potpunih ruptura naročito starijih pacijenata s manje zahtjevnim profesionalnim i životnim potrebama. Za vraćanje potpune funkcionalnosti zgloba izuzetno je važna pravovremena i primjerena reha-bilitacija. Pokreti operiranog zgloba počinju već 2. postoperativnog dana s ciljem vraćanja pot-punog opsega pokreta unutar 6 tjedana. Pri tome funkcionalne ortoze omogućuju kontrolirane pokrete čuvajući ozlijeđene strukture. Kasnijim ustrajnim i dugotrajnim vježbanjem, jačanjem pripadajuće muskulature te postepenim povećanjem opterećenja postižu se najbolji rezultati. |
Sažetak (engleski) | Ligamentous knee injuries are common issues of today's medicine. The frequency of knee injuries is greatest in younger age, especially in professional and recreational athletes due to biomechanical factors, training mistakes, inadequate warming, and more and more sporting activities. The most common injuries are in fast sports disciplines (skiing) and in contact sports with sudden changes in directions (football, handball). Physical incapacity caused by inade-quate diagnosis and treatment of these injuries is considered a major problem that reduces the quality of life of people in the most active years. It is important to have a complete approach to the patient who has already learned from the anamnesis about the injury mechanism, de-tailed clinical tests confirm the suspicion, and radiological methods - ultrasound, computerized tomography and magnetic resonance end up showing lesions. Knee artroscopy is a gold stand-ard for treating most of the internal lesions of meniscus and ligament. It provides minimal in-vasive approach, better visualization of the wrist and easier postoperative recovery. Open op-erations are mainly reserved for bone fracture or extreme ligament lesions of the knee. In addi-tion to operative treatment, non-operative approach, knee immobilization with ortosie or gyps, for the treatment of incomplete ligament ruptures or full rupture, especially older patients, with less demanding professional and life needs are used. To restore complete functional wrists, timely and appropriate rehabilitation is of utmost importance. Operations of the operat-ed joint begin already at the second day of the operations day in order to restore the full range of movement within 6 weeks. In doing so, functional orthoses allow controlled movements while keeping injured structures. Later, lasting and long-lasting exercise, strengthening of the associated musculature, and gradual increase in the load, achieved the best results. |