Костная мозоль представляет собой нарост из соединительной ткани, образующийся при заживлении после перелома. Это не патология, а нормальный процесс восстановления кости после травмы. Она не представляет опасности для организма, не является фактором риска злокачественного перерождения костных клеток. В половине случаев это образование рассасывается самостоятельно в течение года.
Фото 1. Костная мозоль необходима для срастания костей. Источник: Flickr (Michael Dorausch).
Что такое костная мозоль
Костная мозоль формируется из клеток надкостницы и эндокоста, минерализируется и превращается в выступающий участок из полноценной костной ткани.
Наличие такого новообразования на рентгеновском снимке говорит о том, что процесс регенерации поврежденной кости проходит нормально.
Этапы возникновения костной мозоли
Формирование костной мозоли – длительный процесс, который иногда проходит более 12 месяцев. Выделяют несколько стадий формирования нароста:
- На первом этапе – 7-9 дней — происходит образование рубцовой ткани на месте перелома.
- Рубцовая ткань преобразуется в хрящевую ткань. Процесс занимает примерно месяц.
- Далее хрящевая ткань на протяжении 3-5 месяцев минерализуется.
- Последний этап формирования костной мозоли продолжается до 1 года, после чего кальцификации завершается и новообразование рассасывается.
В нормальных условиях – при соблюдении рекомендаций травматолога – формирование костной мозоли не причиняет пациенту никаких неудобств. Но в ряде случаев наличие нароста может вызывать дискомфорт, что становится показанием для его удаления.
Как диагностировать развитие мозоли
Наличие костной мозоли можно определить на рентгене. На снимках образование проявляется как характерный выступ в области перелома или трещины. Сформированный нарост может быть заметен визуально в тех частях тела, где кость находится близко к коже – на ключице, переносице и т.п.
Обратите внимание! Иногда наличие костной мозоли дает о себе знать, вызывая дискомфорт при ходьбе, если нарост образуется на пальце ноги или пятке.
Виды костных образований
В зависимости от типа и места перелома, различают несколько видов костной мозоли.
- Периостальная – образование в форме утолщения на наружной части кости. Обычно такая мозоль быстро регенерируется благодаря хорошему кровоснабжению. Как правило, периостальная мозоль образуется на месте неполных переломов (трещин) костей.
- Эндостальная – образуется внутри кости рядом с костным мозгом в результате полных переломов.
- Интермедиарная – образование между обломками костей, формирующееся в результаты оскольчатых переломов.
- Параоссальная – нарост, окружающий кость на месте перелома со смещением, вколоченного и других видов сложных переломов.
Особенности образования костной мозоли на разных костях
В зависимости от места перелома костные мозоли могут формироваться по-разному. На длинных и трубчатых костях наросты образуются в течение 12 месяцев и обычно они не вызывают никакого дискомфорта при соблюдении рекомендаций врача.
Но в определенных зонах мозоль может формироваться быстрее:
- Ключичная кость обусловливает хорошую видимость нароста и быструю минерализацию мозоли в течение 2 месяцев. В некоторых случаях она может полностью рассасываться, но иногда образует заметный выступ.
- После перелома ребра костная мозоль формируется в течение 1 месяца, а в процессе кальцификации может причинять неприятные ощущения. Полностью процесс минерализации завершается за 3-4 месяца, а рассасывается мозоль за 1 год.
- Переломы пальцев ног заживают в течение полутора месяцев. В результате этого процесса образуются мозоли, которые могут находиться как с наружной, так и с внутренней стороны пальца. Этот вид перелома вызывает большой физический дискомфорт, т.к. мешает ходить и постоянно подвергается механическому воздействию.
- Заживление переносицы происходит за 3-4 месяца, и обычно приводит к деформации носа. Чаще всего костную мозоль в области носовой перегородки удаляют в процессе ринопластики.
- На пятке костная мозоль образуется в течение 3 месяцев. В большинстве случаев наличие образования на пяточной кости приводит к существенному ухудшению качества жизни, т.к. мешает носить обувь, ходить и т.п.
Обратите внимание! Наличие костной мозоли там, где ее можно прощупать, ощущается как твердый однородный нарост, безболезненный при пальпации.
Лечение костных мозолей
Если костные наросты не вызывают дискомфорт и не портят внешность, то лечение не требуется. При рекомендации к удалению (например, если мозоль мешает ходить или выглядит неэстетично под кожей ключицы) проводится хирургическая операция.
Фото 2. Хирургическое удаление мозоли проводят только в крайних случаях. Источник: Flickr (Jay Milbrandt).
Это важно! Следует помнить, что любое хирургическое вмешательство в структуру костной ткани может привести к появлению новой костной мозоли. Поэтому операция по удалению костной мозоли не гарантирует решение проблемы.
Профилактические меры
Чтобы избежать осложнений и ускорить заживление переломов костей, рекомендуется соблюдать меры предосторожности и соблюдать рекомендации врача.
Одним из распространенных осложнений при заживлении перелома костей является чрезмерное разрастание соединительной ткани. Чтобы избежать формирования избыточной костной мозоли, необходима квалифицированная помощь травматолога или хирурга.
При сложных переломах трубчатых костей рекомендуется соблюдать постельный режим в течение двух-трех дней. Поврежденную конечность необходимо надежно зафиксировать, чтобы избежать подвижности осколков костей.
Обычно осложнения, приводящие к образованию крупных мозолей, возникают в таких случаях:
- при неправильном сложении обломков костей неопытным хирургом; — при преждевременной нагрузке на сломанную конечность до снятия гипса;
- при ошибках в фиксации поврежденной конечности;
- из-за несвоевременного обращения к врачу.
В редких случаях осложнения в процессе регенерации костей после переломов наблюдаются из-за аутоиммунных заболеваний, инфекций или дефицита минералов (кальция, фосфора).
Это важно! Если конечность в области перелома выглядит припухшей, отекшей, и на этом фоне наблюдается повышение температуры, необходимо срочно обратиться к врачу.
Костная мозоль после перелома является нормальным явлением во время восстановления, но пациент должен знать, что это такое. В области сращивания костей образуется уплотнение, которое присутствует при заживлении тканей. Когда лечение подобрано правильно, то образование проходит само. Если лечебные мероприятия несвоевременны или некорректны, то оно разрастается и причиняет дискомфорт.
Виды костных образований
Уплотнения бывают разными. Выделяют следующие виды мозолей:
- интермедиальную, появляющуюся среди частей сломанной кости и отвечающую за заживление на начальном этапе;
- параоссальную, соединяющую поврежденные костные частички и напоминающую шишку больших размеров с хрупкой структурой;
- периостальную, которая восстанавливается за короткие сроки, обладает хорошим кровообращением и расположена на наружной части кости вдоль перелома;
- эндостальную, состоящую из клеток головного мозга и эндостана и образующуюся внутри кости.
Особенности формирования
В первые 7 суток после перелома на месте сращения начинается формирование мягкой спайки из соединительной ткани, которую называют провизорная мозоль. Она преобразуется в остеоидное образование, которое в дальнейшем формируется в костную ткань. Появление костной мозоли происходит позднее из клеток периоста и эндоста, а ее трансформация в кость — через 12 месяцев.
На срок сращивания косточек, образование мозоли и ее характер оказывает влияние вид сломанной кости:
- при переломе ключицы необходимо 1,5–2 месяца на формирование образования, которое со временем пройдет само, но некоторые случаи требуют проведения операции;
- при переломе пальца на ноге уплотнение образуется в течение 30 дней, если оно появилось между пальцами, потребуется носить удобную обувь, чтобы не травмировать его и предупредить появление натоптышей;
- при повреждении пятки на формирование мозоли уходит 2–3 месяца;
- при переломе ребра уплотнение образуется на протяжении 3–4 месяцев и рассасывается через год;
- при повреждении носа на сроки формирования и размеры образования оказывает влияние тяжесть нанесенной травмы.
Костная мозоль образуется в течение некоторого времени. На этот процесс влияют следующие факторы:
- правильность и своевременность оказания первой медицинской помощи;
- степень травмирования;
- возраст пациента;
- общее состояние организма.
Уплотнение может появиться после проведения ринопластики носа на протяжении 3 месяцев, но это явление встречается редко.
Реабилитационные меры
Терапевтическое лечение отличается реабилитационно–профилактическим характером, целью которого является предупреждение разрастания уплотнения. Несколько дней больной должен соблюдать постельный режим, а в дальнейшем около 3 недель ограничивать двигательную активность. Кроме этого, в лечебный курс включают:
- прием медикаментов, витаминно–минеральных комплексов и хондропротекторов;
- проведение физиотерапевтических процедур, среди которых электрофорез, ультразвуковая процедура и магнитотерапия;
- лечебная физкультура;
- водное лечение;
- массаж.
Эти мероприятия позволяют ускорить процесс восстановления поврежденных клеток и способствуют правильному сращиванию.
Во время реабилитации человеку необходимо исключить посещение солярия, сауны или бани.
Дополнительными методами лечения являются рецепты из народной медицины:
- Прием ванночек с отваром ромашки, содой или яблочным уксусом. При регулярном проведении процедур наблюдается устранение неприятных ощущений и болезненных симптомов, а также размягчение образования.
- Использование алоэ помогает улучшить процесс регенерации, сократить размеры мозоли и ликвидировать симптоматику. Для этого потребуется разрезать листок растения, приложить его к пораженному участку разрезанной стороной и закрепить лейкопластырем или повязкой из бинта. Процедуру рекомендуется проводить в вечернее время.
Перед использованием народных способов лечения нужно проконсультироваться с доктором.
Чтобы удалить нарост без хирургического вмешательства, нужно избегать перепадов температуры, нагрузок на сломанную кость, и соблюдать диету. Когда консервативная терапия не дает результатов, а мозоль продолжает быстро разрастаться, потребуется оперативное вмешательство.
Операцию должен провести опытный специалист, чтобы не нанести травматических повреждений и не вызвать развитие тяжелых воспалительных процессов. Хирургический метод лечения может быть использован через 12 месяцев после перелома и его ликвидации.
Профилактические меры помогут снизить риск возникновения аномальных осложнений. Для этого необходимо:
- грамотно оказать первую помощь пострадавшему;
- своевременно обратиться к врачу при переломе;
- провести антибактериальные процедуры при открытой травме;
- соблюдать режим при временной фиксации повреждения.
Во время реабилитации нужно следовать рекомендациям врача, регулярно ходить к нему на прием, и делать рентгенографию.
Вывод
Формирование костной мозоли происходит в процессе срастания сломанной кости. Явление считается нормальным до того момента, пока уплотнение не начнет разрастаться, что сопровождается массой неприятных последствий. По этой причине для полного восстановления потребуется вовремя диагностировать увеличение уплотнения и провести лечебные мероприятия. Для удаления образования используют физиотерапевтические и хирургические методы. Их выбор зависит от степени тяжести патологии.
Костная мозоль — непривычное для всех уплотнение кожи. Образование главным образом возникает из-за травмы. Мозоль может существенно усложнить жизнь пациента, снизив его активность. А как можно избавиться от подобной неприятности, какие методы применяет современная медицина, расскажет лечащий врач.
Виды костных мозолей
В медицине любое заболевание имеет свою классификацию. То же самое относится и к костной мозоли.
Врачи различают несколько видов подобных образований:
- Параоссальная. Данный вид считается наиболее опасным. Мозоль обволакивает сломанную кость и обладает, она становится хрупкая и может сломаться даже от небольшого воздействия.
- Околокостная. Образуется из тканей, лежащих вокруг повреждённой кости. При околокостной мозоли возникает отёк и опухоль. Пациента длительное время ощущает боль.
- Промежуточная. В ряде медицинских справочников указывается другое название — интермедиарная. Образуется между обломками. Мозоль не видна и не причиняет вреда для пациентов. Лечение чаще всего не требуется.
- Эндостальная и периостальная. Мозоли этого типа образуются сразу после перелома. Первый тип развивается медленно внутри кости. Периостальный вид появляется в месте перелома сразу, быстро развивается и помогает срастанию.
Как можно понять из определений типов костных мозолей, не все из них требуют медицинского внимания. Подобные образования возникают всегда при переломе. Если они развиваются правильно и сами обломки костей неподвижны, то это помогает срастанию.
Механизм образования
Костная мозоль возникает в местах переломов. Патологические процессы приводят к подобным образованиям. Эти действия называются регенерацией костей.
Весь процесс можно условно разделить на четыре этапа:
- в самом начале на месте перелома появляются рубцы, это первый этап, который завершается через неделю;
- на второй стадии рубцы «перерастают» хрящи, процесс занимает примерно месяц;
- третий этап, длительностью до пяти месяцев, заканчивается окостенением хрящевых тканей, процесс происходит за счёт накапливания кальция в месте перелома;
- полное заживление и окончательно образование костной мозоли происходит через год после перелома.
Все перечисленные процессы считаются нормой и не требуют вмешательства врачей.
Если не соблюдён ряд условий, то образование костной мозоли считается патологией. К подобным нарушениям врачи относят неправильное лечение, неверное совмещение осколков, наличие во время заживления нагноений.
А также к патологической костной мозоли приводит нарушение пациентом рекомендаций врачей. К примеру, если больной слишком рано «нагружает» повреждённую кость.
Диагностика и симптоматика заболевания
Костная мозоль — нормальное образование, сопровождающее сращивание переломанных костей. Но в ряде случаев она вызывает боль и дискомфорт. В таких случаях для выявления причин используется рентгенография. Только с помощью снимка можно узнать расположение костной мозоли, её размеры и возникшие патологии.
Так как образование возникает на месте перелома, то и симптомы у него соответствующие. Подобные повреждения не всегда можно выявить на ощупь или увидеть. Костная мозоль на пальце ноги или на ребре выявляется сложно.
Поэтому необходимо обращать внимание и на симптомы перелома:
- В первую очередь — это боль.
- На повреждённом участке образуется отёк. Кожный покров краснеет.
- У ткани вокруг повреждения повышается температура.
По всем этим симптомам врачи и определяют начало образования костной мозоли. Но точный диагноз устанавливает только рентген. С его помощью также проводят контроль процесса заживления перелома.
Как убрать костную мозоль после перелома?
В первую очередь необходимо разобраться с вопросом — а стоит ли это делать. По сути, костная мозоль не является заболеванием. Это естественный процесс заживления переломов. Другое дело, если произошла патология.
Избавляться от подобного образования нужно при следующих условиях:
- Если образование существенно ухудшает внешний вид. Это особенно важно при переломе костей на видимых участках тела. Часто к избавлению от образования прибегают при повреждении носа.
- Когда мозоль приносит дискомфорт пациенту.
- Если образование вызывает боль.
- Когда патология явно выражена.
При неправильном срастании кости и росте мозоли возникает риск образования ложного сустава. Такие случаи возникают при неверном или полном отсутствии лечения. Поэтому полностью полагаться на природу при переломе нельзя. Даже нормальный рост костной мозоли должен контролироваться врачом, для избегания патологий.
Методы лечения
В ряде случаев избавления от мозоли не требуется. После срастания повреждённых костей она пропадёт сама.
Но если такового не произошло, то применяют один или сразу несколько методов лечения:
- Прописываются медикаментозные средства.
- Используется хирургическое вмешательство.
- Применяют физиотерапевтические методики.
А также в качестве дополнительных мер могут использоваться и народные рецепты. Но в этом случае нужно быть осторожным. К нетрадиционной медицине следует прибегать только после консультации с лечащим врачом.
Важное правило — отсутствие нагрузок на повреждённую кость. В самом начале лечения врачи рекомендуют соблюдать постельный режим. При ходьбе или другом движении костные обломки могут сместиться, что приведёт к патологии.
Медикаментозное лечение или удаление?
Использование лекарственных препаратов при избавлении от костной мозоли направлено на решение нескольких проблем:
- уменьшение отёчности;
- снятие болевых ощущений;
- недопущение начала воспалительных процессов.
Какой препарат использовать — должен решать врач. Для лечения могут применяться инъекции Дипроспана, таблетки Траумеля или Кеналога. Кроме того, ряд медикаментозных средств используют как дополнение при проведении физиотерапевтических процедур.
К помощи хирургов прибегают в крайних мерах. Операция по удалению костной мозоли — не панацея. Образование может возникнуть снова. Поэтому хирургическое вмешательство назначает только в случаях, когда консервативное лечение не дало результат, а костная мозоль доставляет боль и дискомфорт пациенту.
У подобного способа лечения есть свои недостатки. Главный из них — возможное начало воспалительных процессов. Подобное осложнение может иметь серьёзные последствия для здоровья пациента.
Физиопроцедуры
Они составляют неотъемлемую часть консервативного метода.
Костная мозоль после перелома лечится одним или сразу несколькими способами:
- Электрофорез. Процедура назначается с применением Гидрокортизона. Вещество представляет собой гормон, вырабатывающийся надпочечником. Гидрокортизон помогает в заживлении переломов костей.
- Прописываются курсы магнитной терапии. Воздействия поля помогает не только срастанию костей, но и восстановлению тканей вокруг повреждения.
- Применяется в лечении и ультразвук. При этом используются растворы на основе гормональных мазей. Процедура помогает улучшить кровоснабжение повреждённого участка.
- Используется методика воздействия ультравысоких частот.
Физиопроцедуры применяются как часть консервативной терапии. Одновременно с ними прописывается курс медикаментозных средств. Всё это вместе помогает ускорить процесс заживления переломов и снизить риск патологического развития костной мозоли.
Рецепты нетрадиционной медицины
В качестве дополнения применяются и народные методы.
Для ускорения заживления переломов применяются следующие рецепты:
- Хорошо зарекомендовали себя ванночки. В подходящую ёмкость наливают тёплую воду, небольшое количество ромашкового отвара, яблочного уксуса и добавляют пищевую соду. В ванночку погружают повреждённый участок ноги или руки на 20-30 минут. Процедуры повторяют ежедневно. Мозоль начинает размягчаться спустя 1-2 недели.
- Ромашку применяют и самостоятельно, для компресса. Сто граммов сушёных цветков растения заливают полулитром кипятка. После остывания до комнатной температуры в средстве смачивают бинт или марлю и прикладывают к проблемному участку. Компресс фиксируют и оставляют на ночь. Эффект наступает через месяц, при условии ежедневного проведения процедуры.
- Для лечения применяют свежие листки алоэ. Его разрезают вдоль и прикладывают к проблемному участку. Лист фиксируют и оставляют на всю ночь. Процедуры повторяют до исчезновения чувства дискомфорта.
- Для следующего рецепта понадобится небольшая луковица и картофель. Все ингредиенты мелко шинкуются, лучше пропустить через тёрку. Полученную массу помещают в марлю и прикладывают к повреждённому участку. Компресс держат несколько часов. Первые положительные результаты станут заметны через две недели после ежедневного проведения процедуры.
- Для облегчения болей применяют отвар из календулы. Две столовой ложки сухого сырья заливают 500 граммами кипятка. После остывания и процеживания в полученном настое смачивают ткань и прикладывают его к повреждённому участку на один час. Эффект в виде уменьшения боли наступает быстро.
- Для компресса используют настой из травы зверобоя. Сто граммов сухого сырья заливают полулитром кипятка. После остывания добавляют по столовой ложке пищевой соды и яблочного уксуса. В полученном средстве смачивают бинт и прикладывают к нужному месту. Компресс держат один час.
Ванночки и компрессы — основные народные рецепты, помогающие ускорить процесс заживления перелома и избавления от костной мозоли. Но применять их нужно с осторожностью, особенно пациентам, страдающим от аллергии. Лучше предварительно проконсультироваться с лечащим врачом.
Костная мозоль — образование, возникающее в период заживления костной ткани после перелома при нормальном течении процесса регенерации. Важно следить за тем, как заживает перелом, своевременно проходить обследование, соблюдать все рекомендации врача.
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