What can the medicine be offered today for diagnosing damage to ligaments, their treatment and recovery?

Our expert - Doctor medical Sciences, Professor of the Department of Restorative and Rehabilitation Medicine MGSMU Vitaly Epifanov.

The tension of the ligaments usually occurs during injuries: falling, sorcement, often with active sports, especially power species (different types of struggle), as well as when playing tennis, football, basketball. When the ligaments are damaged, the person feels pain and limiting mobility in the joint, sometimes it just "does not work." The discharge of fluid begins inside it, which is accompanied by an edema, swelling in the area of \u200b\u200binjury, pain when pressing or touching.

Finally, only a doctor can be confirmed signs of ligament damage - using special tests. A radiographic study is also required, which is especially important in order to start proper treatment.

Acute period

Lasts 8-14 days. At this time, the main method of treatment is immobilization (ensuring the immobility of the joint). It is imposed on a tough bandage or orthopedic tutor - a small special prosthesis. At the same time, the injured zone is anesthesia.

Depending on the stage of the disease, ice is applied or, on the contrary, there are thermal procedures. The following task is to remove swelling. For this, phonophoresis with anti-inflammatory and anti-eased drugs is used. When inflammation and swelling are removed, it is useful to exposure to heat with paraffin, ozokerite. Rodon or pearl baths can be used at the same time. This improves muscle and joint nutrition, metabolism.

Even before removing the dressing, massage and physical education classes begin, and as soon as possible. The fact is that the injury of the ligament apparatus leads to the formation of pathological sources of pain in the adjacent muscles. And they cause a reflex muscle response, which goes into spasm. This spasm is a protective reaction of the body for damage. Increasing the tone of the sympathetic nerves, forcing the muscles to shrink, is the overall response of the body to pain stress. With the help of massage and therapeutic movements, this problem can be successfully avoided.

In addition, it is also very important to maintain good microcirculation in damaged tissues and around them. This uses special drugs that improve blood circulation, electrophoresis.

Then the second stage occurs when the preliminary preparation of muscles and ligaments to physical exertion begins.

Recovery period

Here, the first place is a minelaxation - relaxation of muscles, which allows you to break the wrong stereotype of movements arising after injury. It can be carried out with the help of electric, thermal influences, massage. After myocarcation, miocarrection follows - the creation of a compensated stereotype of movements and myotonization - fixing the correct settings.

To solve the last two tasks, a special simulator has been developed. This is a loop complex consisting of a system of lattices and suspension, which allows you to remove the power of the earthly attraction and the strength of friction, so that the patient easily repeats the necessary movements of dozens and hundreds of times, increasing muscle strength. In fact, the patient is engaged in a complex in conditions of weightlessness as an astronaut.

Classes in the pool are also very helpful - they allow you to remove the load of the earth's strength from the patient of the spine and speed up the process of strengthening the muscular corset. Therapeutic effect is enhanced in the pool filled with water with a rape. This is a special healing substance, which is the products of vital activity of bacteria that dwell on the surface of mud sediments of some lakes. In the dried form of the rap is added to the water of the basin and has an anti-inflammatory, analgesic effect, improves metabolism in tissues, lymph and blood circulation. All this makes it possible to achieve better results and reduce the amount of discharge from the hospital.

Almost all the time before discharge, especially in the first period after injury, classes with a psychotherapist are important. Patients are trained to create a dominant - a set of proper movement in the affected joint. The main thing is to subjugate the dominant for your will, manage it to suppress pathological impulses in the affected spine. Here, the muscle relaxation training is very important, on the basis of which all autogenous impact techniques are implemented.

After extracting from the hospital

If a micronage occurred, then several weeks are required for recovery. If the bundle break is at least a month. But the degenerative-dystrophic lesion, which may be associated with the wrong previous treatment, will require for rehabilitation of several years. Than younger the victim, the more his ability to regenerate damaged ligaments.

Much depends on how carefully a person subsequently refers to his ligament apparatus, does not strain it over measures. It is very important not only to spare victims, but also support a good muscle tone, continuing to engage in gymnastics.

Tensile bundles is one of the most common injuries. It is enough wrong to turn the leg or hand, make a careless sharp movement - and now the pain is already feeling. For what signs can I recognize the tension of the ligaments? How to cure this injury? What means will help cure ligaments? How effective folk Methods, Various compresses and bulls?

Symptoms

Bundles are responsible for fixing the joint and control motor activity in him. Stretching tendons or ligaments occurs when they excessively loaded on them. Especially dangerous sharp movements with high amplitude. More often suffer tendons on the leg, but the upper limbs damage quite often.

The stretch is called the rupture of the part of the fibers, of which elastic thiefs that strengthen the joint are consisting. Depending on how the defeat is strongly expressed, three degrees of gravity of stretching are distinguished. It is very important to know and distinguish between their symptoms, since the severity of damage it can be concluded how urgently need to be in the hospital, as well as the presence of any other damage to the musculoskeletal system, which could occur along with stretching.

First degree

The first degree is the easiest. With it, damage and symptoms are minimal: the fibers of the ligaments are admored, but they are still capable of performing their function. The surviving part of the elastic fiber holds it in the right position. This contributes to the rapid regeneration of the damaged section of the ligament and complete recovery over a relatively short period of time after injury.

Signs of stretching of the first degree ligaments:

• Moderate sensation of soreness in the occasional region after a sharp movement. Pain can be endured without the use of painful drugs, and it decreases when using sweater means (for example, applying something cold).
• Entry is insignificant or missing.
• There are no bruises at the injury or below.
• The functionality of the joint is practically not changed or slightly complained if the edema is present.

With the first degree, for complete recovery, it is usually enough correct first aid and one or two weeks of therapeutic motor regime.

Characteristic of the complete healing of the ligament and the absence of complications.

Second degree

With a second degree, part of the fibers, of which the bunch is consisting. The articular capsule may be damaged. This significantly reduces the strength and functionality of the binder joint.

Symptoms of damage to the second severity ligaments:

• A pronounced pain that is enhanced when attempts to move.
• Hemorrhage in the joint area or just below.
• Odnocity, due to which the functionality of the joint is noticeably limited.
• Possible "breaking" of the joint, if the bunch is damaged so much that it is no longer able to fix it reliably.
• Redness of the skin, the local temperature rises.

Treatment in such a longer - up to 6 weeks.

Complications are rare, usually only in cases where there was no adequate care or a rehabilitation period was disturbed.

Third degree

The third degree of stretching is called a complete or almost complete bundle break. At the same time, it can no longer perform its functions. Recovery takes more than 2 months, and in some cases it may not come without surgery. Such a trauma is important to be treated under the control of the doctor to reduce the risk of complications (incorrect battle of bond fibers or nerve, the formation of post-traumatic nodules).

Symptoms of full bundle break:

• Strong pain, especially if nerve is damaged. Typically, the reception of analgesics is required.
• Big bruise.
• The joint strongly swells.
• Violated the functionality of the joint. The capsule is not fixed due to which the possible volume of movements increases pathologically. If the bundles of some footage of legs are damaged, for example, ankle, it is losing the opportunity to rest on foot and, accordingly, stand or walk.
• During injury, cotton could be heard, but not crackling, like when a fracture.
• When feeling noticeable, the unstability of the joint is notable.
• The body temperature may increase.

Often, with severe ligaments, other injuries can be observed. For example, (with this pain intensify at night or the next morning after injury), dislocation of the joint or bone fracture. Therefore, it is necessary to refer to the traumatologist and pass the x-ray examination.

Treatment

Medical events begin with the provision that not only specialists should be able to be able to provide. If the tension of the ligaments is insignificant, may not be necessary to contact the hospital, but during severe injury, surgery may be needed. In any case, it will be safer to see a doctor, so that he determined the severity of the injury.

In most cases, after providing first aid, the treatment continues through the use of various medicines and gradually increasing loads on the joint. Also great favor Film medicine used relevant ways can bring.

First aid

The first assistance rendered is at least half of what is necessary to prevent aggravation of injury and complete recovery. When tensile ligaments in most cases, a person is able to help. But it is not always convenient, so it will be better if someone from loved ones do.

Principles of first aid, if tensile tensions occurred:

1. Unloading the joint and peace. It is necessary to remove any load with a damaged bundle, do not strain the muscles, do not make any movements immediately after injury. If the leg is injured, it is strictly forbidden to walk or stand up with an emphasis on it.


2. Immobilization. It is necessary to bandage the joint. This will reduce the risk of a strong edema and limit the mobility. With suspected dislocation or fracture, you need to impose a bus. The bandage should not be too tight. If it feels that the bloodstream is broken, the limb "Nemeth", it is necessary to loosen the bandage tension.
3. Raised position. Helps to avoid large hematomas.
4. Cold. In the first hours, it is necessary to periodically apply cold compresses to the joint. But it is important to follow, so that the cold item has not lying right on the skin, which could cause frostbite.
5. If necessary, you can drink anesthetic medicine.

After first aid, the patient's condition is evaluated. If the complaints are minor, the treatment continues at home.

With severe pain, violations of the joint function, large hematomas should be referred to a traumatologist.

Medicia treatment

Medications for tensile tensions can be used externally (ointment, compresses) or inside (tablets, injection). Some of them treat stretching, while others help to cope with the symptoms.

How to treat tensile ligaments with pharmacy drugs:

1. . Applied with pronounced pain, for the prevention of pain. Anesthesia is possible using tablets or ointments.
2. Mazi with cooling effect. Apply in the first hours after injury. Required to reduce pain and the prevention of edema and hematomas.
3. Ointment and compresses with local irritating effect. Used after you have passed at least a day after the tension of the ligaments. Such means contribute to strengthening blood circulation, which accelerates regeneration processes.
4. Tablets and ointments. Can be used in the first days after injury to eliminate pain and inflammatory process.
5. Antipyretic means. You can drink if the total body temperature has increased.

Usually, pharmacological treatment is highly efficient and helps to quickly cure tensile ligaments.

Restoration of mobility

In order to ensure that the mobility of the joint does not break or quickly recovered, it is important to start it in time. Do not hold the limb in a fixed position for too long. As soon as pain decreased, you need to start doing simple exercises. Physical culture can be supplemented with a massage, then the treatment of tension of ligaments will be even faster and more efficient.

But the hurry with an increase in the load can also harm, lead to additional injury to ligaments and muscles. Therefore, a rule should be remembered to be guided by the selection of exercises: the actions that require effort should be performed, the load should be felt, but in no case should there be pain.

Folk remedies

Treatment of tension of ligaments with the help of traditional medicine can be very effective, especially with minor damage. This trauma is often found, so the recipes of medicine based on herbs and products that are almost in every home there is a lot. These are mainly compresses, ointments, lotions.

Some folk remediesApplicable when tensile ligaments:

• Compress with a mixture of 1 tbsp. Spoons of crushed household soap, 2 tbsp. Water and egg yolk spoons.
• Sticks with warm, almost hot milk. Apply no earlier than the second day after injury.
• Compresses based on bow or garlic.
• Compresses with a mixture of clay and apple vinegar.
• Willing up the joints of the healing plants, for example, berries Bosnes Il Arnica.
• Appliques with application salted dough. Mix flour, water and salt in equal ratios and are applied to the joint. Hold until the dough gets up.
• Compresses using daisy and lavender essential oils, camphor alcohol.

Using folk methods for the treatment of tension of ligaments, it must be remembered that plant-based remedies may cause allergic reactions. Since in this case, almost all recipes are aimed at improving blood circulation through local skin irritation, people with a tendency to allergies, folk remedies can cause unwanted consequences.

Treatment of tension of ligaments provides for long and successive efforts by the patient. But with this attitude, in most cases, injury is cured completely and does not affect the quality of the patient's future life.

The tension of the ligaments complain often. This damage occurs with sharp movements in articulations when an anatomical amplitude is exceeded. Fabrics after such damage usually grow quickly due to high regenerative abilities. The joints are most often suffering.

Many are in no hurry to contact the doctor, but the consequences of such injuries may be quite serious with improper treatment.

What do they consider stretching?

So called a partial hand or a complete gap, which arises as a result of injury. This is usually happening with sharp movements in the joint, when the ligaments are stretched more than their elasticity allows.

There are many nervous fibers and blood vessels in the ligament. Therefore, after the traumatic impact, pain develops.

Basic signs

In addition to pain, other symptoms arise. They depend on the degree of gap:

• The first is a partial supervision. It is accompanied by a minor pain, the mobility is practically not limited. Punching is small or absent.
• The second is a moderate gap, sometimes with damage to the capsule. The pain is strong, especially when driving. Above the joint appears the pronounced swelling, bruises appear, articulation mobility may be limited.
• The third is a complete tendon break. The swelling, bruising, the absence of resistance is expressed well.

Urgent Care

With such injuries, the patient has first aid, which consists of such events:

• full blend of the joint;
• cold compresses on the affected zone -, knee, etc.;
• fixation of articulation with an elastic bandage, tire;
• elevated position for the injured limb.

In the first day, hot bath, massage, rubbing are prohibited. From these procedures, swelling and inflammation will only increase.

After examination, the traumatologist prescribes drugs that reduce painful sensations and eliminate inflammation. They are accepted both inward in the form of tablets and externally in the form.

Additionally use folk recipes. For example, the joint is applied with a puree from grated raw potatoes, aloe leaves, Casisitz from clay. These tools perform auxiliary function and do not cancel the treatment prescribed by the doctor.

When breaking the third degree, a surgical operation is shown. Recovery in this case takes up to six months.

When should I contact a doctor?

If there are complaints described below, the victim is recommended to immediately apply to traumatology. It:

• too strong pain arising when driving;
• numbness;
• extensive redness and hematoma;
• crackling in the injured joint and sharp piercing pain;
• the lack of improved state in 3-5 days.

Such symptoms may indicate that there are more serious damage or other therapy is needed.

Consequences of stretching

Often stretching ligaments lead to serious problems with joints, up to limitation of mobility.

In places of subsequent instance, many small nodules are sometimes formed. They create friction with adjacent tissues, which causes the likelihood of inflammatory processes, permanent aching pain.

With a partial or complete break of bundles with impaired integrity of nerve fibers in the affected joint, tingling is felt, pain that is becoming constant. In turn, pain syndrome can lead to spasm of vessels, deterioration of blood flow and tissue dystrophy due to insufficient nutrition.

How to prevent stretching?

This injury can be avoided or reduced by such risks thanks to the recommendations of the doctor. They are pretty simple:

• sports shoes should be suitable;
• to the ligaments were strong, moderate physical activity is needed;
• the most shoes on high heels, platform;
• it is necessary to adhere to the right diet;
• additional risks creates overweight.

Want to get more specific information about this injury? Read articles "Stretching" heading.

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If, as a result of the injury of the joint joint, there was a full or partial break of the ligaments, then this state of the doctors will be qualified as a tension of ligaments. Human ligaments are clusters of a dense tissue tissue that allow you to hold the joint in a normal position. One sharp movement can lead to injury - bundles will stretch more than their natural elasticity allows. Most often, the ankle, elbow joints are traumatized, but the tension of the ligaments can be diagnosed in the knee joint.

Table of contents:

Basic symptoms of tensile ligaments

The first and basic sign of the state under consideration is a sharp pain in the place of damage to the ligaments - this is due to the fact that the ligament apparatus includes many nerve fibers and blood vessels. But there are other symptoms of tensile ligaments that will be manifested in one degree or another at different stages of the state under consideration.

1 Degree of stretching ligaments

If an easy injury is applied to a binder, then painful sensations will be poorly expressed, the motor activity of the person is not limited, and the swelling at the site of injury if there is also non-intensive.

2 Degree of tensile ligaments

Under this degree, moderate stretching and the break of the fibers of the ligament apparatus occurs. Symptoms in this case will be as follows:

• sharp pain that limits movement;
• eyeflow is rapidly growing at the place of damage;
• there are spilled bruises at the injury.

Note: With 2 degrees of tension, ligaments can be observed and the pathological mobility of the joint.

3 Degree of stretching ligaments

In this case, there is a complete bundle break. The patient notes intensive swelling and redness of the skin in the place of damage, the pathological mobility of the joint appears (instability). If the doctor begins to carry out load tests on the injured joint, it does not meet resistance.

Note: 3 The degree of tension of the ligaments is considered the most difficult, the treatment is carried out in a medical institution, the surgeon will conduct operational interference with the crosslinking of broken ligaments. Recovery period After such injury is long - up to 6 months and more.

Many patients, having received the grass of the joint and stretching ligaments, do not pay for professional medical care - they are trying to independently cope with pain and reduction of motor activity. In fact, such carelessness is fraught with complications, in some cases in the near future may be questioned by the ability of such a patient to independently moving on the legs.

At which symptoms should urgently seek medical help:

• very severe pain in the damaged joint, which makes it impossible to accomplish at least some movement;
• feeling of numbness or tingling in the joint area or the whole limb - this indicates a serious damage to the nerve fibers;
• in place of injury, an extensive hematoma or redness was formed - this is due to damage to blood vessels, and against the background of severe pain, their spasm and subsequent death may occur;
• against the background of a sharp pain, the joint is possible, but the crunch or skidding is heard;
• there is an increase in body temperature, chills;
• full loss of free movements in the joint or, on the contrary, excessive mobility (pathological) against intensive pain.

It is especially important to consult a doctor if, after injury and explicit tension, the pain does not pass within 1-2 days, the tightness of the joint is not restored in full.

In general, the phenomenon under consideration can happen to any person when exercise Or with careless walking. But there are a number of preventive events that will help prevent tensile ligaments. For example, you need to carefully walk in high-heeled shoes, and play sports in special shoes. It is necessary to deal with overweight - even a slight degree creates an additional burden on the joints.

Remember that only an active lifestyle serves as the strengthening of the binder apparatus of the joints.

If the injury to the joint has already happened, then the following can be taken to appeal to medical help:

Note: In the first hours after damage to the ligaments, it is strictly forbidden to take a warm or hot bath, rub or massage the injured place. Otherwise, the inflammatory process will actively develop, and the swelling will begin to progress.

If the patient complains of severe pain, and a crunch appeared in the joint when moving, then this is a reason to call a doctor. The specialist will not only conduct a survey of the joint, but also prescribe anti-inflammatory and painkillers. It is advisable to apply a napkin with ointment diclofenac or ibuprofen to damaged joints - they will remove the swelling, get rid of pain. After the pronounced pain is removed, the swelling is reduced, physiotherapeutic treatment will be prescribed to the patient.

Surgical treatment is appointed only with complete bundles of ligaments.

If the doctor believes that the treatment of tension of ligaments can be carried out at home, it will be reasonable to use for fast recovery and folk remedies. The most effective includes:

People's methods for the treatment of tension of ligaments can be applied only after inspection of the surgeon, this specialist will estimate the condition of the joint and will determine effective treatment. And the specified methods from the category " ethnoscience"In no case should not fully replace the therapy - they will be only one of the components of complex therapy.

Tensions of ligaments are one of the most common injuries in the world. Not only athletes, gymnasts, choreographers, but also people who are minimally connected with physical exertion suffer from this ailment. But how to avoid this unpleasant injury and what to do if the problem has already arisen?

Basic information about tensile ligaments

Under the tension of the ligaments is understood to be an injury at which there is a small damage to the ligament fibers. Often, ligaments of the joints of the limbs suffer: brush, shin, foot, shoulder. Such a disease can overtake the representative of any age and gender, which leads an active lifestyle.

Treatment of tension is quite long, as it takes about one month. A full rehabilitation period can last up to two months.

Common causes of tensile ligaments

The strategy of treatment, first of all, depends on the origin of the problem. Tensions of the ligaments are the movement of the joint, which is much higher than its physical capabilities. The following reasons may result in this result:

· Physical exercise

· Wearing noncomfortable shoes

· Weather factors (ice, snowfall)

· Heavy physical work

· Living conditions

· Obesity

· Infectious and viral diseases

· Flatfoot

· Fractures

· Congenital pathology

Most of the above reasons for the occurrence of tension of ligaments can be avoided, competently distributing the load and adjusting the concomitant diseases.

Symptoms and signs of tensile ligaments

The earlier person will notice the injury, the faster it will receive treatment. It is important to regularly pay attention to its condition, especially with an active lifestyle. Some manifestations of the human body can signal about tensile ligaments, but what?

To begin with, we should consider the tension of the ligaments from the point of view of traumatology, to study the stage of development of injury and symptoms that are inherent in each extent. There are three degrees of tensile ligaments:

1. The first degree appears a noticeable edema, while there is absolutely no hemorrhage. A person can function a damaged part of the body, but is rather limited, and tolerant pains are felt.

2. The second degree is characteristic of the appearance of a rather strong edema and hemorrhage. It is difficult for a person to move independently, there is a strong pain. From the point of view of medicine, the bond fibers occur immediately in several places.

3. On the third degree, the bundle is completely broken. Injury is accompanied by acute sudden pain, strong edema, multiple hemorrhages. The functioning of the damaged part of the body is completely limited, strong pains prevail.

In addition to the above signs characteristic of each of the three stages of tensile ligaments, there are general symptoms that will help to make a more accurate picture of the injury:

· Redness

· Inspection in the field of injury

· Tingling in the field of injury

· Limited motion

· Crunch Sustava

· Body temperature increase

Knowing the symptoms of tensile ligaments, you can speed up the process of providing first aid and facilitate further treatment.

First aid for tensile ligaments

From the quality of first aid, which will be provided in one situation or another, the success and duration of further treatment depends. Moreover, competently organized actions aimed at providing first aid can be significantly alleviated by the state of the affected person. So, consider the first aid aid algorithm when tensile ligaments:

1. Full peace

Immediately after the injury, the victim should be put or planted, where the external impact is excluded. It is strictly forbidden to touch, suck, twist, that is, to make all possible actions to check the functionality of the damaged joint. Mini-diagnostics will hold a traumatologist or paramedic assistance soon, without harming human health.

2. Fixation of Sustava

After organizing peace, it is necessary to impose a patient with a gouring bandage - an elastic bandage, thereby fixing the damaged joint. Of course, such an injury is found, often, when they are not waiting at all. Therefore, the elastic bandage can be easily replaced with a scarf, a simple bandage, a towel. The main task at this stage is to fix the joint and exclude the possibility of re-damage.

3. Cooling

Measures to cool the damaged plot will help reduce hemorrhage and remove the edema. Ideally apply ice, but if it is impossible, it is quite suitable cold water, snow, frozen foods. Such compresses must be applied to the edema 15 minutes every one or two hours.

4. Blood outflow

To facilitate the condition of the victim, it is necessary to organize a blood outflow. To reduce the bloodstream, gently raise the injured part of the body above the body level. For these purposes, you can put under the feet or hands of a person a pillow, rolled things, and everything that can be collapsed by a roll.

5. Anesthesia

Before receiving qualified medical care, the condition of the victim can be significantly alleviated by any painkillers. Of course, it is necessary to clarify the injured person about tolerance drug, turned out to be "at hand."

Complications due to tensions of ligaments: why should you consult a doctor?

Treatment of tension of ligaments should be provided by a traumatologist who will select for the affected individual course and the treatment method will establish a rehabilitation period.

Independent treatment of such injury is fraught with the appearance of complications. At a minimum, pain in the area of \u200b\u200bdamage can manifest itself in chronic form.

What can not be done when tensile ligaments?

There is something that helps, but it is possible that some actions can cause serious harm to human health. So it is categorically impossible to do when tensile ligaments?

· Heat the injured area

The joint, which suffered from stretching the ligament, is categorically impossible to heat the first 3-5 days after injury. It is necessary to avoid hot bath, heap, warm compresses. Failure to comply with this rule can provoke purulent inflammation.

· Make physical exercise

Performing physical exertion during the treatment of tension of ligaments, a person exposes itself with a new danger - a complete break of ligaments. To avoid such a sad outcome, it follows the time of treatment to completely eliminate heavy physical work, sports, choreography, gymnastics. Also do not make hiking, expeditions, long walks.

· Making a massage of the injured area

Massage and the rubbing of the injured joint can lead to abundant hemorrhage and strengthening pain. To avoid serious complications, you need to abandon these manipulations for the treatment.

· Drinking alcohol

Alcohol expands vessels and this is a fact. When tensile, bundles are better not to provoke abundant hemorrhage and acceleration of blood flow, as it will not only aggravate the patient's condition, but can also lead to some complications.

How to avoid stretching ligaments?

In order not to meet with an injury or illness "face to face", you can be guided elementary rules Prevention of one or another illness. Stretching ligaments - no exception. Traumatologists have learned this injury, the path of its origin and collected a number of recommendations on preventing the occurrence of tension of ligaments:

· Control physical exertion in accordance with individual features

· Exclude running with severity in hand

· Limit long walks, long expeditions

· Regularly examined by the doctor, in the case of diseases associated with joints and musculoskeletal system

· Pick special shoes for sports activities

· Carefully walk on heels

Following all the above recommendations, you can provide first aid to a person who suffered from tension of ligaments. It is important to note that the treatment of such injuries must be provided by a traumatologist who will not only hold a qualitative diagnosis, but also select an individual treatment method.