Knee joints are joints that are much more susceptible to various mechanical influences than others. The reason for this is their location. Human legs are in motion every day, and carry the weight of not only the body itself, but also the loads that a person carries with him. It is the knee joints that first begin to suffer from diseases such as arthrosis, arthritis, etc. In addition, problems can arise after an injury resulting from overload or strong mechanical impact. Diseases are often discovered after dislocations and fractures. “Pain localized in the front of the knee can be one of the symptoms of many diseases, so for correct treatment it is necessary to visit a doctor who will conduct an examination and identify the problem.”
The leg hurts below the knee, the bone in front: causes
When figuring out why the leg bones below the knee in front hurt, the doctor may suspect the following reasons:
- strong physical stress on the muscles of the lower extremities, which can provoke the appearance of painful convulsive spasms;
- sprains or ruptures of ligaments that occur when performing movements exceeding the amplitude characteristic of the joint;
- any disease of the joint (or part thereof) of an inflammatory or degenerative nature;
- varicose veins, thrombosis;
- injury or bruise received during sports or a fall;
- inflammation of subcutaneous fat;
- violation of water-salt balance;
- radiculitis;
- pregnancy or excess body weight, causing joint damage;
- fracture of the tibia or fibula.
When the leg bone hurts below the knee in front, additional research may be needed to make an accurate diagnosis.
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Preparing for leg amputation
Before performing leg amputation, it is necessary to conduct a number of studies that will help the doctor have more information about the patient’s health status:
- Clinical blood and urine tests, biochemical blood test
- Ultrasound of the arteries of the lower extremities
- X-ray of the lungs
- Electrocardiogram
Before the operation, a sedative and other medications are prescribed to correct the general condition. The patient signs informed voluntary consent for the operation.
A urinary catheter is placed to monitor urine output.
What examinations should you undergo if you have pain in the leg bones below the knee in front?
Pain in the leg bone below the knee in front should be a reason to contact an orthopedic traumatologist. If necessary, he can refer the patient for consultation to a surgeon, neurologist or other specialist. The examination plan may include:
- a survey to find out under what circumstances pain first appeared, how they are related to external factors, as well as to study the patient’s complaints, information about him and the development of the disease;
- physical diagnostic methods : examination, feeling the diseased limb (palpation), tapping it and analyzing the sounds that arise during this (percussion) - using these methods, the doctor assesses the condition of the area under the knee, finds out whether there is swelling, redness and other deviations from the norm;
- X-ray examination of the lower leg - this method allows you to detect pathologies of the skeletal system: fractures, changes in bone structure, the formation of growths or calcified areas on the surface of the bone and other changes;
- computed and magnetic resonance imaging – highly informative methods of layer-by-layer tissue scanning help to accurately determine the location of the pathological focus, its size and structure, and are used to assess the condition of bone tissue, blood vessels, nerves, and soft tissues;
- ultrasound, Dopplerography, duplex scanning - allow you to study the condition of blood vessels, their blockage or expansion, as well as the speed of blood flow;
- electrophysiological studies : electromyography, electroneurography, electroneuromyography - allow you to assess the degree of damage to the nerve trunk and muscle fibers;
- laboratory diagnostics : analysis of tissues and biological fluids using specialized equipment allows you to assess the severity of inflammatory processes and study the state of the body in autoimmune diseases.
Which specific studies will be prescribed to the patient depends on the results of the doctor’s preliminary conversation with him and the clarity of the clinical picture.
Types of leg amputation in our clinic
Amputation of the lower leg according to Pirogov is an osteoplastic amputation with a good functional result. Our clinic successfully uses this excellent method of amputation for severe gangrene of the foot. This method allows you to preserve the completely supporting stump of the lower leg. In most cases, after 4 months the patient can walk completely freely on the prosthesis without a stick. The heel area is preserved. The photo shows the stump after amputation according to Pirogov. The patient goes fishing and hunting in special shoes.
Amputation of the lower leg at the border of the upper and middle third. Preservation of the knee joint is very important for subsequent rehabilitation. According to our observations, all patients with a healed shin stump stood on the prosthesis and were able to move independently and even work. The technique of leg amputation must be masterful; only in this case can the healing of the stump be guaranteed. After leg amputation, complete social rehabilitation is achieved. Mortality with this operation is significantly lower than with hip amputation. The photo of a lower leg amputation demonstrates the possibility of effective prosthetics.
Pain of pain - discord! Probable diagnoses
If the bone behind the knee in front hurts, the doctor can try to find out the cause by the nature of the pain.
Aching, nagging pain is most often a symptom of a developing inflammatory process in the joint and erosive-destructive lesions of a rheumatoid nature.
Severe, sharp pain occurs when ligaments, tendons are torn, bruised or fractured elements of the knee, acute inflammation of the synovial bursa, exacerbation of degenerative damage to the cartilage lining (meniscus), which acts as a shock absorber in the joint and stabilizes the knee joint, as well as deforming osteoarthritis.
Acute pain in the leg bone below the knee at the front may indicate meniscal damage.
Aches in the lower leg often indicate the development of osteoporosis, a chronic progressive bone disease characterized by increased fragility.
The boring nature of pain in bones and muscles is observed with osteomyelitis, an infectious and inflammatory disease that affects the structural elements of bones. The pain is often accompanied by symptoms such as redness of the skin, swelling, and an increase in body temperature to 38–39 degrees.
Throbbing pain indicates advanced deforming arthrosis or meniscus injury.
Burning pain is characteristic of pinched sciatic nerve (they can reach the toes), as well as bone tuberculosis.
Shooting pain usually occurs when a nerve trunk is pinched.
Dull pain can accompany inflammation of the bursa of the joint, as well as chronic osteochondritis, a disease in which a small section of cartilage is separated from the adjacent bone and is displaced into the cavity of the knee joint.
Why do my shins hurt when I have flat feet?
Flat feet are characterized by an irregular anatomical shape of the foot (flattening of its longitudinal and transverse arch). As a result, the foot ceases to function as an effective spring when walking.
As a result, additional load falls on the muscular-ligamentous apparatus of the lower leg and foot, which become overloaded and quickly tire while walking. Due to muscle fatigue, painful sensations appear in the lower leg, especially in the anterior muscle group. After a short rest, such pain usually goes away quickly. Using comfortable shoes with shock-absorbing soles or orthopedic insoles significantly alleviates pain in the lower legs when walking.
The bone in the leg below the knee in front hurts: how is it treated?
If the cause of discomfort under the knee is an injury - a bruise or a fracture - treatment will be aimed at eliminating the inflammatory process, relieving heat, pain, swelling and redness, as well as healing bone fragments. In the latter case, the bone fragments are first aligned, and then they are fixed in the correct position using various types of bandages until a callus is formed.
In diseases of an infectious nature (bone tuberculosis, osteomyelitis and others), the efforts of doctors are directed towards fighting the pathogen. In this case, you cannot avoid taking antibiotics that are effective against a specific pathogen.
Treatment for pinched sciatic nerves and nerve trunks is aimed at relaxing the muscles and relieving pain. Typically, drugs from the group of centrally acting muscle relaxants, nonsteroidal anti-inflammatory drugs, glucocorticoids, and analgesics are used. Neurotropic vitamins from group B can also be prescribed, which can effectively influence the processes occurring in the nervous system.
In the case of diagnosing vascular pathology, the goal of the therapy used is the correction of disturbances in circulatory function, aimed at improving the health of blood vessels. Usually, drugs from the group of venotonics (phlebotonics) are prescribed, which improve the condition of the vascular wall and normalize blood microcirculation in the affected area.
With increased blood viscosity, antiplatelet agents and anticoagulants are additionally prescribed. The former prevent platelets from sticking together and forming blood clots. The latter make the blood more liquid, facilitating its passage through the vessels. In particularly advanced cases, surgical treatment is resorted to: the dilated vessel is removed (phlebectomy), a special substance is injected into it that glues the vascular walls (sclerosing) or the vessel is sealed using a laser (laser coagulation).
Follow-up after leg amputation
The vascular surgeon at our clinic guides the patient from amputation to prosthetics. After the patient is discharged, we send him to a rehabilitation center, where we mobilize him with lifting on crutches and a walker and subsequent temporary prosthetics. For early prosthetics, we have established contacts with a prosthetic company that provides temporary prosthetics to teach our patients to walk.
After rehabilitation, the patient must undergo an ultrasound scan of the arteries and examinations by a vascular surgeon at the clinic once every 6 months. If problems with the blood circulation of the stump are detected, then we prescribe hospitalization and vascular revascularization.
What to do if pain in the leg bone below the knee in front is caused by metabolic disorders?
A common cause of a very unpleasant condition, when the bone on the leg below the knee in front hurts, is a violation of metabolic processes in bone tissue.
Normally, two closely interconnected processes are constantly taking place in bone tissue - the destruction of old sections of bone and the construction of new strong bone structures in the vacated areas.
With age, destructive processes begin to prevail over creative ones. Scientists explain this fact by a deficiency of sex hormones, especially testosterone, which stimulates an increase in the number of building cells and prolongs their life. Bones become loose, cavities form in them, and the risk of fractures increases.
The cavities make it difficult for calcium to be removed from the dismantled areas of the bone into the blood. The mineral enters places not intended for this purpose - the cartilage tissue of the joints, causing its liming and the subsequent development of inflammatory and degenerative processes. Arthritis or arthrosis of the knee joint develops.
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The new remedy allows you to influence the very cause of fractures, the development of arthritis and arthrosis - metabolic disorders. Osteomed Forte gently stimulates the production of the body's own sex hormones, activates restoration processes in bone tissue and normalizes metabolic processes.
Research organized by the Penza Institute for Advanced Medical Studies has shown that the use of a new osteoprotector helps close voids in the bones, accelerates the healing of fractures, strengthens bone tissue and eliminates pain.
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How is the operation performed?
The patient is placed on his back, after which the leg is treated with an antiseptic solution. The surgical field is covered with sterile sheets and the surgeon marks the boundaries of the incision with a marker. If a standard operation is performed, the incision is made at the border of the middle and upper third. Two flaps are cut out from the outside and inside. Along the access route, vessels and nerves are ligated. Then the soft tissues are pulled back and the bones are sawed through. Bone filings must be processed. In order to reduce the volume of the leg stump, the soleus muscle is removed. This also leads to improved blood circulation in the stump due to a decrease in the volume of blood supplied to the tissue. The bone filings are covered by the gastrocnemius muscle. The wound is drained and sutured. After the operation, a plaster splint is applied to prevent bending of the knee joint.
When performing amputation according to Pirogov, the incision is made through the posterior part of the sole above the ankles and then circularly above the ankle joint. This creates a flap that includes the heel bone and the skin over the heel. The shin intersects 10 centimeters above the ankle joint. Then the heel bone is fixed to the bone file of the lower leg, and the skin over it is sutured. The advantage of this amputation is the creation of a supporting stump, which, after healing, allows you to walk without a prosthesis.
When amputating the lower leg, general complications may develop:
- Myocardial infarction
- Pulmonary embolism
- Bleeding
Sometimes there are problems with stump healing:
- Suppuration or necrosis of the stump
- Osteomyelitis of the stump
- Neuroma formation
Late complications after leg amputation
- Phantom pain - pain in a non-existent removed limb
- Causalgia - burning pain in the stump associated with irritation by neuromas
- The formation of trophic ulcers - the problem is associated with a deterioration in the blood supply to the stump
- Bedsores from a prosthesis - due to poor fit of the prosthesis socket to the stump
Complications can be prevented by detailed examination of patients before surgery, prevention of thromboembolic complications and adequate assessment of blood circulation in the stump.
