Fracture of the forearm ( ulna and / or radius ) - Causes, Symptoms and Treatment .MF .
basis forearm form two bones: the ulna and radius.These bones are interconnected interosseous membrane.The proximal (close to the body), the end of the forearm forms a joint surface of the elbow joint.At the other end, forearm, connecting with a brush, forming the wrist (carpal) joint.For fractures of the forearm can be damaged by one of the two bones or bone immediately.
Symptoms of a forearm fracture
• fracture of the diaphysis (body) of both bones of the forearm in the upper, middle or lower third of the forearm. fracture of both bones of the forearm is accompanied by severe pain, severe swelling and bruising at the site of the fracture.If a displaced fracture, observed deformation and shortening of the forearm.When making movements in the affected arm may feel the crunch of bone fragments.Because of the pain may be restricted movements of the elbow and the wrist.The rotational movement of the forearm around its axis (supination and pronation) sharply limited.
• Isolated fractures (single) body ulnar or radial bone in the upper, middle and lower thirds. fracture of one of the forearm bones manifest the same symptoms, but with less severity.Displacement of fragments is less common, becausebone intact prevents it.
• Fractures of the bones, accompanied by dislocation of the articular end of the other. For example, a fracture of the ulna body entails a dislocation of the radial head in the elbow joint and fracture of the radius of the body often leads to dislocation of the radial head in the wrist, which is due to the close connection of bones data.In the case of displacement of fragments, fractured ulna or radius is accompanied by a correspondingly dislocated articular end of the beam or the ulna.
• fracture of radius in typical location. This is the most frequently occurring fracture of the forearm bones and the skeleton in general.With this turn of damaged articular advanced end of the radius, which combines with a brush, it forms the carpal joint.For the radial bone fracture in typical place is characterized by a sharp pain in the wrist, the pain gives to a brush.Swelling and bruising are expressed significantly and spread to the hand and fingers.At the turn of the offset, there is a visible deformity in the wrist can be felt the crunch of bone fragments.Movement at the turn "in a typical place" will be severely limited in the wrist and almost broken at the elbow.
fracture of radius in typical location
Fractures of the forearm without bias before the X-rays, can be confused with injuries of the forearm and the wrist ligament injury.
Open fractures of any of the above areas are accompanied by bleeding, the presence of bone fragments in the wound and soft tissue injury of the brush.
First aid for fractures of the forearm
This may come any improvised analgesics (analgin, ketorolac, nimesil, etc.) should not be taken for this purpose alcohol, it can only aggravate the injury and forcomplicate communication with the patient's doctor.
• Immobilization damaged
limb segment is achieved by imposing on the forearm of the tire.The tire can make improvised.Boards, rods or sticks are fixed on the forearm, using a bandage.Always requires fixing the wrist, elbow and shoulder joint is sufficient to immobilize and unload using a bandage 'scarves »
• Overlay hemostatics dressings, in the presence of bleeding
Open fractures are accompanied by bleeding, which is necessary, in the provision of first aid to stop or weaken.It is sufficient to overlay a tight bandage on the injury.If the bleeding is quite strong and pulsating (arterial bleeding), you must apply a tourniquet on a limb, but no more than 1.5 hours.
forearm fracture for the diagnosis of X-ray study performed in two projections.
fracture Fractures of the diaphysis (body) of both bones of the forearm, as well as isolated fractures of the diaphysis radial or ulnar without displacement treated by applying a plaster cast of the middle third of the shoulder to the head of the metacarpal bone ( "bone" on the brush).If displaced fracture or dislocation is accompanied by the neighboring bones, then produce a reduction of fracture and dislocation, and then applying a plaster cast of the middle third of the shoulder.The total period of continuous data fractures plaster immobilization of 6-8 weeks.If it is impossible and unsuccessfully reposition fracture surgery is performed with the production of fixing plates or rods.The cast is applied after an operation for a period of 4 to 8 weeks, depending on the result of the operation.
At the turn of the radial bone in a typical place applied plaster from the upper third of the forearm to the head of the metacarpal bone to the fingers remain free to move.In the case of displacement, reduce a fracture and impose a similar bandage for up to 6 weeks.If the fracture is not successfully manage the right, set the lock plate.
After removing the plaster start to active rehabilitation of the patient.Plates and rods are removed in time from 6 months to 1.5 years.
Rehabilitation forearm fracture
for rehabilitation of patients with fractures of the forearm is used physiotherapy, physical therapy and massage.At home, to relieve inflammation and the development of more effective movements are applied warm bath with sea salt - for 15-20 minutes three times a day.
From physical therapy used magnetic-laser therapy, UHF, electrophoresis, mud and paraffin baths.
Exercise therapy for fractures of the forearm
After 3-4 days after helping and casting proceed to active movement in his fingers broken arm.
After 10 days allowed to an arbitrary voltage and exercise the muscles under the plaster cast, the exercise should be repeated several times a day.
After removing the plaster start to develop movement in the wrist (carpal) and elbow joints, if the latter has been immobilized in the immobilization.It is also necessary to develop a rotational movement of the forearm (pronation and supination).
Exercises for development of the elbow joint:
- in a sitting position at the table, a children's fingers take the machine and make "katatelnye" motion on the table, the elbow joint, the motion toy on the table, bent and unbent;
- Playing with a ball in a standing or sitting position;
- Set up your hands behind your head, hands meet in the castle and stretch, straightening Castle palms up;
- After 2-3 weeks after removal of plaster, use dumbbells with a small weight (up to 2 kg.), Producing a flexion-extension movements of the elbow.
All exercises for the development of the elbow joint manufacture only in conjunction with a healthy side.Exercise perform 3-4 times a day for 10-15 repetitions.
Exercises for development of the wrist joint (often have to be developed with "in a typical place" turn radius):
- Exercises with carpal expander.These exercises improve blood flow in the joints and muscles contribute to the development of the hand and forearm;
- loosening and tightening the stopper on the bottle, producing healthy and diseased hand alternately;
- Unrolling fictional test rolling pin;
- circular motion in the wrist, to take this round object in the brush;
- Lead brush aside the thumb and little finger;
- flexion and extension in the wrist, creating elastic resistance (suitable fixed rubber hose or bicycle camera).
Part of exercises for the development of the wrist is performed in the bath with sea salt, which will improve the result.Start with 10-minute exercises at a time, gradually increasing the amount.Repeat 3-4 times a day.
sure to follow the rotational movement of the forearm.These movements we make, for example, when tightening the bolts or screws with a screwdriver.
Massage should be carried out on the muscles of the shoulder and back, it will significantly improve the blood flow to the affected arm.It was only after 3-4 weeks after removal of plaster and maintenance of inflammation, proceed to the careful massage damaged forearm and developed joints, 10-15 sessions for each area.
In carrying out rehabilitation measures can not prevent the rise of gravity more than 3 kilograms, bring hand to significant fatigue and pronounced pain.
forecast forearm fracture
As a rule, the forecast for fractures of the forearm bones favorable overall treatment time reaches 3 months, at the turn of the forearm bones of the body, and 2 months at the turn of the radial bone in a typical place.Only open and complicated fractures are treated for a longer time.
doctor traumatologist Varanovich NA