Fracture of the forearm: rehabilitation and treatment
The forearm is part of the arm, including the radial, ulna. In fact, this is the extension of the shoulder. The joint is elbow joint. The forearm is connected to the wrist with a wrist joint. In the ICD, a fracture of the forearm is encrypted with code S52.Such a trauma is a serious injury, obligating you to urgently contact the doctor. One of the important stages of help is immobilization with a fracture of the forearm. It must be done quickly, neatly, without worsening the patient's condition.
Fracture: causes of
Fracture is provoked by the resulting bone injuries, the causes of which are:
- unsuccessful falls;
- direct blows;
- hand twisting.
The risk of a fracture of the forearm is higher if the patient has:
- older than average;
- low muscle mass;
- bone disease;
- sports activity.
There is a high likelihood of fracture of the forearm in those who face violence or do not receive adequate nutrition.
How to suspect?
With open / closed fracture of the forearm, patients complain of:
- deformation of the affected area.
A sick arm can not move in the normal range.
If you have these symptoms, you should immediately call your doctor. On a primary examination, a specialist conducts a patient interview, collecting information on both symptoms and previous events that provoked a fracture of the forearm. Also, the doctor examines the injured area to make an accurate diagnosis.
To diagnose an open / closed fracture of the forearm, first of all do X-rays. This allows you to get information about the internal structures of the human body, gives an idea of the state of bones. The doctor can pinpoint the problem area.
Another effective and accurate method of obtaining data is computed tomography. In testing, use a computer and powerful X-ray, which allows you to get an accurate picture of internal damage and structure of bones, muscle tissue. Tomography allows you to get an idea of the condition of the tendons, cartilage. If the fracture of the forearm is complex, then tomography becomes an indispensable assistant to a doctor who is engaged in the restoration of bones.
You can cope with the problem
Modern medicine allows you to treat a fracture of the bones of the forearm, however, success depends on what is the trauma: exactly where it is within the body, how complex it is. Usually doctors conduct activities aimed at:
- return of bones to their original state, which is often accompanied by anesthesia, surgery;
- keep the affected area motionless until the bones coalesce.
To make the tire effective for fracture of the forearm, it is imposed by one of the following methods:
- plaster bandage applied before the operation, and also in cases when the invasive method is not needed;
- metal plate( installed during operation);
- screws( are installed invasively).
To reduce pain syndrome, injections of anesthetics are made. After surgery, the patient's condition is regularly checked by tomography or X-ray to monitor the healing process. In case of an unexpected displacement of bones, you can immediately diagnose this and take appropriate measures.
And what's next?
When first aid was given in the fracture of the forearm, the operation was done and the patient recovered, special exercises should be done. Their main task is to strengthen the muscles, to restore the body's ability to move. The main task of the patient and doctors is to restore the ability to function to the shoulders, fingers. Usually prescribed physiotherapy and prohibit sports and any heavy loads.
Usually fracture of the bones of the forearm heals about 10 weeks, sometimes - faster. If there was an open or fracture of the forearm with displacement, then the duration of treatment and rehabilitation is greater. In some complex cases, complete recovery will not be achieved. However, in any case, the success of events is largely determined by how clearly the patient follows the instructions of doctors. If they are violated, the likelihood of complications is high.
How to prevent?
Of course, the ability to help with fracture of the forearm is a useful and important skill, but it is even more useful to know how to prevent such a situation. As preventive measures, it is recommended that:
- avoid dangerous situations that can cause injury;
- to control the content of vitamin D, calcium in food;
- regularly do bone strengthening exercises;
- to train muscles;
- at work, observe the safety rules in sports.
Conservative and invasive
A fracture of the forearm can be treated either surgically or in a conservative way. The second option is possible if there is no bias or if the patient's condition is such that the operation carries great risks to life. The conservative method assumes a long stay in the plaster bandage, which can provoke an incorrect fusion. In many patients who thus treated fractures, the affected limb functions much worse than before the fracture. There are also unstable fractures, in which it is difficult to achieve accurate repositioning.
Operation by many traumatologists is recognized as the best known treatment option in our time. There are minimally invasive methods, which allow to operate the ulna and radius bone. The doctor during the event holds a reposition of bones, fragments, placing them physiologically correctly, and then fixing the situation with special devices. Small invasion is achieved by the fact that only small punctures are used to carry out manipulations, and all movements are controlled through X-rays. Soft tissues remain in storage, recovery takes a relatively short time interval, you can leave the hospital earlier. In addition, with this operation, the risk of complications is reduced.
Clamps and consequences
For fractures of the forearms use a variety of fixatives. One of the most effective - intraosteal rods, irreplaceable for damages of diaphyses. With the use of such latches, you can achieve results with minimal muscle damage. The operation accompanying the installation of fixatives leaves scars, but they are very small, almost invisible even for doctors.
Another popular type of retainer is the plate, fastened to the bones by screws. Osteosynthesis is a kind of "gold standard" of medicine. The most modern plate models allow you to fix bone fragments in the most correct position and hold them until the fracture has grown together.
This is important!
In the case of an open fracture, surgery can not be avoided. Intervention involves the use of special apparatus that fixes the forearm from the outside. This allows you to stabilize the patient's condition, after which you can proceed to further activities.
When the wound heals, the apparatus is removed and the bones fixed with plates or rods. This approach helps to minimize the likelihood of purulent complications.
To operate the forearm zone is not a simple task. This area is rich in nerves, blood vessels, the damage of which can have a very negative effect on the patient's condition. If you receive additional injuries, there is a high probability of complications that can lead to irreversible loss of motor activity or sensitivity. The most likely violation of the functioning of the brush. To avoid complications, the surgeon must carefully plan and implement the intervention.
Danger of healing.
. The adult diaphysis is healing a long time. After six weeks, do an X-ray of the damaged area to check the presence of the callus. After another four weeks, a test is performed on the level of strength. Normally, the bone should score up to 80% of the strength level before the fracture. Reorganization of the tissue and complete healing take years.
As a result of the splicing of the damaged area, it is possible to remove the metal retainer. This exercise is not mandatory, but sometimes the presence of a metal element causes discomfort or even pain, which is an indication for removal. Plates, rods are withdrawn from the human body two years or later. Obligatory condition - on a roentgen signs of consolidation should be obvious.
Typically, a typical fracture is a Smith or a Collapse. With this bone damage, debris is not displaced. After X-ray examination, a plaster bandage is applied to the patient to immobilize the affected part. The plaster cast starts at the fingertips, and continues up to a third of the forearm. Immobilization of the hand lasts about a month. When the gypsum is removed, physiotherapy is prescribed to develop the muscles of the wrist. With normal development of the situation, the recovery takes from one to two weeks.
A simple fracture, complicated by displacement, requires a traction reposition, when the bones are normal, pulling the injured arm. The event requires anesthesia - local, conductive. The assistant doctor pulls the brush, the other assistant pulls the limb in the opposite direction, holding the elbow. Gradually, so stretch the bone fragments, create a distance between them, and the doctor manually places all the debris into place, pressing them to take the correct position.
And what's next?
When the repositioning is complete, make the dressing out of the gypsum, keeping the arm tension in order to avoid a re-shift. When the gypsum dries, the tension gradually decreases.
If the fragments could not be moved successfully, or if a fracture is accompanied by a very large number of fragments, if the dislocations or joints have repeatedly appeared, then the operation is urgently needed. Osteosynthesis is carried out, fixators are used from metal, and then a gypsum dressing is applied. Usually with such a fracture in a plaster it is necessary to spend a month or a half, and rehabilitation takes 2-4 weeks.
Fracture: consequences of
Fracture provokes consequences of varying severity. They depend on the location of the damage and its complexity. If the fracture is easy, then everything heals quickly and leaves no visible traces, does not provoke complications. But the displacement of the fragments is a signal of increased danger of additional problems. If an open fracture with an offset is diagnosed, then the situation is classified as very complicated.
The following consequences of fractures are commonly observed:
- dysfunction of the nerves;
- pathology of splicing;
The last complication occurs most often and is provoked by soft tissue injuries. The main difficulty is that it is internal, and visually reflected by a bruise or invisibly to the eye in principle. The doctor should consider that bone fragments can injure blood vessels, soft tissue.
Internal bleeding often accompanies closed fractures with displacement. With open fractures, vascular damage is more important, since the fragments are strongly displaced, and external bleeding occurs.
Nervous activity disorder
This consequence of the fracture occurs quite often and is classified as rather severe. It is provoked by the fact that bone fractures damage the structure of nerve trunks located near the bones. More often nerve damage is fixed if the fracture with displacement is open. At the moment when the bone gets damaged, mechanically it touches nearby trunks of nerves, because of what they lose their normal performance.
Disturbance of nervous activity is manifested by loss of sensitivity, including pain and temperature. In addition, the fingers or the whole brush lose mobility, the limb grows dumb, the joint functions are blocked.