Manual reduction of a radius fracture. Forearm fracture. Causes of fracture, displaced fracture, radius fracture, ulna fracture. Treatment of a fractured ulna

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A fracture of the radius of the arm is considered one of the most common injuries.

It accounts for almost 16% of all injuries sustained at home. It is especially common in women during menopause.

The first mentions of fracture can be found in ancient medical treatises of Egypt and China. Even then, ancient healers paid attention to this type of injury and made recommendations for the treatment and rehabilitation of victims.

Fracture of the radius in a typical location

Traumatologists have such a concept as “fracture of the ray in a typical place.” This is because the vast majority of fractures (almost 75%) occur in the distal part of the bone (closer to the hand).

Fracture of the middle and proximal (located closer to the elbow) part of the radius occurs in only 5% of cases.

There are two types:

• Smith, or flexor. It happens when a person falls on a hand bent towards the back of the forearm. As a result, the bone fragment of the radius is displaced to the outer surface of the forearm;
• Wheels, or extensor. Occurs when the victim falls on the palmar surface of the hand. As a result, hyperextension occurs in the wrist joint, and the bone fragment is displaced towards the dorsum of the forearm.

As can be seen from the description, Smith's fracture and Wheel's are mirror images of each other.

Classification of injury

Depending on the nature of occurrence:

• Pathological - occur not so much under the influence of mechanical force, but as a result of a decrease in bone mineral density. The disease, a clear manifestation of which is pathological fractures, is called osteoporosis;
• Traumatic. They arise as a result of the impact of any mechanical factor on the bone: impact, fall, twisting, excessive physical activity, etc.

Depending on the violation of the integrity of the skin:

• Closed fracture of the radius of the arm, when the skin over the injury site is not damaged;
• Open. In this case, the integrity of the skin is broken, and bone fragments come out.

Depending on the fault line:

Any type of fracture can be with or without displacement of bone fragments.

There is also an anatomical classification:

• Fracture of the diaphysis (body) of the bone;
• Intra-articular fracture of the head and neck of the radius;
• Fracture of the styloid process.

Symptoms

The injury is accompanied by a fairly clear clinical picture. The main signs and symptoms of a broken arm are as follows:

First aid for a fracture of the radius of the arm

There are three fundamental steps that must be carried out when providing first aid. These include:

• Early immobilization (immobilization) of the injured limb;
• Adequate pain relief;
• Local exposure to cold;

Immobilization of an injured limb is the first step in first aid. Correct fixation of a limb performs several tasks at once:

• Minimizes additional bone displacement;
• Reduces the risk of soft tissue damage from fragments;
• Reduces pain.

Before immobilization, it is important to free your hand from rings, watches, bracelets, etc. Otherwise, they can cause compression of blood vessels and nerves. To give a fixed limb a physiological position, it must be bent at the elbow joint at an angle of 90 degrees and brought to the body, turning the hand upward.

To minimize pain, you can use drugs from the NSAID group.(non-steroidal anti-inflammatory drugs). These include diclofenac, ibuprofen, ketonal, dexalgin, Celebrex, etc. The listed drugs can be taken in tablet form or as intravenous and intramuscular injections.

Local application of cold also reduces pain. In addition, under the influence of low temperature, vasoconstriction occurs and tissue swelling decreases.

Use cold for pain relief with caution so as not to cause frostbite. To do this, wrap heating pads or ice packs in a towel before use.

Diagnostics

Radiation diagnostic methods are the “gold standard” in the diagnosis of fractures. Most often in routine practice, radiography of the limb in two projections is used.

An X-ray will show not only the presence of a fracture, but also its nature, the presence of fragments, the type of displacement, etc. These data play a key role in choosing treatment tactics.

Sometimes traumatologists use computed tomography to diagnose complex injuries.

Treatment of radius fractures

Treatment tactics directly depend on the nature of the damage and are selected individually in each specific case.

In the case of a bone fracture in a typical location, treatment consists of closed reduction (“reassembly”) of the bone fragments and application of a plaster cast to prevent displacement. Typically the plaster cast covers the hand, forearm and lower third of the shoulder.

How long to wear a cast for a fracture of the radius of the arm? Immobilization lasts on average 4-5 weeks. Before removing the plaster cast, a control x-ray is required. This is necessary to assess the fusion of inert fragments.

Sometimes it may not be possible to treat an injury with a cast alone. Then resort to the following methods:

• Percutaneous fixation of fragments with knitting needles. The advantage of the method is its speed and low trauma. However, with this treatment it is impossible to begin early development of the wrist joint;
• Open reduction of bone fragments using metal structures. In this case, the surgeon makes an incision in the soft tissue, compares bone fragments and fixes them with a metal plate and screws.

Unfortunately, surgical methods have a number of negative aspects. First of all, there is the risk of wound infection. Therefore, after the operation it is necessary to take a course of broad-spectrum antibiotics. The second disadvantage of surgical treatment of fractures is the long rehabilitation period.

Recovery time

The duration of the recovery period depends on the complexity of the injury and is, on average, 6-8 weeks. The duration of recovery is influenced by factors such as the scale of the operation, the speed of wound healing, the state of the immune system, the presence of bone diseases, etc.

Often, the recovery process after a fracture of the radius is delayed due to the fact that patients neglect doctors’ recommendations, in particular, they independently remove plaster casts ahead of schedule. This is fraught with a number of complications, which will be discussed below.

If, after removing the cast, your arm swells, this is a normal process; you can find out how to get rid of swelling after a broken arm.

Rehabilitation and how to develop an arm after a fracture of the radius

Rehabilitation after a fracture should be carried out comprehensively and include massage, physiotherapy, as well as physical therapy. The success of treatment largely depends on how responsibly a person approaches each of the listed activities.

Massage

You can begin the restoration of a limb with a massage. Correctly performed massage after a fracture of the radius has an analgesic effect, improves recovery processes, and also prevents muscle wasting.

They start with a shoulder massage, then work with the elbow joint, and only after that they move on to massage the areas around the injury. Finally, a hand massage is performed. The duration of the massage session is about 15 minutes.

Physiotherapy methods

Physiotherapy plays an important role in rehabilitation. The following procedures are used:

• Electrophoresis with calcium preparations. The essence of electrophoresis is the slow directed movement of drug particles deep into the tissue. Calcium increases bone mineral density and accelerates the healing of bone fragments;
• Low frequency magnetic therapy. Has an analgesic and anti-inflammatory effect;
• UHF method. This technique is aimed at warming up soft tissues. As a result, local metabolism improves, which accelerates regeneration;
• Ultraviolet radiation. Under the influence of ultraviolet radiation, vitamin D is produced, which is necessary for better absorption of calcium.

Exercise therapy classes

As a result of prolonged immobilization, muscles lose tone, which is fraught with the development of malnutrition. This is why timely initiation of exercise therapy for a fracture of the radius is so important. Classes should begin with the simplest exercises, for example, with alternate bending of fingers. The doctor will write out an exercise regimen on how to develop your arm after a fracture of the radius.

Exercises after a fracture of the radius should be performed carefully, without sudden movements.

It is important to carry out exercise therapy under the guidance of a specialist who will select a set of exercises in accordance with the patient’s physical capabilities and ensure that they are performed correctly.

Complications and possible consequences

They can be divided into two groups: immediate complications of injury and its long-term consequences.

Immediate complications of injury include:

• Damage to the nerve bundle (for example, rupture). It entails a violation of sensitivity (thermal, tactile, motor, etc.);
• Damage to the finger tendons, as a result of which the function of flexion or extension of the hand may be impaired;
• Damage to blood vessels with the formation of a hematoma;
• Partial or complete muscle rupture;
• Infectious complications (for example, infection joining the wound surface).

Long-term complications are not as common. These include osteomyelitis (purulent melting of bone), limb deformation due to improper fusion of bone fragments, and the formation of contractures.

Features of a fracture of the radius in a child

The structure of a child's bones is different from that of an adult. This is due to the presence of bone growth zones, better blood supply, as well as the characteristics of the periosteum - the membrane that covers the bones from the outside.

The formation of “green branch” type fractures is very common in childhood., or subperiosteal fracture. Due to the fact that the periosteum in children is very flexible, it does not lose its integrity during injury.

When a bone falls or is hit, it bends, the convex side breaks, and the concave side remains intact. Thus, the fracture is incomplete and heals much faster.

Despite these features, fractures in children should be taken seriously. There are often cases when improper fusion of bones in childhood leaves an imprint in the form of impaired hand function for life.

The general condition during this period was excellent. After another 12 days, the doctor said that the bone had shifted:

The bone was pulled out again and plaster was applied:

After the second reduction, the doctor said that perhaps after some time it would be necessary to surgically remove the fragment, but he did not say which one. Immediately after the reduction, pain appeared at the site of the “beam” fracture when extending and bending the fingers in extreme positions, and a feeling of tension. A strong feeling of discomfort, pain when moving the arm in a dream, when walking. The ring and little fingers occasionally become numb, but the blood flow is generally satisfactory. A slight pain is also felt in the area of ​​the proximal carpal bones, which took the blow of the “ray” and the ulna.

After all, the length of the beam remained the same, and enough time had passed since the injury.

Emergency medicine

Comparison of fragments can be done under local anesthesia. For this purpose, 10-15 ml of a 2% novocaine solution is injected into the fracture area along the dorsum of the forearm. It is also necessary to inject 2-3 ml of a 2% novocaine solution into the area of ​​the styloid fracture, which doctors often do not do. Repositioning of fragments should begin only after complete anesthesia has set in the fracture area, therefore, after administering the novocaine solution, you must wait a few minutes. Usually, with the onset of pain relief, patients’ mood improves, the pained expression on their face disappears, and they allow them to touch their hand without fear.

Reposition of fragments can be done using various devices or manually. To perform manual adjustments, you must have two assistants. You can limit yourself to just one, if in the office where the fragments are repositioned, there is a special device for fixing the shoulder and providing countertraction. The design of this device is simple, and it can be made in any trauma room. Several rings are strengthened in one of the walls at different distances from the floor in order to use them with different heights of victims. A strong cord is attached to the ring, at the end of which there is a wide loop made of durable fabric. The victim's arm is threaded through this loop and placed on the distal part of the shoulder. To make it convenient to put the loop on the injured arm, it can be made split and fastened with several buckles on the shoulder. When using a loop, there is no need for a second assistant (see Fig. 37).

After anesthesia, the victim is seated on a bench and his arm is bent at the elbow joint at a right angle. If there is no special device, then one of the assistants sits on a chair opposite the patient, grabs and holds his shoulder with both hands. Another assistant grabs the area of ​​the eminence of the first finger with his right hand, the remaining fingers with his left hand if the right hand is damaged, and, conversely, with his left hand - the area of ​​the first finger and the right - the remaining fingers with a fracture of the left hand. Slowly, smoothly, without jerking, he performs traction in order to sufficiently stretch the retracted muscles. The surgeon stands with his back to the victim's face and with the palm of one hand presses on the distal fragment from the radial side, and with the palm of the other he applies counterpressure to the proximal fragment, eliminating the radial displacement of the distal fragment. At this time, the assistant performing traction on the hand gives it the position of ulnar deviation. Having eliminated lateral displacement, the surgeon positions his hands so that the first fingers of both hands are on the back, and the remaining fingers are on the palmar surface of the forearm. Having thus grasped the distal part of the forearm, the surgeon rests his first fingers on the distal fragment displaced to the rear, while simultaneously moving the proximal fragment to the rear with the remaining fingers of both hands (Fig. 40). Having eliminated this displacement, two plaster splints are applied - wide dorsal and palmar narrow, after which X-rays are taken in two projections.

Rice. 40. Reposition of fragments in a fracture of the radius in a typical location.

As already noted, accurate comparison of fragments is important to restore hand function. This can be established not only visually. One of the objective signs of the standing of the fragments is the position of the radioulnar angle. Normally it is defined as follows. On the radiograph, a vertical line is drawn through the radioulnar joint, parallel to the longitudinal axis of the radius, perpendicular to it through the same joint - a horizontal line towards the apex of the styloid process of the radius. The angle formed by the third line and the horizontal line is radioulnar, which is normally 30° (Fig. 41). It must be remembered that the angle of inclination of the articular surface of the radius is normally 10°. This angle is checked on a photograph taken in a strictly profile position. Restoring relationships is the main task when repositioning fragments. Decreasing or increasing angular ratios negatively affects bone function.

Rice. 41. Radioulnar angle in the intact wrist joint. Explanation in the text.

After repositioning the fragments, a plaster cast is applied, and there is no need to fix the elbow joint. The plaster cast should cover the forearm from the elbow to the metacarpophalangeal joints. An assistant holds the hand in a position of ulnar deviation and in a position intermediate between pronation and supination. We do not consider it necessary to give the hand an average physiological position. The dorsal or palmar flexion of the hand is determined by the direction of the fracture line. With a strictly transverse fracture line, the hand is given an average physiological position. If the fracture line goes obliquely in the distal direction from the dorsal to the palmar side, the hand should be given a dorsiflexion position in which the distal fragment is well held. With an oblique fracture line running in the proximal direction from the dorsal to the palmar side, the distal fragment is better held when the hand is palmarly flexed.

Fixation can be ensured by a properly applied deep dorsal plaster splint reinforced with a soft bandage. Some surgeons strengthen the splint with plaster bandages, thereby turning it into a circular bandage, others fix the limb using dorsal and palmar plaster splints, which are strengthened with soft bandages. We do not attach much importance to the design of the plaster cast, but we believe that each cast should fix the fragments well and not have constrictions and dents that cause discomfort.

After the bandage has hardened, the patient can be sent home. The next day he must go to the doctor to check the condition of the bandage. If the bandage compresses the forearm and causes circulatory problems, then cut the soft bandage securing the splint, slightly loosen its edges and bandage it again. The circular bandage is cut on the palmar side and pulled apart slightly, after which it is secured with a soft bandage. If the bandage weakens in the first days due to the disappearance of swelling, then it is strengthened with new ones without removing the old bandages. 5-7 days after applying the bandage, it is necessary to take a control x-ray, since after the swelling subsides, re-displacement of the fragments may occur. Unfortunately, not all surgeons fulfill this requirement, so often after the bandage is removed, incorrect fusion of the fragments is detected. If secondary displacement is detected, it is necessary to immediately reposition the fragments.

For fractures of the radius in a typical location without displacement, the hand is given an average physiological position and a posterior plaster splint is applied from the upper third of the forearm to the metacarpophalangeal joints. From the first days after repositioning the fragments and applying a plaster cast, the patient is recommended to make movements with his fingers and in the elbow joint, which promote better blood circulation, reduce swelling of the fingers and quickly restore their functions.

If the fragments were well compared and tightly held with a plaster cast, then it can be removed after 4-5 weeks. By this time, fusion occurs, which is quite well expressed clinically and radiologically. If the fracture is not complicated, the functions of the hand and forearm are usually restored by 6-8 weeks.

After removing the bandage, massage of the hand and forearm and physical therapy are prescribed to restore mobility in the wrist joint and finger joints. Massage and gymnastics help eliminate swelling of the forearm and hand and stiffness of the fingers.

For an isolated fracture of the styloid process of the ulna, a dorsal plaster splint is applied from the middle third of the forearm to the metacarpophalangeal joints. The hand should be given an average physiological position and ulnar deviation. The plaster cast is removed after 2-2 weeks. By this time, the victim’s ability to work is restored. If the separation of the styloid process is recognized in a timely manner and a plaster splint is immediately applied, then the damage usually goes away without a trace.

In case of marginal fractures of the radius, the fragments should be reduced and the forearm should be fixed using a dorsal plaster splint for up to 3 weeks. Due to the fact that these fractures are intra-articular, it is important to accurately compare them in order to avoid disruption of the congruence of the wrist joint and the subsequent formation of deforming arthrosis with all the ensuing consequences.

Particularly difficult is the treatment of comminuted comminuted fractures of the radius in a typical location. These fractures are usually intra-articular, and it is not easy to compare fragments of the epimetaphysis, broken into several parts, with each other, and then with the proximal fragment. In addition, if it is possible to compare these fragments, then it is quite difficult to keep them in the desired position. That is why the functional prognosis for such fractures is unfavorable. After fractures, there remains limited mobility in the wrist joint and almost constant pain when moving due to a violation of the congruence of the joint.

Conservative treatment of such injuries is carried out in the same way as for non-comminuted fractures of the radius in a typical location. In most cases, it gives disappointing results. After local anesthesia, the fragments are repositioned manually or using a device. By squeezing the fragmented metaepiphysis in the lateral and anteroposterior direction, they try to bring the fragments together. Then a plaster cast is applied, most often a circular one. In order to prevent secondary displacement of fragments under a plaster cast, L. Bohler (1928) proposed passing one wire through the II, III, IV and V metacarpal bones, and the other through the ulna in its upper third. Then I apply a circular plaster cast from the middle third of the shoulder to the metacarpophalangeal joints, plastering both knitting needles and bending the forearm at the elbow joint at a right angle. With this method of treatment, the plaster cast is removed no earlier than after 6 weeks. After this, control X-rays are taken, the needles are removed and massage, therapeutic exercises and physiotherapeutic procedures are prescribed.

V. A. Chernavsky (1947) proposes a more active tactic for comminuted fractures of the radius that tend to secondary displacement in a typical location. It consists in the fact that after comparing the fragments and x-ray control in a closed way, several wires are passed through the distal fragment in different directions, which are determined from the x-ray. The wires are placed in such a way as to hold the fragments juxtaposed with each other and the entire metaepiphysis with the proximal part of the radius. For certain indications, such tactics are completely justified.

Dubrov Ya.G. Outpatient traumatology, 1986

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Reposition of the radius with displacement

Fracture of the radius of the arm in a typical location, with displacement | Ray fracture, recovery after

Diagnosis of fractures

​everything is fine! With repeated injury, yes, with development, no, provided that a bone callus has formed!​

Complications after fractures of the radius can be caused by the nature of the fracture, incorrect treatment tactics, or the actions of the patient. They are divided into early and late.​

​Thermal conditions when exercising in water should be mild. Water temperature: from 34 to 36 °C. Gymnastics is performed with the arm (forearm, hand) completely immersed in water. Hydrokinesitherapy is prescribed after removing the plaster cast.​

​Post-immobilization period: exercises are performed in front of a table with a smooth surface to facilitate sliding of the hand. Exercises in warm water, as well as everyday activities, in particular self-care, are useful. It is necessary to avoid carrying heavy objects and hanging. Massage of the affected limb is very useful.

In some situations, fractures of the radius are combined with dislocation of the head of the ulna. In this case, in addition to repositioning the fragments, it is necessary to realign the head of the ulna.​

​multiple - several bones are affected;

Treatment of radius fractures

​Such displaced fractures of the radius can be treated without surgery. The alignment of slightly separated fragments should only be performed by a surgeon. After this procedure, the arm is fixed, limiting mobility, and fusion is carefully monitored. A repeat x-ray to determine the correct alignment of the fragments is done after the swelling disappears.​

​Suppuration in the area of ​​metal structures (extremely rare);​

​But there are doctors (ardent adherents of these methods) who use them for all types of fractures of the radial bone of the wrist.​

​Closed reduction and percutaneous pin fixation​

Fractures of the radius in a typical location without displacement are usually fixed with a plaster or polymer bandage to avoid displacement. If the radius fracture is displaced, then the fragments must be returned to their correct anatomical position and fixed until the fracture heals. Otherwise, there is a risk of limited hand movements and rapid development of arthrosis of the damaged joint.​

​Most fractures of the distal radius are diagnosed by conventional radiography in 2 projections. Computed tomography (CT) and magnetic resonance imaging (MRI) are used in the diagnosis of complex fractures of the distal radius, to evaluate associated injuries, and for preoperative and postoperative management.​​Early complications:​​Attention is paid to all joints from the fingers to elbows. In the initial stages, the patient helps himself to do exercises with his healthy arm. All movements should be performed before the pain syndrome, and not through it. Very often, a fracture of the radius in a typical place is combined with a separation of the styloid process. The diagnosis is made based on a survey, examination, palpation (fragment crepitation syndrome), as well as the results of an X-ray examination. Immobilization: fixation with a plaster cast from the base of the fingers to the upper third of the shoulder in a physiological position.

​combined - damaged bones and internal organs.​

​Reposition (alignment) of bone fragments can be open or closed. The term “open reduction” refers to an operation (most often under local anesthesia) during which access to the broken bone is opened by making an incision in the most convenient place, depending on the location of the fracture.​

​Damage to blood vessels, nerves, tendons (iatrogenic complication);​

​The device is installed for 4-6 weeks, during which time sufficient healing of the fracture occurs.​

​Has been popular for many years and continues to be one of the most popular methods internationally. ​

​The common concept among the average person is “reduction of a fracture”—​

​Delay in diagnosis of distal radius fractures of the arm can result in significant morbidity.​

​Attachment of infection with the development of a purulent process in an open fracture.​

The exercises begin with flexion and extension of the joints, then adduction and abduction, pronation and supination are done.

​Displacement of the styloid process during a fracture can be not only in the dorsal or palmar region, but also at various angles. Treatment tactics are selected strictly individually in each specific case after an X-ray examination, and in some cases, computed tomography.​

Open reduction of radius fracture

Fractures of the radius in the neck and head are of the following types:

Fractures of the radius sharply reduce the ability of patients to work and are manifested by severe pain in the forearm and swelling. Depending on the type of fracture, the symptoms may be supplemented by the presence of a hematoma, tissue rupture with bone coming out into the wound, the presence of deformation in the area of ​​the fracture with intact skin, etc.

If, during a fracture, parts of the bone are significantly displaced relative to each other, surgical intervention is necessary, during which the fragments are repositioned (compared) and fixed. These measures help prevent improper fusion, which is correctable, but requires surgical intervention and brings additional suffering to the patient.

​Most patients return to their daily activities after a distal radius fracture within 1.5 to 2 months. Of course, the terms of rehabilitation after a fracture of the radius depend on many factors: the nature of the injury, the method of treatment, the body’s reaction to the damage. Pros: low trauma, speed, absence of a large incision (performed through 2-3 mm punctures of the skin.

​First, the doctor closes the displacement of the fragments, then wires are drilled through the fragments in certain (taking into account the nature of the fracture) directions.​

​Computed tomography (CT) is used to plan operative repair, providing increased accuracy in assessing articular alignment in intra-articular fractures. Also in the postoperative period, to determine whether the fracture has healed.​

​It is quite possible to supplement exercises in water with exercises with soft sponges and balls; subsequently, the size of the objects should decrease. To train fine motor skills, buttons are lowered into the water, which the patient must grab and catch.​

Recovery after a radius fracture

​One of the types of treatment for this fracture is manual reposition of the fragments under local anesthesia, followed by plaster immobilization of the limb. However, this approach may result in secondary displacement of bone fragments, which will complicate further treatment of the fracture.​

​without displacement of bone fragments;​

​The diagnosis is made on the basis of a survey, examination, palpation, the presence of pathological syndromes (crepitus, pathological mobility), as well as a set of instrumental diagnostic results.​

​Rehabilitation measures after healing of a displaced radius fracture. In addition to combining bone fragments, surgical intervention is required for fractures of the head of the radial bone, in which a small fragment breaks off from the bone. In this case, the fragment is removed without growing.​

​Almost all patients have limited wrist movement after immobilization. And a lot depends on the patient, his persistence in restoring the range of motion after a fracture of the radius. If a patient is operated on using a plate, then as a rule the doctor prescribes exercise therapy for the wrist joint from the first week after surgery.​

​Disadvantages: such devices are not cheap, the ends of the rods remain above the skin; risk of infection of the surrounding skin; inconvenience in dressing and treating wounds; the impossibility of starting early development of the wrist joint, resulting in the risk of irreversible contracture (lack of movement in the joint).​

• ​Pros: low trauma, speed, lightness, low cost, no incision and, as a consequence, a postoperative scar​
• ​. Elimination of displacement of fragments is correctly called -
• ​After a wrist injury, it is necessary to exclude a fracture, even if the pain is not very intense and there is no visible deformation, there is simply no emergency in this situation. You need to apply ice through a towel, give your arm an elevated position (bend at the elbow) and contact a traumatologist.​

Rehabilitation after a fracture of the radius of the arm

​Physical factors used in the post-immobilization period: paraffin baths, electrophoresis of lidase, potassium, ultraphonophoresis of lidase, electrical stimulation of muscles, salt baths.​

​Rehabilitation of forearm bone fractures for different types of fractures in a given anatomical region varies slightly. It is important to know the general directions of restoration measures and vary techniques depending on the characteristics of a particular fracture.​

​comminuted fracture with displacement;​​The goal of treatment is to restore the anatomical integrity of the bone and the function of the damaged part.​​In cases of complex fractures of the head or neck of the radial bone with displacement, additional fixation of the “head-neck” joint is performed during surgery using a special pin - brake, the end of which is left above the skin. The pin is removed after about two weeks.​

​Do not self-medicate!​

Combination of fragments in a displaced fracture of the radius

​Since the types of fractures of the distal radius are as varied as their treatment methods, rehabilitation is different for each patient.​

​Disadvantages: the ends of the wires remain above the skin so that the wire can be removed after the fracture has healed; the risk of wound infection and penetration of infection into the fracture area; long-term wearing of a plaster cast for 1 month; the impossibility of starting early development of the wrist joint, resulting in the risk of irreversible contracture (lack of movement in the joint).​

When does a displaced radius fracture require surgery?

​But if the injury is very painful, the wrist is deformed, there is numbness or the fingers are pale, it is necessary to urgently go to the emergency room or call an ambulance.​

​Secondary displacement of bone fragments due to improper application of a plaster cast or incorrect reposition of fragments.​

Possible complications of a displaced radius fracture with proper treatment

​At the third stage, when fixation is not required, the load on the affected limb is not limited. When performing a complex of physical therapy, additional equipment for weights is used, as well as hanging and resistance exercises. During this period, the emphasis is on complete restoration of the limb and elimination of residual effects of the fracture.​

In case of a fracture of the radius, after comparing the bone fragments, a plaster cast is applied from the base of the fingers to the upper third of the shoulder. The arm should be bent at the elbow joint at an angle of 90 degrees and supported by a scarf. Immobilization time: for an isolated fracture of the radius - 1 month, for multiple fractures (radius and ulna) - 2 months.​

Possible complications with proper treatment of a displaced radius fracture

Diet for a displaced radius fracture

There are two types of treatment for fractures: operative and conservative. They try to resort to surgical interventions in extreme cases and in the presence of certain indications for this method of treatment.​

​Even competent treatment of radial bone fractures is not a guarantee against complications. Thus, with a deficiency of calcium and other microelements in the body, the intensity of bone fiber growth may be insufficient. Lack of mobility of a fixed arm can lead to muscle flaccidity if the patient’s physical preparation was insufficient before surgery. Swelling that remains for some time after removal of the splint or plaster is not a complication; it is a normal phenomenon caused by congestive processes due to immobility, which goes away fairly soon.​

Only a doctor can determine the diagnosis and prescribe the correct treatment. If you have any questions, you can call

• ​Open reposition external osteosynthesis with a plate and screws. The operation involves a surgical incision, access to the broken bone by carefully retracting tendons, vessels and nerves, mobilization of bone fragments, elimination of displacement and fixation in the correct position. The progress of the operation is demonstrated in the video: ​
• To confirm the diagnosis, radiographs of the wrist joint are taken in 2 projections. X-rays are the most common and widely available diagnostic bone imaging method. ​

​Damage to tendons, ligaments with the formation of diastasis between bones or adhesions between tendons (the cause of stiffness in the joints).​

​Therapeutic exercise includes complexes of gymnastics, mechanotherapy and hydrokinesitherapy.​

Principles of treatment of radial fractures

​During this period, therapeutic gymnastics exercises are performed for joints free from plaster casts: active, passive and static, as well as imaginary movements (ideomotor) in the elbow joint.​

​First of all, it is necessary to diagnose a fracture and find out whether there is displacement of bone fragments. After this, treatment tactics are developed. If there is no displacement of the fragments, conservative treatment is prescribed, consisting of anesthesia and application of a plaster cast. In case of displacement of fragments or fragmentation of the bone head, surgical treatment is necessary, which consists of osteosynthesis.​

​Fractures of the radius are classified depending on the traumatic factor and the individual characteristics of the patient’s body.​

​In order for a connective callus to form at the fracture site as quickly as possible, it is necessary to provide the body with calcium, which is found in cottage cheese, cheese, milk and many other products.​

The intensity of pain during a fracture gradually subsides over several days. ​

​After repositioning the bone fragments, the arm is fixed with a plaster splint in a certain position (depending on the type of fracture). A splint is usually used for the first few days as swelling increases. After this, it is possible to change the splint to a plaster circular bandage or a polymer bandage. Immobilization for radial fractures lasts an average of 4-5 weeks.​

​Treatment of fractures of any bones consists of assessing the nature of the fracture and choosing tactics.​

• ​Hydrokinesitherapy: the lesson is carried out as in the previous stage, but is supplemented by performing household manipulations. They are designed to increase the range of motion in the joints and allow the patient to expand the scope of exercises: imitation of washing hands and dishes, washing and squeezing, etc.​
• ​Physiotherapy measures from the third day after injury: UHF therapy on the fracture area, magnetic therapy and ultraviolet irradiation. It must be taken into account that UHF therapy is contraindicated in the presence of metal structures in the area of ​​treatment. This factor is not a contraindication for magnetic therapy.​
• If the head of the radial bone is crushed or comminuted, it can be removed. However, such measures are not practiced in children, so as not to affect the bone growth area.​

​We will look at some of them below.​

​Calcium absorption can be interfered with by excessively fatty foods and oxalic acid contained in spinach, parsley, sorrel and some other types of greens.​

​ask a question by email.​

​Local cold on the first day for 15 minutes every hour, rest, elevated position of the arm (bent at the elbow at the level of the heart) and NSAIDs largely eliminate the pain completely. But everyone’s pain threshold is different and some patients need strong painkillers, which can only be purchased with a prescription.​

​Broken bones are fixed with titanium plates, so the patient is allowed early development of movements in the wrist joint. In addition, it is not necessary to wear a plaster splint, because The metal structure holds the fragments in the correct position quite rigidly, which prevents displacement during movements. ​

​Depending on the nature of the fracture, control radiographs may be needed 10, 21 and 30 days after reduction. This is necessary in order to timely identify secondary displacement in the plaster and take appropriate measures: re-elimination of the displacement or surgery.​

​The goal is to return the patient to a level of functioning. The doctor's role is to explain all treatment options to the patient; the patient's role is to choose the option that best suits his needs and wishes. ​

​Therapeutic physical education is supplemented with occupational therapy (restoration of everyday skills and self-care functions).​

General methods of rehabilitation after a fracture of the radius

​1.5 weeks after the fracture, magnetic stimulation of the muscles and affected nerves, pulsed UHF EP, infrared laser therapy (exposure directly through the plaster cast) or red laser therapy (holes for the emitter are cut out in the plaster) are used.

First period: immobilization

​One of the most common injuries to the forearm is a fracture of the radius in a typical location. Then the fracture area is localized in the lower part of the beam. This injury occurs as a result of a fall on an outstretched arm with the wrist joint bent or extended.​

A fracture without displacement of fragments is most favorable for the patient, does not require surgical intervention and allows the patient to recover quickly. Occurs at different heights of the radius. With an isolated fracture (with the integrity of the ulna), its diagnosis can be difficult. Treatment consists of fixing the fracture site with a two-split plaster cast and then replacing it with a circular plaster cast.​

​Some foods can supply the body not only with calcium, but also with other substances necessary for the restoration of bone tissue (for example, vitamins A, E and D). For fractures, it is recommended to include in the diet:

​A non-displaced radius fracture does not require surgery. The entire ulna performs a supporting function, and with reliable fixation using a splint and compliance with the resting regime of the limb, the radius quickly heals. A displaced fracture requires a special approach; the treatment method and time to restore functionality largely depend on the nature of the fracture.​

Second period: removable orthosis

​External fixation devices​

​The bandage is removed 4-5 weeks after the fracture. Physical therapy of the wrist joint is prescribed for the best rehabilitation.​

​There are many treatment options for a distal radius fracture. The choice depends on many factors, such as the nature of the fracture, the age and activity level of the patient. This is described in more detail in the treatment.​

​If there was no displacement in the control image 7-8 days after reposition, then there will be no displacement (unless, of course, there is a re-injury), because the formation of callus is already underway. And you don’t need to develop anything. You will develop it 5-6 days after the immobilization is removed.​

​Complete recovery of the limb occurs after 4-5 months for an isolated fracture and after 6-7 months for a multiple fracture.​

​Massage of the collar area, general ultraviolet irradiation.​

Third period: no fixation

​Immobilization: from the metacarpophalangeal joint to the upper third of the forearm. Duration: from 1 month (fracture without displacement of bone fragments) to 1.5-2 months (with displacement of bone fragments).​

​A fracture with displacement of fragments in certain cases requires osteosynthesis (extraosseous, transosseous or intraosseous) with plates, screws, screws or wire sutures.​

Fractures are classified based on the number of bones affected:

​The symptoms of a displaced radius fracture in most cases are not pronounced. The presence of edema is characteristic of various injuries, and the mobility of the hand is preserved during such fractures, so the presence of a displaced fracture, as well as the degree of “divergence” of the bones, can only be determined on the basis of an x-ray examination. The images are taken in two projections, which allows you to accurately determine the position of bone fragments.​

During conservative treatment with a plaster or polymer bandage, it is necessary to monitor the hand. Observe whether the fingers swell, whether the fingers turn pale, and whether the sensitivity of the hand is preserved.​

Shock wave therapy

Complications

​Surgical treatment of radial fractures​

​Conservative treatment of radial fractures​

• ​Mr. X​
• For poorly healing fractures and the formation of false joints, shock wave therapy is prescribed. This method is based on the targeted impact of an ultrasonic wave on the fracture area to stimulate tissue regeneration processes and accelerate the formation of callus. This type of therapy allows you to speed up rehabilitation time and in certain cases is an excellent alternative to surgical treatment.​
• ​After the plaster cast has been replaced with a removable plaster orthosis, gymnastics should be aimed at preventing the occurrence of contracture in the joints: all joints are worked out sequentially from the fingers to the shoulder. Occupational therapy is added: restoration of self-care skills. During this period, the following are very useful: massage, thermal physiotherapy, therapeutic exercises in warm water (hydrokinesitherapy), mechanotherapy.​
• ​Therapeutic gymnastics: breathing exercises, gymnastics complexes for joints free from plaster casts with the obligatory involvement of the fingers.​
• In the presence of extra-articular, non-comminuted fractures, manual reposition of the fragments is performed under local anesthesia and a two-split plaster cast is applied. After the swelling subsides, it is changed to a circular plaster cast until the end of the immobilization period.​
• ​isolated - one bone is injured;​

fracture of the radius with displacement.

​There are cases when, during a fracture with bone displacement, parts of the bone diverge slightly.​

​If the plaster presses, this may be a sign of compression of soft tissues, blood vessels, nerves and lead to irreversible consequences. If such symptoms appear, you should immediately consult a doctor.​

​They are mainly used for open fractures of the radius, because the fracture is considered conditionally infected and there are contraindications for immersion osteosynthesis (i.e. using plates and screws). For any open radial fractures in a typical location, surgery should be performed as soon as possible (within 6-8 hours after injury). The soft tissues of the fracture area and bones should be thoroughly washed with antiseptic solutions. The wound is sutured and an external fixation device is installed.​

​Sometimes the misalignment is so severe and unstable that it cannot be corrected or held in the correct position in the cast. In this case, percutaneous fixation with pins or surgery may be required: open reduction, external osteosynthesis with a plate and screws.​

Malunion and nonunion fractures

radius in a typical location

Old, malunion and non-union fractures of the radius in a typical location with displacements, subluxations and deformations of the lower end of the forearm impair the function of the hand in the wrist joint and, to some extent, the pronation of the forearm. Deformation in the area of ​​the wrist joint causes a cosmetic defect and is a source of moral rather than physical suffering for young, middle-aged, and sometimes elderly women. In old cases, within 2-4 weeks, and sometimes later, it is possible to perform the reduction using conventional techniques - manually with the use of some force. In more severe cases, reduction may be hampered by the displaced lower end of the ulna, located (against the norm) at the same level (and more often below the articular surface) with the shortened radius. In these cases, resection of the lower end of the ulna over 2-3 cm greatly facilitates reduction. If it fails, a minor operation - resection of the lower end of the ulna - not only provides cosmetic improvement and smoothes out the deformity, but also improves function in the wrist joint and reduces pain.

Malunion of radius fractures in a typical location is common. Depending on the nature of the displacement of the distal end of the radius, greater or lesser deformation and limitation of the function of the wrist joint are noted. The main reasons for malunion and deformities are: 1) poor and insufficient reduction; 2) re-displacement of fragments in a plaster cast after swelling decreases; 3) severe fragmentation of the epiphysis; even after good reduction, the fragments in such cases are often displaced again and when the articular surface of the radius is damaged, the congruence of the joint is disrupted; 4) large compression of the epimetaphysis of the radius, which is usually observed with fractures in elderly people; due to kneading of the cancellous bone, fusion occurs with shortening of the radius and, thus, the protruding head of the ulna is located distal to the articular surface of the radius; the wrist joint is expanded; 5) complete rupture of the ligaments of the lower radioulnar joint and, as a result, displacement of the distal end of the ulna; 6) too early removal of the plaster splint and the use of therapeutic exercises (before healing of the fracture); this can lead to repeated displacement of the fragments and deformation.

There is a wide range of deformities, dysfunctions and cosmetic disorders. In this regard, it is necessary to distinguish between cases in which surgical methods need to be used. If the deformity is not pronounced and does not cause any significant dysfunction, surgery is not indicated. Even with significant deformities, completely satisfactory hand function is often restored under the influence of therapeutic exercises, massage and physiotherapy.

Surgical intervention is indicated for significant deformation, impaired congruence and function of the wrist joint and post-traumatic deforming arthrosis, which are often the cause of pain in the wrist joint.

In young people, especially women, with deformation, even without significant dysfunction, there is often a need for surgical correction of a cosmetic defect. If the deformities are accompanied by Sudeck's osteoporosis, surgery should not be undertaken until the signs of this syndrome increase, remain stable or continue to decrease. In other words, surgery for deformity is possible only after complete elimination of the syndrome of acute painful post-traumatic osteoporosis.

In most cases, surgery results in improvements in both the appearance and function of the wrist joint. The choice of surgical intervention depends on the nature of the deformity and the degree of dysfunction of the joint.

• 1. Often with malunion fractures of the forearm in a typical location with significant deformation, protrusion of the lower end of the ulna, which is located distal to the articular surface of the radius, the function of the wrist joint can be significantly limited. In these cases, a small operation - oblique resection over 2-3 cm of the distal end of the ulna, which to a certain extent blocks movement in the wrist joint, not only reduces the deformity and smoothes out the cosmetic disorder, but also improves the function of the joint and reduces pain. After subperiosteal removal of the end of the ulna, it is necessary to suture the edges of the periosteum and thus connect the end of the resected ulna to the lig. collateral carpi ulnare (Fig. 81). After the operation, a plaster splint is applied from the elbow to the heads of the metacarpal bones above. Then therapeutic exercises and thermal procedures are prescribed.
• 2. A simple corrective osteotomy is indicated for angular curvatures of the axis of the radial bone, if the length of this bone and the articulating surface are preserved. After osteotomy, the fragments are connected using a 2-3 mm thick wire, which is passed through both fragments and fixes them in the correct position. One end of the needle is brought above the surface of the skin. If a gap has formed between the fragments, it is filled with spongy bone taken from the wing of the ilium, or with homogeneous bone. After the operation, a plaster cast is applied from the elbow joint to the heads of the metacarpal bones. The pin is removed after 4-6 weeks, and the plaster cast after 8 weeks after surgery.
• 3. If the radius is shortened, a simple corrective osteotomy of the radius with resection of the distal end of the ulna is indicated. Fragments of the radius are fixed in the same way as indicated above, and the resected part of the ulna is used as an autograft. In some cases, it is possible to lengthen the radius after osteotomy by transplanting a bone autograft taken from the outer part of the distal end of the ulna according to Campbell.
• 4. In some cases, with severe deformities with destruction of the radioulnar articular surface, deforming arthrosis, dysfunction and pain, the question of arthrodesis of the wrist joint arises; in some cases, resection of the distal end of the ulna is also performed.
• 5. Comminuted fractures of the epiphyseal region with damage to the growth plate in children can cause premature cessation of growth of the radius; the degree of growth disturbance and the resulting deformity are difficult to predict.

Radial epiphysis fractures with suspected growth plate injury should be monitored every 6 to 12 months to determine the fate of the growth plate. In young children, radial growth discrepancy may require resection of the distal ulnar germ cartilage. This should not be done in children at an age at which the ossification phase of the radial epiphysis is approaching. In such cases, it is more appropriate to perform a subperiosteal resection of 2-3 cm of the ulna above the growth cartilage of the distal end of the ulna and then connect the distal and proximal fragments with a suture or screw.

Rice. 81. Resection of the distal end of the ulna for an improperly healed fracture in a typical location.

Nonunion of the distal radius is a rare complication. In these cases, as a rule, there is shortening of the radius. The distal end of the ulna is resected over a length of 2-3 cm, the fragments of the radius are compared, they are fixed with a wire, one end of which is brought out above the skin, and bone transplantation is performed with cancellous bone plates. The pin is removed after 6 weeks, and the plaster cast after 8-10 weeks.

The human hand is a unique tool that ensures successful knowledge of the surrounding world. She is virtually constantly in motion, providing tactile awareness of the surrounding space.

For this reason, trauma that sometimes occurs to the upper extremities significantly impairs the quality of life. Especially such a dangerous injury as a displaced arm fracture.

Constant movement of the arms is ensured by a complex bone structure connected by joints and tendons:

• In total, there are 206 arm bones in the adult human skeleton.
• In an infant, this number is much higher. Babies have 350 bones, some of which grow together as they grow older.

Rehabilitation after a fracture

A set of rehabilitation measures is recommended for patients undergoing treatment for a broken arm. The following procedures are recommended to restore hand mobility. This is facilitated by a special set of exercises. They can only be performed if there is dull pain. If the pain intensifies, you need to stop exercising.

Exercise therapy complex for recovery and development of the arm:

• Take a small ball transfer it from the healthy hand to the hand of the sore hand, squeezing.
• Perform rotational movements in the joint which is located in the fracture zone.
• Raise a gymnastic stick above your head with straight arms, fix the position and slowly lower it.
• Cross your arms in front of the face at eye level.
• Perform torso turns with palm clapping in front of the body and behind the back.

A set of exercises for recovery

Using self-massage

Self-massage helps speed up recovery. To carry it out, take the cream and make soft stroking movements, kneading the area of ​​the arm affected by the fracture until the skin becomes slightly red.

Principles of nutrition for a broken arm

Foods rich in calcium and potassium help speed up recovery processes:

• Cottage cheese and dairy products are included in the diet.
• The restoration of bone tissue, joints and ligaments is helped by the inclusion in the diet of dishes that contain.
• Including jellied meat and jelly. It is also important to include foods rich in vitamins in your diet: vegetables and fruits, herbs.

Calcium rich foods

Comfortable sleeping positions

When an arm is broken, a person independently chooses to sleep the position in which he is comfortable and in which there are no pain reactions:

• When the sore area is located in the area of ​​the wrist or hand, you can sleep in any comfortable position.
• If your forearm or shoulder is injured, you need to lie on the healthy half of your body.
• If necessary, place a cushion under your back to prevent a spontaneous rollover onto your affected arm.

Features of treatment of a broken arm in a child

Children can often underestimate the extent of what is happening. If the baby’s skin on the arm is inflamed, swelling is noted, palpation reveals a painful area and temperature, immediate contact with a specialist is required.

An important condition for successful treatment of a fracture in a child is monitoring the lack of physical activity. It is advisable not to let the child go outside in the first days to protect the affected area from re-damage.

Consequences of a fracture and possible complications

The highest quality treatment does not guarantee the absence of consequences and complications of a broken arm. Significant harm to health can be caused by untimely access to a medical facility.

The most common consequences include:

• Loss or decreased mobility due to improper fusion. In this case, both the bone itself and the joints located next to it may hurt.
• Purulent-septic complications in open form.
• In situations where a fracture has caused the bones to separate from the soft tissues, the section of bone is completely removed. The tendons have to be sutured and the resulting area of ​​skin excised.
• When soft tissue changes, in some cases a contracture is formed. They reduce the level of mobility of the limb. Even after a successful operation, the prospect of fat embolism remains.

Disability due to a broken arm

If you contact the ITU after a broken arm, the possibility of assigning disability is small:

• For upper limb injuries disability is assigned in 25% of cases from the number of applications.
• Most of the ITU decisions on the assignment of disability, about 50% are due to injuries of the hand or metacarpal bones.
• In any case, disability is assigned in the event of recognition of confirmed permanent or temporary disability. A displaced fracture often leads to this result.

​After the immobilization stage has ended, the patient is prescribed massage and physical exercise. After removing the plaster, it is recommended to take warm pine and salt baths, which contribute to complete rehabilitation after the injury.​

If there is a fracture with displaced fragments, mandatory anesthesia and reposition of the inert fragments in their place are necessary. Only after this the arm is fixed using plaster splints, and then a control radiograph is taken. If the expected results are not achieved, repositioning and fixation of the bone with a wire is necessary, which will be removed after a few weeks, but

A fracture of the distal arm is characterized by unbearable pain and swelling, and deformation of the hand. To establish an accurate diagnosis, an x-ray in two projections is required.​

​There are cases when, during a fracture with bone displacement, parts of the bone diverge slightly.​

• ​After first aid has been provided to the victim, it is necessary to go to the emergency room, where specialists will prescribe further necessary treatment, apply a plaster cast, and also recommend suitable exercises and physical therapy (physical therapy).​
• ​at the moment of injury, a characteristic crunching sound is heard (with other injuries, a click usually occurs);​
• Extensor
• ​in 1.5 – 2 months. In the first days after injury, UHF and ultrasound are used to reduce pain and relieve swelling. Light exercise is also indicated to improve blood circulation and prevent muscle wasting.​

​Damage to Galeazzi​

• ​swelling in the area of ​​the brachioradial joint;​
• ​In the winter season, the number of musculoskeletal injuries increases. One of the most common types of injuries is a fracture of the radius bone of the arm.​
• The plaster will remain on the arm for a month

​It is worth noting that the first thing that needs to be done for any shoulder fracture is​

​Necks and heads. Such injuries usually occur when they occur at arm's length.​

​Such displaced fractures of the radius can be treated without surgery. The alignment of slightly separated fragments should only be performed by a surgeon. After this procedure, the arm is fixed, limiting mobility, and fusion is carefully monitored. A repeat x-ray to determine the correct alignment of the fragments is done after the swelling disappears.​

• ​Comminuted fractures in the elbow area require proper connection of bone fragments. How this event will take place depends on the results of the x-ray examination.​
• ​with a strong displacement, the broken limb is very different when examined;​

​These types differ in which side is subject to the greatest pressure. When there is a flexion fracture of the wrist joint, the fragment goes into the area of ​​the palmar surface. In case of an extensor type injury, the fragment is deflected towards the forearm, towards its dorsal area.​

• ​At the end of the immobilization period, the following recovery measures are prescribed:​
• ​This injury is a fracture of the radius at the top of its middle part, in which the lower fragment is displaced and the head of the ulna is dislocated at the wrist. Such a fracture can occur when falling on an outstretched arm or during an impact.​
• ​limited movements.​

Fracture of the head and neck of the radius of the arm

​carry out general pain relief measures​

• ​Diaphysis isolated. It is quite rare and occurs after a blow directed to the radial side of the forearm. The danger is that the musculoskeletal functions of the hand are significantly impaired.​
• ​Reposition (alignment) of bone fragments can be open or closed. The term “open reduction” refers to an operation (most often under local anesthesia) during which access to the broken bone is opened by making an incision in the most convenient place, depending on the location of the fracture.​

​In some cases, a plaster cast on the elbow area is applied only a few days after reduction.​

​After a few hours, severe swelling appears, which can spread over a large area;​

A comminuted fracture is diagnosed when the bone is broken into three or more fragments. If displacement is added to such an injury, it greatly complicates the situation.​

​physical therapy;​

​Symptoms of Galeazzi damage:​

​Cervical fractures can occur with or without a violation of the axis of the radial bone and congruence (correspondence of the articular surfaces) in the humeral-radial joint. The radius is a long, immobile tubular bone located in the forearm. The head of this bone is formed by its upper part, and slightly below the head there is a neck - the narrowed part of the bone. Fracture of these parts of the bone most often occurs when falling with emphasis on an outstretched arm.​

​If the bones are completely crushed, surgical intervention and the use of endoprosthetics are necessary.​

• ​. 1 ml of a one percent solution of promedol is perfect for this. It is worth calming the victim by giving him valerian or tazepam.​
• ​Damage to the diaphyses of both bones. Occurs with a direct blow. A fracture appears on both bones at the same level. When falling, both bones break at the thinnest point. Such injuries are very serious.​
• If, during a fracture, parts of the bone are significantly displaced relative to each other, surgical intervention is necessary, during which the fragments are repositioned (compared) and fixed. These measures help prevent improper fusion, which is correctable, but requires surgical intervention and brings additional suffering to the patient.

​Only in rare cases is surgery required. However, it can only be called effective in the first weeks after receiving a fracture.​

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​if there is a splintered injury, then a hematoma or bruise caused by a rupture of the vessel is possible;​

​A comminuted fracture if not treated correctly can lead to loss of limb mobility or improper functioning.​ ​massage;​

Types of fractures

​significant swelling, deformation and pain in the wrist and lower third of the forearm;​

• ​Fracture of the distal radius of the hand and wrist​
• ​When the head of the radius is fractured, the cartilage is often damaged, and this injury is not diagnosed in any way. Meanwhile, damage to the cartilage can lead to decreased mobility in the joint. Fractures of the head without displacement, marginal fractures with displacement, and also comminuted fractures are classified.

​In case of an isolated fracture of the diaphysis, it is mandatory to apply a circular plaster cast for up to ten weeks, which completely covers the entire damaged area and fixes the hand from the beginning of the fingers to the middle third of the hand.​

​If conditions permit, it is necessary to apply a special splint, but do it correctly. First of all, the arm is pulled to the side at the shoulder joint and bent at the elbow at a right angle. The forearm should be in a mid-position between pronation and supination. To place a cotton ball or bandage into your hand, bend it towards the back and bend your fingers slightly. It is impossible to fix the fingers extended.​ ​Damage to the Galleation. This displaced fracture of the radius is characterized by a fracture of its upper third part, displacement of the lower fragment and dislocation of the head in the wrist. The causes of such injuries can be either a blow or a fall on the hand.​

​Rehabilitation measures after healing of a displaced radius fracture. In addition to combining bone fragments, surgical intervention is required for fractures of the head of the radial bone, in which a small fragment breaks off from the bone. In this case, the fragment is removed without growing.​

What are the causes of such damage?

​After the required period of time, the doctor will tell you what is necessary to ensure a quick recovery from a fracture of the radius. In particular, he will talk about the benefits of exercise therapy, as well as what exercises are necessary to quickly restore the functionality of the limb.

​the damage site is overheating;​​Both types of injuries may differ in what exercises and physical therapy to use for rehabilitation.​

Symptoms

​phonophoresis.​

​impossibility of moving the hand and forearm.​

• ​Fracture of the distal (lower) section is more common in women and occurs mainly when falling on an outstretched arm or in an accident. Fractures of the distal radius, depending on the nature of the displacement of fragments, are classified into two types:​
• ​Symptoms of a radial head fracture are:​
• ​Restoration of the radius in case of displacement is carried out using reposition through regular x-ray monitoring.​
• ​A cloth roller is placed in the armpit, which must be secured through the healthy shoulder girdle.​
• The distal part is the most typical fracture for the radius. It most often occurs in the weaker half of humanity and occurs when a person falls on their hand.​
• ​In cases of complex fractures of the head or neck of the radius with displacement, additional fixation of the head-neck joint is performed during surgery using a special brake pin, the end of which is left above the skin. The pin is removed after about two weeks.​
• ​Exercises and exercise therapy aimed at rehabilitation will cover all joints of the affected limb.​
• ​if nerve endings are damaged, loss of sensitivity or numbness is possible;

Diagnosis and treatment

To get a fracture of the bone of the wrist joint, which is reinforced by displacement, sometimes it is enough to accidentally fall on it with your weight. In some cases, this happens out of the blue, perhaps due to ice or when riding a bicycle. Sometimes such injuries are diagnosed after being involved in a traffic accident, in more rare cases - when a heavy object falls on the elbow joint. A comminuted fracture can occur during an injury at work involving heavy machinery, as well as during serious construction work.​

First actions

After fusion, warm baths are shown - pine, pine-salt, etc.

​Treatment of a fracture of the radius of the arm​

Extensor (Collis) - when the distal end is displaced to the back;

Treatment procedure

​pain in the joint that gets worse when trying to move;​

​If the reposition is unsuccessful, surgical intervention by a surgeon is required.​ The splint is applied starting from the healthy shoulder joint, onto the back through the suprascapular region, then tied around the posterior outer shoulder surface, forearm, and so on to the base of the fingers. The hand should be hung on a scarf or bandage.​

The main symptoms of a fracture of the neck and head of the radius are the appearance of swelling, pain in the elbow joint, which greatly intensifies when bending the arm, and it is difficult for the victim to touch the elbow. You can clarify the diagnosis using x-rays.​

Rehabilitation after injury

​Even competent treatment of radial bone fractures is not a guarantee against complications. Thus, with a deficiency of calcium and other microelements in the body, the intensity of bone fiber growth may be insufficient. Lack of mobility of a fixed arm can lead to muscle flaccidity if the patient’s physical preparation was insufficient before surgery. Swelling that remains for some time after removal of the splint or plaster is not a complication; it is a normal phenomenon caused by congestive processes due to immobility, which goes away fairly soon.​

​It is especially important to use exercises to warm up your fingers. Some exercise therapy procedures are used in warm water. This helps reduce stress on the affected limb.​ ​The motor ability of the elbow and hand areas is practically lost.​

​People who have weakened bones and a calcium deficiency are especially at risk.​

​Hand bone injuries are one of the most common injuries. This causes some discomfort and difficulty and requires a professional approach to treatment. One of the most common disorders is a displaced fracture of the radius. It is important to find out what first aid should be provided to the patient, as well as what exercises and exercise therapy to use for such a diagnosis.​

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In case of a fracture without displacement of the fragments, conservative treatment is carried out, which consists of applying a plaster splint to achieve anatomical reposition and fixation of the fragments. The period for applying plaster is 4 weeks.

Combination of fragments in a displaced fracture of the radius

​flexion (Smith) - when the displacement occurs towards the palm.​

​limited movements;​

​One of the most severe injuries is damage to both bones of the forearm at once. If the displacement has not been confirmed, conservative treatment in the form of splints can be applied.​

When does a displaced radius fracture require surgery?

​If special means intended for first aid are not available, use available materials, which can be planks. It is worth transporting the victim

​An isolated fracture of the diaphysis does not have such a rich clinical picture; a small tumor can be visually observed, the patient reports pain during rotation or upon contact with the arm. An accurate diagnosis, as in the first case, can only be made by x-ray.​

Possible complications of a displaced radius fracture with proper treatment

​In order for a connective callus to form at the fracture site as quickly as possible, it is necessary to provide the body with calcium, which is found in cottage cheese, cheese, milk and many other products.​

In order for the arm to fully recover after a fracture, in most cases the exercises will have to be performed for about two months. Only in this case will the pain in the arm go away and no longer bother you.​

Possible complications with proper treatment of a displaced radius fracture

​To accurately confirm the diagnosis and prescribe the correct treatment, it is important to take an x-ray. Also, in some cases, a procedure may be required that involves moving the displaced bone fragments back into place. After this, standard treatment can be applied.​

Diet for a displaced radius fracture

​Those who suffer from osteoporosis are most likely to suffer such injuries. Also, the level of calcium in the body is often reduced in older people or pregnant women.​

​Any treatment for wrist joint fractures should be carried out under the supervision of a physician. This is especially true for displaced fractures.​

In case of a displaced fracture, the fragments are first repositioned (after anesthesia). Next, a plaster cast and a splint are applied. On days 5 - 7, after the swelling has subsided, an x-ray is performed to monitor secondary displacement.​

bolivspine.com

​This type of injury is characterized by the following symptoms:​​swelling;​

• ​Unfortunately, such a displaced fracture of the arm often forces the doctor to resort to reduction with the help of fixing structures. Most often, such operations are performed immediately after the swelling has subsided, in order to reduce the time to restore mobility in the injured arm, a plate is installed on the radius bone, and an intraosseous pin is installed on the ulnar bone.

• ​only in a sitting position​

• ​In the case of a fracture of both forearm bones at once, a clear clinical picture is observed, due to the fact that the fracture is quite severe. You can visually observe the appearance of swelling, visible deformation and visual shortening of the forearm. The patient experiences severe pain and

• ​Calcium absorption can be interfered with by excessively fatty foods and oxalic acid contained in spinach, parsley, sorrel and some other types of greens.​

• ​Author of the article:​

Observable signs

​First of all, it is important to immobilize the injured limb. This will help avoid further injury and make treatment easier. You can immediately apply a splint from available materials. The hand needs to be suspended on a bandage.​

​The main symptoms of a wrist fracture are very similar to a dislocation or other wrist injury. Depending on the physiological characteristics and complexity of the injury, the pain from such a fracture may not be pronounced, so some do not immediately seek medical help.​

​When it occurs, small bone fragments may break off from the main bone, causing the limb to fail to heal properly and subsequently impair normal movement. In some cases, a comminuted fracture of the ulnar zone has to be treated using surgical methods. If there is a tendency to secondary displacement, surgical intervention is performed, in which one of the osteosynthesis techniques is used - with knitting needles or plates. Pain in the wrist joint, which intensifies when attempting to move;

Hemarthrosis (bleeding into the joint).

​Damage to the Galeatia is corrected by reducing the resulting dislocation and fixing the bone using two knitting needles. The plaster cast is removed only after ten weeks. If the treatment does not give the desired result, osteosynthesis is used.​

First aid in action

​.​​When you try to turn, you can hear a characteristic crunch​​Some foods can supply the body not only with calcium, but also with other substances necessary for the restoration of bone tissue (for example, vitamins A, E and D). For fractures, it is recommended to include in the diet:

​A non-displaced radius fracture does not require surgery. The entire ulna performs a supporting function, and with reliable fixation using a splint and compliance with the resting regime of the limb, the radius quickly heals. A displaced fracture requires a special approach; the treatment method and time to restore functionality largely depend on the nature of the fracture.​

​For open fractures, first of all, it is important to treat the affected area with an antiseptic, then apply a bandage. This will help eliminate the possibility of any infection.​

​The main symptoms of a fracture of the wrist joint are as follows:​

​Most often, treatment for a fracture of the wrist joint in the elbow area is carried out in women or in the elderly. They can be divided into two types: ​Rehabilitation after a fracture of the radius bone of the arm​​sensitivity disturbance;​

Treatment period

​Clinical manifestations of a radial neck fracture:​

​If the lesions are old and have not healed properly, the distraction method is used. Fractures of the distal part are treated with conservative methods, if there is no displacement of the fragments, but if there are any, they are fixed using two knitting needles. If there is a large amount of debris, a distraction method is used using a lightweight apparatus.​

​Depending on the nature of the radius fracture, the doctor chooses the appropriate treatment for the patient.​ ​.​ ​Among the main fractures we will consider the following​

​The symptoms of a displaced radius fracture in most cases are not pronounced. The presence of edema is characteristic of various injuries, and the mobility of the hand is preserved during such fractures, so the presence of a displaced fracture, as well as the degree of “divergence” of the bones, can only be determined on the basis of an x-ray examination. The images are taken in two projections, which allows you to accurately determine the position of bone fragments.​

To make rehabilitation after a fracture of the radius faster, a cold bandage can be applied to the affected area in the first hours after the injury. This compress must be used for 15-20 minutes, then the bandage must be removed. The procedure can be repeated, paying attention not only to the area of ​​injury itself, but also to the elbow area.​

​at the moment of the fracture, a strong sharp pain is felt, but soon its intensity may decrease somewhat;​

​flexion;​

​The recovery of a hand after a fracture of the radius is approximately

​swelling and deformation of the back of the hand.​

​pain in the elbow joint;​

​Immediately after the patient has been injured, UHF and ultrasound are used to reduce swelling in the damaged area and pain, as well as improve blood circulation and prevent muscle wasting.​

Subsequent rehabilitation

​The most conservative treatment for a fracture of the radius is typical for injuries of the neck and head that occur without displacement. In this case, a plaster of two splints is applied to the damaged area. The hand must be immobilized for a week and a half.​

Damage to Galeazzia is accompanied by severe swelling, deformation and pain. It becomes impossible to rotate not only the forearm, but also the hand.​

Hello, control radiographs are not much different from the initial ones taken after reposition. The control photographs again show no elbow joint. The elbow joint must be monitored in case of fractures of the forearm bones in children. Perhaps he was assessed clinically upon admission and did not find any changes, but still the image is more reliable, especially since performing radiographs with the capture of two joints does not contradict, but exactly follows the principles of performing these same radiographs. When the child was admitted, I made sure that the head of the radius bone occupies its correct position in the elbow joint and sleep peacefully and don’t remember anything else. At the age of 10 years, the body can independently repair a lot of such damage. Only rotational displacements (when one fragment is twisted relative to the other) and angular displacements of more than 15 degrees are not corrected (although some authors give even up to 30, but from experience I can say that angular displacements exceeding 15 degrees can surround themselves with a “retinue” of unpleasant complications. Conventionally, there is a concept of "acceptable displacement", however, anything that is "acceptable" increases the risk of re-displacement and, as a result, the likelihood of repeated interventions. Therefore, the doctor always strives to perform the best possible reposition. In your case, you need to weigh everything carefully. If If you perform repeated reduction without fixation, then there are no guarantees that the fragments can be kept in the correct position. If this does not work, then you cannot do a closed reduction for the third time without fixation - you need to fix it. Any repeated reduction means additional tissue trauma. Therefore, it is logical to consider the issue from doing it once and for all reliably. If the fragments maintain their current position without repeated manipulations, then most likely the child will recover over time and all residual deformations (which currently exist) will be corrected. However, the decision still needs to be made during an in-person examination. It is important to consider current symptoms with mandatory assessment of neurological and vascular deficits. Insisting on something that the doctor does not want to do or does not consider necessary is a thankless task. It is your right to get advice from another specialist. It is your right to receive complete information from your doctor. Parents must understand what, according to the doctor, is happening to their child, what the doctor plans to do, why he plans to do it, what possible consequences await the child after action or inaction. Usually this is all discussed with the doctor and, with an adequate attitude towards each other, does not cause any communication difficulties.
Sincerely.