Treatment of a fracture of a radius and restorative exercisesDamages of a forearm are the most frequent traumas. The forearm consists of the elbow and radius bones. At the top they are aimed at the elbow, below - on the wrist. The ulnar bone approaches the little finger, and the radial bone - to the thumb of the hand.
Fracture of the arm beam is following the fall on the outstretched arm of .
Injuries associated with fracture of radius:
- fracture of ulna;
- dislocation near the located bones;
- ligament tears.
These injuries account for a quarter of the total number of fractures of the bones of the hands and 90% of fractures of the bones of the forearm. In women, fractures of the radius in a "typical place" occur 2 times more often than in men. The reason for this is the lower density of the bone tissue of the female body.Most often, ray fractures in a "typical place" occur in women of menopausal age and in children under 10 years old.
Possible causes of
fractures Among the most common causes of fractures of the radius of the arm, the following are distinguished:
- fall on an elongated arm;
- Osteoporosis - increased brittleness of bones, especially under loads and shocks, is typical for people of 60 years of age;
- car accident;
- falling from the bike;Injury in the workplace,
- , etc.
This is due to the anatomical structure of the bone, which in some places is more delicate. Accordingly, in these places it is easier to break.
There are 2 types of damage:
- Fracture of the Wheel - a fragment of the radial bone is pushed to the back of the forearm. He bears the name of a surgeon who first described this type of fracture. Such a break is called extensor.
- Smith Fracture is the opposite of the fracture of the Wheel. Displacement occurs in the direction of the palm. For the first time such a case was described by a doctor in 1847.It is called the flexor.
It is especially important to know the first signs of fracture of the ribs. It is this fracture that most often results in damage to the internal organs. See our article for more details.
Timely first aid for a fracture of the collarbone determines the overall success of treatment and subsequent rehabilitation. Details you can find here.
Other types of ray injuries
Among the other types of fractures are:
- intraarticular - the fracture line covers the wrist joint;
- extraarticular - does not span the joint region;
- open is accompanied by skin damage;
- closed fracture of the radius;
- fracture of the cervix of the radius;
- comminuted - the bone is broken into 3 or more pieces;
- is primarily open - skin damage is observed outside the bone;
- re-opened - skin damage from the inside.
Classification of fractures is important due to the fact that the type of fracture depends on the method of its treatment.
What happens with a fracture
Symptoms of a fracture of the radius:
- pain in the joint, which are strengthened by hand movement;
- forged movements;
- hemorrhage in the joint;
- swelling in the area of the shoulder joint.
Such fractures are clinically weakly expressed, therefore the final diagnosis is made after the examination of the X-ray. In addition, you need to consider whether a ray fracture is combined with a fracture of the ulna or dislocation.
Types of diagnostics
The main diagnostic methods are:
- Conventional radiography in 2 projections is the most popular and available method for diagnosing fractures.
- Computed tomography - is relevant for intraarticular fractures to assess the alignment of the joint surface. In the postoperative period gives precise information about bone fusion.
- Magnetic resonance imaging - is used to diagnose complex fractures, combinations of several fractures.
Treatment and first aidTreatment for fracture of the radius should be started with first aid. Timely first aid is the key to overall success in treatment.
First aid for fracture
Professional first aid and immediate medical attention is the basis of competent treatment and the prerequisite for restoring all the functions of the hand.
With a closed fracture, one must immobilize the injured limb with a solid tire or other improvised means. The tire is applied from the middle of the shoulder to the base of the fingers.
The arm is bent at right angles and placed in a kerchief tied around the neck. Reduce pain by injecting analgin or applying ice to the site of injury.
With open fracture, it is necessary to stop bleeding, disinfect the wound and apply a clean bandage. To prevent blood loss during arterial bleeding, you need to put a tourniquet on the middle of the shoulder. The fixing bandage is the same as with a closed fracture. Ice will help to remove swelling. Then the patient needs to be hospitalized.
The photo shows a fracture of the radius of the arm
To correctly treat a fracture, you must first evaluate the nature of the damage, and only then choose the method.The main goal of fracture treatment is to return the damaged limb, and, accordingly, the person to the previous level of functioning.
There are many treatment options.
Fractures of the ray without displacement are fixed with gypsum or polymeric bandage. If the fracture of the radial bone with displacement, then the parts of the bone are put in the correct position and fixed until the fusion.
In time, untreated treatment threatens the development of joint arthrosis and loss of mobility of the hand.
The limb will remain stationary for 4-5 weeks.
Then the doctor prescribes a referral to the exercise room, where after a fracture of the radius, the joint undergoes the necessary rehabilitation.
The operation for fracture of the radius is applied in case of inability to properly support the bone before adhesion with gypsum. In this case, physicians perform a fixation with their knitting needles through the skin or operation, a closed reposition and fixation with knitting needles through the skin, is the most popular method of international medicine.
First, the doctor closes the displacement, then inserts the knitting needles in certain directions.
- risk of infection of the wound and infection instead of fracture due to the presence of the spokes over the skin;
- prolonged wearing of plaster bandages;
- risk of lack of movement in the joint due to late development.
Open repositioning of fracture
An incision is made, the muscles and tendons are moved away, and the reposition of the fragments in theis correct. The bones are fixed with metal plates.
In this case, wearing gypsum is not required, becausethe bones are in the correct position due to the plates.
External fixation devices
Are indicated for wearing with contraindications to the use of plates and screws. With all open fractures, the patient should be operated on as soon as possible, thoroughly disinfecting the tissues around the fracture. The wound is sutured and the apparatus is fixed for 4-6 weeks.
- devices are expensive;
- risk of infection due to rods over the skin;
- uncomfortable dressings and wound treatments;
- risk of lack of dynamics in the joint.
Recovery after fracture
The types of fractures of the radial bone are so different as the methods of their treatment, then rehabilitation after a fracture of the radius for each patient is selected.
The hand grows after 1.5 - 2 months.
At first, after fracture for the removal of pain and swelling use UHF and ultrasound. Also, after fracture of the radius, exercises are useful for the purpose of restoring blood flow and preventing muscular hypotrophy.
If the patient is operated with a plate, the doctor will prescribe the LFK joint after 7 days after the operation.
After the end of the splicing period, the following restoration procedures are prescribed:
- exercise therapy;
After convalescence warm coniferous, coniferous-salt baths are useful.
It all depends on the patient. How much he himself is stubbornly struggling to restore limb mobility.
Possible complications of
For non-surgical treatment with the application of gypsum or a polymeric bandage, it is necessary to observe the brush. To look, whether there is an edema, whether pales fingers, whether sensitivity remains.If zhmet gypsum, this is a sign that the soft tissues and nerves are squeezed, which can lead to irreversible consequences. If such a sensation is detected, it is necessary to urgently consult a specialist.
At the heart of preventing the fracture of the ray of the upper limb lies:
- avoiding various types of injuries;
- falls from a height that can lead to this type of damage;
- treatment and prevention of osteoporosis.
Video: How to avoid complications of fracture of the radius
After the period of imobilization, the patient begins rehabilitation after the injury. After the cast is removed, he is prescribed therapeutic gymnastics, physiotherapy and massage. As a rule, in order to reduce the exercise load, it is recommended that they be carried out in warm water.
Before starting to go to the gym, doctors recommend that perform the flexing and extension of the elbow joint for several days to avoid discomfort.
Rehabilitation of the hand is simply necessary, otherwise the place of the injury will hurt for a very long time. To help the patient cope with unpleasant sensations, massages with the use of gels and ointments help to activate metabolism in the damaged site, so that the healing process goes faster.
Rehabilitation is always a patient process for the patient, requiring perseverance and patience. Actions that contribute to recovery should be carried out consistently and systematically, so that they bring the proper effect, while the duration and amount of the load does not increase.
Methods of influence
The main methods of influence are the correct approach to the rehabilitation period. Such funds are appointed by the doctor, the motor condition of the patient, his general condition, and the period of the illness. The funds are appointed taking into account the three periods that the victim passes:
LFK in different stages of
In the first immobilization period, the tasks of exercise therapy are: teaching the patient the skills with which he can help himself, preventing muscular atrophy, difficulties in mobility in the joint, as well as a restorative effect.
Recovery after fracture of the radius can not occur without the use of exercise therapy, which at this stage of recovery consists of 75 percent of respiratory and general development exercises and 25 percent special, designed for the damaged surface.
Exercises for the injured limb are aimed at developing the elbow joint, fingers, forearm and shoulder muscles. The patient performs them in a sitting, lying or standing position. Among the whole complex, you can single out independent exercises, morning exercises and therapeutic exercises.
Therapeutic physical culture in the second period is aimed at restoring the motor functions of the damaged joint. In this period, about 25 percent of respiratory and general development activities and 75 specially designed for damaged bone. The list of exercises for the radius consists of exercises in water with resistance, with weights for the entire limb and individual joints. The duration of such classes in this period is from half an hour to forty-five minutes, both independently and with an instructor.
The third recovery period is characterized by the achievement of the following goals: restoration of musculoskeletal functions, elimination of complications, training of the whole organism as a whole. The essence of bone restoration consists in prescribing the patient general developmental exercises, which gradually need to be performed with burdening. Particular attention after the fracture is given to active games and occupational therapy.
Along with LFK, as a means for rehabilitation, use massage.
Radial fracture requires professional massage of the damaged surface. In the first, above described period, segmental-reflex is used, when special attention is paid to the fingers of the hand. In the second period, areas located below and above the injured zone are massed, using a variety of techniques.
In the third period, bones are restored using electromagnetic laser therapy, mud treatment, balneotherapy, depending on what are the complications and what is the degree of their severity.
If to speak about massage of a radial bone as a whole, the first that it is necessary to influence the nearest to fracture departments, including a neck and a back.
Perform the massage by following the following non-complex exercises:
Stroking is performed by the palm or fingertips, performing circular motions.
As the means for rubbing the back of the fingers protrudes, which should be moved along the spine slightly pressing.
If the nature of the fracture allows you to use as a means for massage, tapping, vibration and stroking in the area of damage.
The area that undergoes the massage depends on the place where the bone is broken, if it is a brush, you should start the procedure from the shoulder. It is worth remembering that the closer to the damaged area, the sparing the pressure should be.
Do not intensively apply any rough methods in the massage, it can cause the appearance of pain, in addition, such actions can affect the displacement of bone fragments.
Exercises for the load
If the exercises for fracture of the radial bone are performed independently, proceed as follows.
To begin with, needs to warm up the problem site by performing flexion and extensor exercises. A damaged arm should be on the table, using a healthy one, you should lift your forearm and slowly lower it.
After such non-complex exercises, the forearm is placed at right angles to the surface on which it is located and perform circular motions. It is advisable to put something soft under the elbow when doing this exercise.
The only condition is the absence of a fracture in the elbow.
Then you have to stretch your fingers, by raising them, then turn your hand with your brush down and raise it. If such exercises cause difficulties, it is worthwhile to help yourself with a healthy hand.
Rehabilitation after fracture of the radius with or without displacement( LFK and other methods)
Conscientious performance of exercises in the interests of the patient
. Before starting the medical gymnastics, the person must independently learn how to flex and unbend his arm. Simple exercises will help normalize blood flow and joint nutrition, accustom the muscles to work and prepare them for more complex movements and stresses.
A good effect is exercised in the water, preferably warm. The complex of exercises is developed by a specialist for each specific case and patient. In the beginning, constant control over implementation is necessary, after a person can perform everything independently.
There are many sets of exercises, but before you give preference to one or another, you need the advice of a doctor or rehabilitologist. The proposed complex can also be used, but only after consultation.
At the first stages of rehabilitation, the help with a healthy arm is allowed.
You can start all with flexion-extensor movements. The patient's hand is placed on the table, and the hand is raised and lowered, and it is possible to make movements in the sides. Multiplicity of performance can be up to 10 times, after which you can start kneading your fingers.
Next, you need to lift your fingers, on a flat surface of the table. In the beginning, it is done with a healthy hand, and afterwards by yourself. Multiplicity of execution is up to 10 times.
The hand remains also on the table, only now it is necessary to reduce and dilute the fingers. Fingers slide on the table surface, and the folding performance is from 6 to 12 times. The brush is shifted palm upwards and in this position the fingers are clenched into a fist, and then they are unclenched. Multiplicity of execution is from 5 to 10 times.
Small objects, balls, cylinders, cans - all this can help during the rehabilitation of
. Fingers can sort through small objects or perform creeping movements on the surface of the table. Crawling movements can be done not only on the surface of the table, but also lying on the surface of the wall or bed, at any convenient time. After that, you can make movements that resemble the process of pickling. Everything is like trying to add a dish during its preparation. Multiplicity of repetitions is up to 10 times.
After the brush again turn the palm down and simulate the game on a stringed instrument or piano. For more fun, you can do this exercise to music, but it's strictly at the request of a person.
Exercises can take about half an hour, it is better to repeat them several times a day.
There is an exercise that requires a cylinder having a diameter of about 4 cm. Such a cylinder can replace a jar with glue. He clasps all his fingers, each finger is straightened out in turn, after which it is returned to its original position.
The duration of the gym is about 25 minutes, for a day you can perform from two to three cycles of therapeutic gymnastics. Over time, it is necessary to increase the amplitude of movements, do this every two - day. In the case of regular and correct exercise, strict adherence to recommendations, the rehabilitation period is shortened, and recovery is much faster.
This is an important stage in the rehabilitation process and is aimed at eliminating muscle spasm, resorption of hematoma and edema.
After a fracture, a hemorrhage occurs at the injury site, which may vary in volume. Often it reaches significant proportions( with a pelvic fracture up to 3 liters, hips - up to 1.5 - 2 liters).Gradually the hematoma resolves in some cases, it can become festering or cause the development of a false joint. But there is also a positive moment, it is the initial stage of the fracture fusion.
To accelerate the process of adhesion is used:
- electrophoresis( possible with novocaine, for pain relief);magnetotherapy;
- ultrasound with hydrocortisone or novocain, anesthetic gels;
If there is metal after the operation, warm and apply physiotherapy warming character is contraindicated.
Massage allows you to relax the muscles, give them a normal tone and restore normal nutrition. Use in the process of massage can be special gels and ointments, they contribute to the influx of blood and relieve pain.
Massage should be as cautious as possible, and pain or other unpleasant sensations should alert the
. Begin the massage from the forearm, gradually moving to the brush. At first the movements are smooth, performed with low intensity. After the amplitude increases with the process of rehabilitation. Often, up to 10 massage sessions are prescribed, the multiplicity and quantity is set by the doctor individually, depending on the severity of the injury and the degree of displacement.
During the massage there should be no pain or discomfort.
In the rehabilitation period, an important stage is nutrition, since bones require the intake of nutrients. This is how the bone gets all the necessary resources. The diet should contain as much calcium, magnesium, these minerals contribute to the early consolidation, contributes to this and collagen. Vitamins are necessary for the body to develop immunity and strength.
Vegetable purees and soups should be eaten, sour-milk products are useful, soft porridges contain a large amount of fiber. The diet itself should be varied.
What is useful after fracture of the radius( photo)Vegetable puree Kefir Kasha
The rehabilitation process takes a certain time and requires the maximum expenditure of the most affected. A doctor or a rehabilitologist only directs or advises, and it depends on the person how quickly he will get rid of the consequences of a fracture or performed surgical intervention.
LFK and massage at fractures of hands
Stimulation of regeneration, prevention of contractures, stiffness of joints, preservation of clearness and coordination of movements.
Features of exercise therapy
Fractures of clavicle .Immobilization is carried out by tires and bandages for 3-4 weeks. LFK appointed from the first days after the injury. In the I period, against the background of restorative exercises, perform various movements with fingers, a brush, in the elbow joint, a slight withdrawal in the shoulder joint in a position of inclination toward the injured clavicle or lying on the back. In the II period, exercises are prescribed for the muscles located proximally to the shoulder, and later for the muscles of the entire upper extremity belt( flexion, extension, withdrawal, bringing in the shoulder joint with the help of sticks, clubs, etc.), swimming. In the III period exercises are complicated.
scapula fractures are rare. The technique of exercise therapy is similar to that of a collar bone injury.
Fractures of free upper limb .Often there is a fracture of the surgical neck of the shoulder and fracture of the radius in a typical place( 1-4 cm proximal to the joint surface of the radius).LFK appointed on the 2-3rd day: in the I period - respiratory, tonic, ideomotor exercises and special exercises for the injured hand, initially elementary in lightweight PIs, and then with increased load. Required training of similar muscles of a symmetrical limb. In the second period, add stretching exercises, in water, walking, running. With fractures of the upper and middle parts of the shoulder, special attention is paid to strengthening the deltoid muscle, and with fractures of the lower third of the shoulder and in the elbow joint area - training of the triceps brachial muscle, with fractures of the forearm diaphysis - finger wrist exercises.
Massage starts from the 2nd-3rd day after fracture. At the first stage, massage of healthy tissues is carried out, and if the longette is removable - the suction massage of the injured limb. Massaging the cervico-thoracic spine, and then the muscles are healthy, symmetrical defeat of the limb zone. It is possible to carry out vibration massage with the help of apparatuses on a plaster bandage in the direction from the distal to the proximal. The duration of the massage is 5-10-15 minutes. After removing the elongates, the elbow joint should be massaged for 2-3 minutes with ice, and gentle massage of the damaged segment. Do not allow the muscle tone to increase on the damage side.
Complex of exercises for fractures of metacarpal bones and phalanges of fingers( II period)
The brush rests on the smooth surface of the table.Dilute and remove fingers on the surface of the table and in a warm bath. Bend and unbend fingers, lead and lead the thumb. Remove the thumb and bring it to the bottom of the V finger. Compare the thumb with the tips of all the others in turn. Alternately raise each and all fingers from the support plane. Bend and unbend the brush in the metacarpophalangeal joints. Bend and unbend the distal phalanx while fixing the proximal phalanx.
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