Arm fracture types of injuries, symptoms, diagnosis, treatment

A fracture of the arm is a violation of the integrity of bones in a variety of injuries. The disease has an uncomplicated and complicated course, with serious pathologies requires surgical correction. Doctors advise not to hesitate to visit the trauma center – improper bone fusion may require correction in the surgical department.

General information

Violation of the integrity of bones during a fracture of the arm is a common occurrence, especially in the cold season. Specialists identify several options for injuries:

  • open form – at the time of a fracture of the arm, soft tissues and skin break, the bone is visible through the wound;
  • closed – soft tissues remain intact.
  • diaphyseal damage – the middle of the bone is affected;
  • metaphysical – periarticular fracture of the arm;
  • intraarticular – in case of trauma, the ligamentous apparatus and articulation are involved in the pathology.

By the number of lesions:

  • multiple type – with damage to both upper limbs, several bones in one of the hands;
  • isolated – pathology affects one area.

By the presence of offsets:

  • without displacement of debris relative to each other;
  • with primary – during trauma;
  • with secondary – some time after the last fracture of the hands.

The disease can be characterized by injuries of longitudinal, transverse, oblique, fragmented, fragmentation. For the causes of the ailment, it has a traumatic and pathological origin.

symptomatology

Typical clinical manifestations of a hand fracture are:

  1. Severe pain at the time of injury, any movements provoke an increase in discomfort with radiation to adjacent tissues or throughout the upper limb;
  2. A decrease in temperature in the hand – the condition is provoked by rupture of the arteries and refers to dangerous symptoms;
  3. Swelling of the tissues, swelling in the area of ​​damage, local subcutaneous hemorrhage – manifestations are characteristic of injuries of the wrist;
  4. Unnatural localization of the affected limb, a decrease in its length, visible deformation changes – with a displaced fracture of the arm;
  5. Decreased range of motion of the damaged upper limb;
  6. The defeat of nerve fibers and a decrease in sensitivity in certain areas of the arm;

An increase in temperature due to a broken arm is manifested by redness of the dermis. The response of the body to the resulting shock state when damage to large bones leads to an increase in temperature.

The condition lasts for several days and spontaneously disappears. The above symptomatic signs do not always indicate fractures, may occur with other injuries of the upper limbs. To accurately determine the type of pathology, a full-fledged diagnostic examination is necessary.

Causes

Sources include falling with straightened arms, strong blunt bumps, excessive pressure on the limb, stress during osteoporosis, bone neoplasms, age-related changes.

Diagnostics

When contacting the trauma center, the patient is sent to an x-ray. Radioscopy gives an assessment of the injury that has occurred, shows the type of fracture of the arm, the possible displacement of fragments.

With insufficient informational content of the procedure and suspected arterial damage, CT is additionally prescribed – manipulation helps to identify the location of ruptures of tissues, nerve fibers, hidden bleeding, and hematomas.

Treatment

The basis of therapy is the provision of emergency care, the application of gypsum, rehabilitation measures.

Timely help helps eliminate complications of injury, the standard algorithm includes:

  • Immobilization – complete immobilization of the affected limb is carried out by applying tires from existing materials. Straight boards, straight sticks are suitable for them – they are bandaged to the affected area. If the fingers were additionally damaged during a fracture of the hand, then they are fixed with a comb, manicure file or attached with a bandage to a nearby finger. In the process, it is forbidden to independently make fragments of bones, to align the deformation of the arm with force. A damaged limb needs to be hung on a scarf, scarf or a dense piece of fabric.
  • Anesthesia – expressed pain syndrome is stopped by an analgesic: Baralgin, Analgin, Benalgin, Pentalgin.
  • Prevention of puffiness – fractures of the hand with concomitant damage to the fingers are often accompanied by damage to blood vessels. Immediately after an injury, all rings, chains and other jewelry must be removed from the victim. It is forbidden to try to remove them by force – if the ring does not give in, the problem is solved in the trauma center, where the doctor will remove it without unnecessary pain.

With open types of arm fractures, the problem is often complicated by bleeding.

By treatment is meant its correct fusion and subsequent restoration of all lost functions, in order to return the patient to his usual way of life. In traumatology, the victim is given gypsum or other fixatives to immobilize the limb.

The duration of walking with gypsum depends on the complexity of the fracture and ranges from 6 to 10 weeks. In childhood, the pathology heals faster. After providing basic care, the patient may be recommended to take painkillers for 72 hours. In the future, the pain syndrome disappears and does not bother the patient.

Operations are assigned for certain indicators:

  1. An open form of pathology or a strong displacement of bone fragments requires the installation of metal structures. When comparing fragments, tight fixation is achieved in one position, which helps to accelerate the fusion processes. During the procedure, anesthesia is used, in rehabilitation – standard painkillers. At the end of the manipulation, a plaster cast is applied to the upper limb. The recovery period is longer than after other types of injuries.
  2. Closed form in the shoulder area – be treated by inserting a pin into the hole of a pre-drilled bone. The core is fixed fragments of bone tissue. All auxiliary devices after the end of therapy are removed through the injection site. If the installation was carried out for elderly patients, then the metal structures are not removed, they remain in the damaged limb until the end of life. This type of surgical correction refers to osteosynthesis. The procedure helps to properly fuse bones, prevents spontaneous displacement of fragments. The type of fixative is selected indiv >

Long-term treatment of a diseased hand with a constant presence in a plaster cast is not limited to. Recovery procedures after immobilization help to restore the lost range of motion, tone muscle tissue. Rehabilitation lasts one calendar month.

If over a long period the numbness of the limb does not disappear, then the patient additionally undergoes diagnostic examinations regarding the alleged damage to nerve endings. The following procedures are included in the course of rehabilitation measures:

Secondary therapy is represented by the following manipulations:

  1. Magnetotherapy – exposure to magnetic fields is widely used in all types of injuries, including damage to bone and joint tissues. Sessions help get rid of swelling of tissues, accelerate the regeneration processes. Procedures can be carried out at home – with the device.
  2. Laser therapy – a point effect on problem areas allows you to increase blood circulation in a sick hand, get rid of inflammatory processes.
  3. UHF – the procedure relieves pain, inflammation in the tissues. Exposure to acoustic pulses is widely used in the postoperative period.
  4. Ultrasound – ultrasonic waves increase the permeability of cells, accelerating metabolic processes, helping to supply a sufficient amount of nutrients.

The average number of manipulations is 6-10 sessions. With available indicators, mud therapy, paraffin-based applications, and thermal procedures are additionally prescribed.

They help accelerate recovery after a fracture of the arm: stabilize blood circulation, get rid of discomfort.

Due to the length of time the upper limb is in a fixed position, development can cause certain difficulties. For uniform recovery, the patient is prescribed to undergo medical gymnastics classes. The time of the first training is prescribed by the attending physician – early training can cause significant harm.

The first classes begin after a decrease in swelling and a decrease in pain in the affected area. Loads increase gradually, until the full development of muscle tissue and the ligament-tendon apparatus. The whole period the patient is recommended to additionally train the hand with an expander. Aqua aerobics can be included in the course of physiotherapy exercises. Classes are held on the basis of a medical institution, under the constant supervision of an instructor.

Massaging the fractures of the arm allows you to increase blood circulation in it, to ensure the influx of nutrients and oxygen. In most cases, sessions are prescribed after removal of the plaster cast, and they are carried out in the district clinic. The positive dynamics of the procedures is presented by eliminating uncomfortable sensations, reducing swelling of tissues, and relaxing muscle spasm.

At home, you can use special devices, strictly following the instructions attached to them. Exceeding the massage time can negatively affect recovery, worsen the general condition.

Diet and vitamin therapy

The entire course of rehabilitation, patients must adhere to a specific dietary table. The menu includes products that accelerate healing: dairy, sour-milk products, a sufficient amount of fresh fruit and vegetable crops, meat and fish with a minimum amount of fat.

Additionally, vitamin therapy is prescribed for patients. Multivitamin complexes positively affect the functioning of the immune system, normalize metabolic processes, and make up for the deficiency of nutrients. Depending on the state of the body, the Alphabet, Complivit, Duovit, Vitrum, Centrum, Multi-Tabs, Multimax, and special Merz tablets can be recommended.

Possible complications

Prolonged ignoring of the symptomatic signs of a fracture of the arm, refusal of professional help, violation of the rules for immobilization of the limb can lead to serious consequences, especially after open injuries. Common complications are:

  1. The formation of a false joint – an additional joint is formed with a large gap between bone fragments. Initially, there is an overgrowth of connective tissues, in the future they are transformed into a non-standard joint. Increased bone mobility in the problem area leads to impaired performance of the damaged upper limb.
  2. Suppuration in the area of ​​injury – major hemorrhages provoke the development of extensive hematomas, in the absence of therapy, they begin to become inflamed. Further purulent processes can be complicated by a phlegmon, an abscess.
  3. Osteomyelitis – penetration into the open wound of pathogenic microflora becomes a source of the development of the disease. The inflammatory reaction in the bone tissue takes a chronic course with periods of remission and exacerbation. A part of the victims at the site of the passage of bacteria forms a fistula with the release of purulent contents, particles of bone necrosis.
  4. Deforming osteoarthritis – a pathological process is formed with lesions of the articular surfaces of bones, leading to impaired mobility of the articular apparatus. This condition occurs with prolonged use of plaster dressings or other means of immobilization.
  5. Shortening the affected limb – pathology occurs with open forms of a fracture of the arm, displacements of fragments of bone tissue, fused in unnatural positions.

The above complications can be avoided only with a timely visit to the trauma center and the exact implementation of all the instructions of the attending physician.

Preventive measures

Hand fracture prevention includes standard recommendations from traumatologists:

  1. Observe maximum caution during the cold season when moving on slippery surfaces. The correct selection of shoes with non-slip soles will help to prevent accidental falls on ice.
  2. To increase the stability of bone tissue, a sufficient amount of calcium and other beneficial substances must be present in the diet. Constant sports, morning exercises, long walks will help increase muscle tone. Seasonal vitamin therapy will prevent a lack of calcium in the bones, help increase their endurance and resistance.

A broken arm refers to serious injury that cannot be ignored. Timely seeking professional help will help to reduce recovery time as much as possible, and prevent the formation of complications.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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