Often, a fracture of the elbow joint occurs due to trauma or a direct fall on the elbow. Such a violation is often diagnosed in people involved in traumatic, contact sports, as well as in children who lead a mobile, active lifestyle. When a crack in the bone is formed, the victim instantly develops characteristic signs, in which it is dangerous to delay visiting a doctor.
- Causes of violations
- Types of damage
- Diagnosis of a fracture of the elbow joint
- What treatment is prescribed?
- Physiotherapy and massage
- Do I need a diet?
- Arm fracture in the elbow joint: signs, methods of treatment
- Causes, types, symptoms of injury
- Types of fractures
- Fracture of the elbow joint in a child
- Signs of a fracture
- Elbow fracture treatment
- Conservative treatment
- Operative therapy
- Rehabilitation period
- Elbow fractures: types, symptoms, treatment, rehabilitation
- Causes of Injury
- Types of fractures
- First a >
- Conservative treatment
- Operative therapy
- Possible complications
- In conclusion
- Elbow joint fracture treatment methods, causes and symptoms of injury, rehabilitation rules
- Causes of Injury
- Types of fractures
- Conservative treatment methods
- Rehabilitation period
- Possible complications
- Types and treatment of fracture of the elbow joint
- Features of a fracture in children
- The first stage
- The second stage
- What is the danger of injury to the ulnar fracture of the humerus and how long it heals
- Damage Features
- Types of fractures
- First aid
- Diagnostic features
Causes of violations
Elbow fracture most often occurs due to a fall on a joint or a direct limb. Shocks, dislocations and injuries of the humerus can also provoke the destruction of the articular joint. Congenital weakness of the ligament-tendon apparatus of the elbow is also a factor under the influence of which the chances of damage to the joint increase.
Types of damage
Less often, a fracture of the ulnar process is diagnosed, although when it falls, this section of the limb takes on the main impact force. There are still fractures:
- the head and neck of the radius
- epicondyle of the humerus;
- coronoid process of the ulna.
In addition, a marginal fracture of the ulna is distinguished with displacement, when bone fragments change their normal location, and without displacement. In case of damage to the integrity of the skin and the exit of bone fragments to the outside, an open fracture is diagnosed. If the soft structures remain intact, the fracture is considered closed. Periarticular, intraarticular fractures of the elbow joint are also distinguished.
If the elbow joint is damaged in a child or an adult, and the bone is broken, signs develop instantly. There is acute pain, hematoma and swelling are formed, due to which the arm does not normally straighten. If a bone displacement has occurred, the victim is not able to move his hand, due to damage to the nerve endings, the limb is numb. An intraarticular fracture is characterized by pathological joint mobility.
A fracture of the ulnar process and condyle causes soreness localized in the back of the joint. If the neck of the radius is damaged, the syndrome is concentrated in front of the joint. Fracture of the coronoid process is characterized by acute pain in the anterior zone of the joint, while limb flexion-extension is limited.
Diagnosis of a fracture of the elbow joint
If the victim has characteristic symptoms of an elbow fracture, it is urgent to deliver the person to the emergency room, where he will be examined by a traumatologist.
After a visual examination, the patient is given a direction to an x-ray, which is performed in 2 projections. If there is a fracture of the elbow joint with a shift, while there is suspicion of destruction of the soft tissues, an MRI or CT scan is additionally prescribed. Depending on the variety and severity of damage, the doctor selects an individual therapy regimen.
What treatment is prescribed?
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If the fragments remained in a normal position, or a fracture occurred with a displacement of no more than 20-30 mm, conservative treatment is performed. In this case, immobilization of the limb is mandatory, therefore, gypsum is applied to the elbow joint, the arm is fixed at an angle of 45-50 °. To relieve a pain symptom, analgesics are prescribed. When puffiness begins to decrease, re-radiography is performed. If there is no secondary displacement, the gypsum is left for another 3-4 weeks, and after that a supporting dressing is used. If there are no complications, a course of therapeutic exercises is prescribed. When all the doctor’s recommendations are followed, full recovery occurs in 6-8 weeks.
In the case when a person is diagnosed with a fragmentation fracture, and a displacement of the elbow joint has occurred, surgery is mandatory. Osteosynthesis is often performed, which uses screws, plates, knitting needles. After surgery, the arm is immobilized with gypsum, which must be worn until the bone fuses to the end.
During the rehabilitation period, it is important to follow all the doctor’s recommendations, otherwise the risk of developing negative consequences is high. To normalize the functioning of the joint, a set of therapeutic exercises is necessarily prescribed. While the arm is in a cast, it is recommended to perform isotonic muscle contractions, in which the limb remains immobilized. When the joint begins to heal, and the risk of complications is over, the LFK complex expands, exercises for flexion-extension of the joint are added. Basic training looks like this:
- Sitting at the table, place your hand in front of you. Slowly raise and then lower the limb.
- Put your hands behind your back. With a healthy limb, carefully sip the patient, but make sure that there is no discomfort.
As the condition improves, the load on the joint gradually increases. To achieve the maximum effect from the exercises, it is important to exercise regularly, without missing a single lesson. During training, there should be no discomfort and pain, but if such symptoms appear, you should inform your doctor. If necessary, he will correct the exercises.
Physiotherapy and massage
While the hand is gypsum, massage is prohibited. After the risk of complications has passed, it is recommended to massage the back, arms above and below the elbow. Thanks to manual massage, it will be possible to restore the functionality of the joint, reduce pain, prevent muscle atrophy, strengthen the tendon-ligamentous apparatus. Hand fracture is successfully cured with the help of physiotherapeutic procedures that contribute to the normalization of blood circulation and nutrition of the affected areas. Due to this effect, tissues regenerate and recover faster. Treatment is carried out using such methods:
- laser heating;
- mud applications.
Do I need a diet?
In order to recover faster after a fracture, it is important to establish nutrition.
It is recommended to enrich the diet with products that contain collagen:
- poultry meat, fish;
- sea kale;
- buckwheat, oatmeal;
- vegetables and fruits;
A fracture of the right or left elbow is considered a serious violation requiring adequate therapy and a long rehabilitation course. If you follow all the recommendations of a doctor, complications often do not arise. Otherwise, the following consequences are possible:
- repeated fracture, which mainly occurs due to excessive load on the joint;
- the formation of post-traumatic contractures;
- infectious complication;
To avoid fractures of the elbow joint, it is recommended to move carefully and avoid falling onto a straight arm or directly onto the joint itself. When practicing traumatic sports, you need to protect your elbow from bumps with the help of orthoses. Adequate recovery will help to eliminate repeated injuries and the development of post-traumatic complications, during which it is important to dose the load on the limb, and also regularly perform therapeutic exercises.
Arm fracture in the elbow joint: signs, methods of treatment
According to statistics, one fifth of all fractures are fractures of the arm in the elbow joint. Elbow is a complex formation. Its constituent parts are the humerus, ulna and radius, as well as the articular joints. They are connected by muscles, tendons and ligaments. In addition, vessels and nerve fibers are located in the joint that provide limb movements. It is because of the complexity of the structure of the injury in this area that is often accompanied by complications that may require surgical treatment.
Causes, types, symptoms of injury
How can the elbow joint be broken? Most often, such an injury occurs when falling. At this moment, a person reflexively exposes his elbow. Such situations can occur when playing sports, a car accident, falling into ice on an arm extended or bent at the elbow, and causing a direct blow to the elbow joint.
Elderly people, children, as well as patients with osteoporosis are more prone to elbow injury. This is explained by the weakness of the ligamentous apparatus and the fragility of bone tissue in these categories of the population.
Types of fractures
Fracture in the elbow can be of the following varieties:
- closed and open;
- intraarticular and periarticular;
- with and without displacement;
- combined with dislocation.
When injuring the articular region of the elbow, the ulnar process suffers first. When injured, fragments are separated from it, which, when displaced, can damage blood vessels, nerves and muscle tissue.
In the event of a fall on the elongated upper limb, the neck or head of the radius is broken. Violation of the integrity of the coronoid process is combined with injury to the forearm or humerus. Displacement of bone fragments is also observed.
If the humerus is injured, then this can be accompanied by a condyle fracture and dislocation in the elbow.
Fracture of the elbow joint in a child
In childhood and adolescence, bone injuries are localized at their growth points. Diagnosing elbow damage in children is not easy. The structure of the joint cavity and bones in childhood is different from that in adults. For example, a violation of the integrity of the ulnar process is difficult to see on an x-ray, because it fuses with bone only by the age of fifteen. Often in children, condylar fractures of the humerus and intraarticular injuries can be observed.
Signs of a fracture
How to understand that the elbow joint is broken? This can be done if the following symptoms are present:
- The presence of a hematoma or bruising.
- Swelling in the area of injury.
- Deformation of the articular region, its increase in size.
- Impaired mobility not only in the elbow, but also in the shoulder.
- If the vessels were damaged, then pulsation on the affected limb may be absent. In addition, the limb acquires a bluish tint, fingers become cold.
- If nerve fibers are affected, the patient may feel numbness, tingling, and other unpleasant sensations in the hand.
- If the ulnar process is involved, the pain in the shoulder area is disturbing, the limb in the elbow does not bend.
Elbow fracture treatment
Treatment should begin with immobilization. The upper limb is brought into a bent and elevated position. It is important to do this as a first aid, especially with an injury with displacement. Otherwise, fragments can damage blood vessels and nerves near the joint. But if fixation in this position causes pain, forcibly giving the hand such a position should not be.
In a medical institution, radiography is performed in two projections. If the trauma is intraarticular, they also do computed tomography. Then the limb is fixed with a plaster cast. If no bias is detected, apply a plaster cast for a month.
Trauma with displacement and the presence of fragments requires their reposition. Closed trauma and displacement of fragments less than 5 cm, allows you to do this percutaneously. In other situations, surgical treatment is carried out.
It is carried out in the absence of offsets. It is carried out by wearing a plaster cast. Physiotherapy, exercise therapy can also be prescribed.
The goal of conservative treatment is to ensure that the limb is immobilized, to prevent swelling, and to relieve inflammation.
A fracture of the neck of the radius without displacement requires wearing plaster for three weeks. Injury of the coronoid process is treated with a plaster cast for a month. Then rehabilitation is needed, which takes about two weeks.
With a fracture of the epicondyle and the absence of displacement, the posterior gypsum splint or circular bandage is applied to the upper limb. The duration of its wearing is three weeks.
The displacement of fragments requires surgery, after which they also apply gypsum for a period of six weeks. Rehabilitation in this case lasts from two weeks to one and a half months.
It is carried out with an injury to the joint of the elbow with displacement, as well as in the treatment of a chronic fracture. An operation is needed to match fragments. If it is not done, there can be serious consequences, in particular, the forearm will not extend to the end. Open trauma requires intervention during the day.
Surgical treatment consists in comparing fragments and fixing them with knitting needles or bolts. In some cases, it becomes necessary to eliminate fragments or a damaged head. In the latter case, an endoprosthesis is installed instead of the head. As part of the operation, stitching of muscle tissue, torn tendons or ligaments is also carried out. In case of violation of the integrity of the ulna, plastic is necessary, in which fixing plates are used.
In the postoperative period, for rigid fixation, it is recommended to wear retainers – an orthosis or splint. The orthoses include thin metal plates. The constituent elements of the splints are plastic or iron plates. The use of clamps is necessary to hold the limb in the same position. This is important to create complete rest for the affected arm.
However, one must remember that wearing gypsum leads to muscle atrophy. For prevention, you need to start doing exercises on the second day after the injury, when the pain in the arm becomes less pronounced. The consequences of improper rehabilitation are contracture in the articular region of the elbow.
On the second day after injury to the articular region, gymnastics for the fingers, hand, wrist joint and shoulder should be performed. To prevent swelling, the limb must be carefully raised above the head, wound behind the head.
A week after receiving the injury, the muscle tissue under the plaster cast can be strained without making any movements. Also during this period, it is necessary to perform breathing exercises.
After removing the plaster cast, the limb is bent and unbent at the elbow, gradually increasing the multiplicity and speed of movements. In the initial stages of recovery, you can help with a second hand.
You can not bend the limb in the elbow with a fracture of the ulnar process. This threatens a new injury.
At the next stage, the patient does a set of exercises selected by the attending specialist. The following items are executed:
- Upper extremities interlocked in the lock lead behind the head.
- Cautious flexion and extension in the injured limb.
- Smooth rotational movements in the elbow.
- Gymnastic exercises using a stick or ball.
These exercises can be done in the pool or in a warm bath with the addition of sea salt. Salt reduces soreness and stimulates the regeneration of damaged structures. Swimming, massage and physiotherapy are helpful. It is also necessary to follow a diet with the inclusion in the diet of foods rich in ascorbic acid and collagen.
A fracture of the arm in the elbow joint always requires a thorough examination. Untimely fixation of the limb threatens to develop complications, and treatment that is started late is dangerous for the development of contractures. Compliance with the recommendations of a specialist will help in the future to avoid arthrosis, bone growths and preserve the functionality of the joint.
Elbow fractures: types, symptoms, treatment, rehabilitation
The elbow joint has a rather complex structure. The presented part of the upper limbs is formed by the radial and ulnar bones, which are connected to the humeral tissue. Inside the main elbow joint there are several small ones. Large nerves and blood vessels that are responsible for the mobility of the entire limb pass through the area. Therefore, fractures of the bones of the elbow joint, in addition to the difficulty of motor functions and the development of a serious pain syndrome, are fraught with a whole host of complications.
What therapy is used for damage to this plan? How to treat elbow fractures? What is required for rehabilitation? We will try to answer the questions presented.
Causes of Injury
A fracture of the elbow can be obtained both as a result of a fall and due to a significant shock load on this area. The most common bone damage here is internal.
Types of fractures
The following types of elbow bone injuries are distinguished:
- A closed fracture of the elbow joint is characterized by damage to the radial bone, its neck and head. Most often occurs as a result of excessive load when focusing on a straight limb.
- Open fractures of the elbow joint – in addition to the occurrence of cracks in the bone structure, soft tissues are damaged by fragments. In severe cases, rupture of the skin occurs, a gaping wound forms, which is accompanied by profuse loss of blood.
- Fracture of the coronoid process occurs due to significant shock loads on the bone tissue. Such injuries are rare. Damage to this plan is characterized by consequences in the form of displacement and dislocation of the forearm.
A fracture of the elbow joint with or without offset is also isolated. Often, with such injuries, one bone suffers.
- The presence of sharp sustained pain, which gives to the hand and wrist.
- Limited limb mobility or its complete paralysis.
- Unhealthy, unusual for a person mobility of the arm in the area of the elbow joint, for example in the lateral direction.
- The occurrence of edema, the formation of bluish hematoma, subcutaneous bruising.
- Neurological symptoms – numbness of fingers and hands, tingling of the forearm.
- Damage to blood vessels, muscle tissue, skin (open fractures of the elbow joint).
A clear sign of serious damage to the elbow joint is severe pain in the back of it. Gradually, an edema and hematoma are formed on the front surface of the injured area. Subsequently, the ability to flex the arm is lost. The injured limb hangs limply. When performing the movement of the forearm there is muscular stiffness.
After a fracture with displacement of the bone, the ability to extend the arm is retained. However, lifting the limb and rotating it to the sides cause significant discomfort.
First a >
As the bone tissue joins, the arm is periodically freed from plaster to develop the joint. Over time, such a bandage is replaced with a rigid fixator, which has a system for adjusting the amplitude of movements.
The success of operative therapy directly depends on the accuracy of the actions of the trauma surgeon, in particular, the comparison of bone tissue fragments, their verified fixation in the anatomically correct position. The center of traumatology and orthopedics is capable of ensuring such an operation.
With the usual damage to the structure of the end of the ulna, therapy is aimed at tightening the tissues of the medical wire loop. Sometimes an additional fixation of the bones in a static position with the spokes is required.
If you have to treat internal fractures of the elbow joint with the formation of fragments, therapy is based on bone grafting. In such situations, it is difficult to loop the tissues, as this can lead to shortening of the articular surfaces. Instead, resort to the use of dynamic compression plates.
In cases where there are signs of bone fracture, the center of traumatology and orthopedics may offer the patient the replacement of bodily tissue with a special prosthesis. Produce plastic and metal implants. They are installed using bone cement.
In order to prevent the occurrence of complications in children, in particular the loss of functionality of the limb, treatment should be carried out under the supervision of adults. First of all, the injured hand must be completely at rest throughout the course of therapy. The child should not burden a limb, perform sudden gestures. The admission of similar negligence can lead to the repeated fracture.
- therapeutic exercises;
- physiotherapeutic procedures.
The development of a joint with the help of physiotherapy exercises is possible already on the first day after fixing the limb with a plaster cast. Naturally, in this case, avoid bending the arms at the elbow. The main emphasis is on the movement of the fingers and wrist. It is recommended that the injured, in the prone position, start the injured limb behind the head, straining the muscles of the forearm and shoulders. Such decisions contribute to the removal of swelling as a result of the activation of lymphatic drainage from the tissues.
When restoring the ability of the joint to bend, it proceeds to its gradual development. To do this, the main part of the plaster cast is removed, and then measured, unsharp movements are performed with the limb. When rehabilitation with the help of therapeutic gymnastics, it is forbidden to bend and unbend the arm completely, as this may cause a second fracture.
To massage resort only after complete removal of the plaster cast. Moreover, the impact on the muscles of the shoulder girdle and back in a sparing mode. Regular execution of such procedures allows you to eliminate pain, strengthen the atrophied muscles, stretch the ligaments and ultimately fully restore the mobility of the arm.
As for physiotherapeutic procedures, they are recommended to alternate with therapeutic exercises. Here resorted to methods of UHF, magnetic therapy, electrophoresis, treatment of curative mud.
As a result, it is worth noting that the victim, after discharge from the hospital, needs to clarify several issues for himself. It should be clarified with the attending physician, how best to make movements in the elbow joint, when you can load a limb with a weight, how to avoid relapses and complications, what you can expect in the near future.
Elbow joint fracture treatment methods, causes and symptoms of injury, rehabilitation rules
A fracture of the arm in the elbow joint is a frequent injury regardless of age. The elbow has a very complex structure, therefore, with an injury, it is not always possible for a person to suspect such a dangerous violation due to developing symptoms. It is important to understand that timely diagnosis and the right first aid will allow you to conduct effective treatment and recover completely. The treatment and consequences of the injury are inextricably linked.
Fracture of the elbow joint
Causes of Injury
A crack in the right or left elbow is a serious injury. In this case, the triceps tendon remains intact, there is a slight shift of fragments. ICD-10 code: S53.
When the victim broke the joint of the elbow with a tendon rupture, the injury was intra-articular.
The comminuted form of the fracture also occurs when a significant increase in the size of the elbow and its severe deformation occur. Most often, intraarticular damage is diagnosed.
The causes of a joint fracture are:
- falling on an outstretched arm or on a straight line on the elbow – the neck or head of the radius is broken;
- direct hit / bruise on the ulnar process – a fracture in the ulnar process with or without displacement;
- forearm injury, causing fracture of the coronoid process of the ulna.
The listed damage can occur not only in an adult, but also in a child.
Types of fractures
Fractures of the elbow joint in medicine are characterized by a large number of different classifications in groups. They are open or closed, periarticular or intraarticular. Also, an intra-articular complex fracture displaces tissues, provokes fragmentation of the bone, the formation of multiple fragments, dislocations.
The main classification of the disease is based on the type of affected element. There are such types of fractures:
- ulnar process – about 1,5% of all cases;
- radial head / neck – occurs when a person during a fall does not have time to bend his arm, landing on a straight line;
- coronoid process;
- external epicondyle;
- diaphysis of the ulna with the mechanism of damage of a direct strong blow;
- bones of the shoulder.
The joint of the elbow due to its structure during a fracture loses the ability to move around two axes.
You can start to suspect injury by the characteristics of the clinical picture, which progresses immediately after exposure to a traumatic factor:
- sharp pain radiating down along the entire arm, also to the forearm;
- violation of the motor ability of the elbow, a change in the shade of the skin, a bruise;
- frequent deviation – problems with flexion and extension;
- neurological symptoms – numbness and tingling;
- increased mobility of the arm at the elbow – an amplitude of movements appears from s >Fracture pain and crunch
A child experiences a shoulder reaction with an injury – the hand goes down along the body, and the baby tries to hold it with his healthy hand. A search for a comfortable position for pain relief is also noted. Additional signs include moods, extreme agitation, and complaints of discomfort.
The process of treating a joint, provided that the injury is accompanied by damage to nerves and blood vessels, is realized only through surgery. The doctor confirms the diagnosis by x-ray. Then there is a complex therapy in a hospital setting. Its main features:
- accurate mapping of fragments;
- the need to wear a fixation;
- early function.
One of the principles of treatment is mandatory fixation.
The doctor can additionally prescribe an examination of the joint with the help of a puncture – taking fluid from the site of the injury. This is necessary for testing for the presence of blood, pus in the synovial environment.
In recent years, modern medicine, as an effective restoration of the elbow joint after a fracture, uses transosseous osteosynthesis. It is carried out with the help of external fixation devices, which quickly and efficiently resonate fragments, firmly fixing them and allowing you to start early recovery through exercise therapy. The priority of surgical treatment over conservative remains undeniable.
With extensive trauma, fragments of the joint must be fixed using the spokes of the Ilizarov apparatus or the rod apparatus. This is necessary so that the soft tissues can heal before the final operative fixation of the fracture. This minimizes the likelihood of infection and amputation.
Conservative treatment methods
Elbow joint fracture without displacement is usually treated conservatively. In the first 6 days, edema can still persist and even increase. In this regard, it is required to put on the posterior gypsum bandage in a position when the forearm is bent at the elbow at an angle of 80 – 90 degrees.
The bandage is applied from the upper third of the shoulder bone, reaches the wrist joint. The forearm is placed palm up. The immobilization period is 3 weeks. Subsequently, it continues in the span, sometimes removing it to develop the elbow. Instead of gypsum, it is permissible to wear a rigid fixation orthosis with the possibility of adjusting the amplitude of motion.
When the victim is displaced for at least a week, they are hospitalized in a hospital, and treatment is carried out under the constant supervision of a doctor.
Fracture of the elbow with a pronounced displacement requires mandatory surgery. Otherwise, the forearm will not unbend fully – this is a serious problem in the work of the upper limb.
The success of the operation is correlated with the accuracy of matching fragments, their fixation in the correct position. Subsequently, the organization of proper rehabilitation and development is required.
Most often, the treatment of a fracture of the elbow joint requires surgical intervention for correction and recovery. In this case, the patient is given general anesthesia.
If the injury is accompanied by fragmentation, the surgeon can replace the joint with a prosthesis. This often happens in elderly patients. Implants are made of metal and plastic, fixed with special bone cement. But after treatment, a complication may appear – an injury to the ulnar nerve. This rarely happens, usually the work of nerve fibers is completely normal.
In a comminuted fracture with displacement and detachment of the apex of the process of the elbow bone, fixation of fragments by a special titanium construction is required. It restores the integrity of the joint and the surface of the ulna.
So, the fracture treatment process must take into account the nature of the injury, it includes such mandatory steps:
- restoration of the destroyed area;
- reliable fixation of the damaged area until the moment of complete adhesion.
For fixing are applied:
- orthoses or plaster casts;
- titanium plates and screws;
- screws without an additional element.
And also, often for fixing use knitting needles and tightening loops.
Considering that atrophy of joints and tendons occurs in the gypsum, and after surgery the design requires development, it is important to pay sufficient attention to joint development and rehabilitation measures. To the joint began to recover, the doctor prescribes special complexes of therapeutic exercises. At first, these are slow flexion and extension movements.
When the bone coalesces and the pain recedes, the rehabilitation phase begins. It lasts from 2 weeks to 1,5 months. At the same time, not only gymnastics is organized, but also physiotherapy.
Exercise therapy is carried out in 3 periods and ultimately helps to achieve a good result.
The first period includes 2 stages:
- Joint development already on the 2nd day after the injury. The goal is the removal of edema and pain, the restoration of blood flow.
- Exercises for flexion and extension of the elbow in a cast.
The second period of rehabilitation through exercise therapy begins after healing and includes such exercises:
- rolling on the surface of the forearm of the ball, it is important to fix the shoulder;
- flexion and extension of the arm at the elbow;
- exercises with a stick or ball;
- gymnastics in the water.
In the second period, you need to try to perform the exercises carefully, not to force events, since there is still a risk of relapse. Exercises to bend the forearm help accelerate the growth of the appendix. Each exercise is repeated 4-6 times, gymnastics is organized up to 4 times a day.
In the final third period, physiotherapy is prescribed – paraffin baths, ozokerite, then exercise therapy is again implemented.
With any form of fracture, the following are contraindicated:
- muscle fatigue;
- exercises that provoke pain;
- passive movements;
- weight lifting.
Rehabilitation after a fracture
Failure to comply with contraindications provokes severe swelling, pain, reflex muscle contraction and an increase in bone deformation, that is, the formation of spurs. For this reason, it is not recommended that a fracture of the elbow be performed using massage.
Incorrect treatment, rehabilitation and too much physical exertion lead to complications:
- recurrence of injury;
- pain in the elbow and forearm;
- muscle spasm;
- the growth of bone deformation – the formation of growths and spurs.
If you don’t put on a fixation, neglect other rules of recovery, then the consequences may be irreversible: the activity of the arm is lost, problems arise with its full extension.
Any injury to the elbow joint requires immediate medical attention, as it can be a fracture. Only in case of timely immobilization of the bone and following all the appointments of a specialist can complications be prevented and motor activity of the damaged limb can be completely restored.
Types and treatment of fracture of the elbow joint
The structure of the elbow joint is quite complex. It is formed by three large bones (humeral, radial and ulnar), as well as the main and three additional joints. A fracture of the arm in the elbow joint is very dangerous due to the large vascular and nerve channels passing through this department.
During the fall, people instinctively put forward their hands, which is why a large load goes to the elbow, provoking a violation of the integrity of the bone. This is the most common cause, but fractures also occur as a result of:
- with a strong blow by an external object on the joint;
- in road accidents and various accidents;
- among athletes (when the main burden is on hands like in tennis and volleyball);
- when trying to catch a heavy object falling at high speed;
- in case of industrial accidents.
Most of all fractures of the elbow are children and people aged, as their bones and ligaments are quite fragile. People with osteoporosis are also at risk.
Fracture of the elbow joint has many classifications. It can communicate with the external environment (open type) and not violate the integrity of soft tissues (closed type), intraarticular and periarticular, based on the location of the injury. Damage can be complicated by displacement of damaged tissue elements, fragmentation, splinters and dislocation.
The complex structure of the elbow gives rise to a classification that relies on the type of damaged element:
- fracture of the ulnar process (approximately 0,8-1,5% of all cases);
- fracture of the neck and / or head of the radius (if the victim does not have time to bend his arm in the fall and lands on a straight line);
- fracture of the coronoid process;
- fracture of the condyles (humerus).
Features of a fracture in children
A child’s elbow fracture is significantly different from adult fractures, since the joint is fully formed only by the age of 16 (fused with bone). Children lead an active lifestyle, and the elements of the elbow joint are not yet communicated with each other and are fragile, therefore, fractures are very common (especially at bone growth points).
If damage to the bone and joint has nevertheless occurred, severe pain will signal this, which gives out to the wrists and fingers. Other symptoms may indicate a fracture of the elbow joint:
- pronounced edematous processes sometimes with a change in the color and structure of the skin;
- change in the shape and size of the joint (deformation and enlargement);
- blocking motor activity in the shoulder joint;
- lack of pulse on the injured hand, cooling of the fingers (insignificant, but more than usual);
- loss of sensation or tingling in the limb;
There are signs indicating a specific type of fracture:
- Damage to the ulnar process causes pain in the forearm and shoulder, and the most severe pain is localized in the back of the joint. The extension function of the arm is completely impaired.
- A fracture in which the neck of the radius is damaged is characterized by pain in the forearm and the front of the joint. Edema may not appear at all or manifest itself to a small extent. The rotation of the forearm is almost impossible.
- If the coronoid process is affected, the pain will be localized on the front of the joint, and flexion and extension will be limited.
- In case of fracture of the elbow joint with displacement, all active movements (rotation, flexion and extension) cause severe pain, while the victim can perform passive movements without difficulty.
To diagnose a fracture, the radiograph method is used. But if the injury has one or more complications, the doctor may order computed tomography to make an accurate diagnosis and identify the clinical picture.
- Treatment for a fracture of the appendix of the elbow (without displacement) consists in fixing the limb for a period of six weeks. For this, a plaster cast is applied, which blocks the movement of the wrist and elbow joints.
- Fracture with displacement is treated operatively. The chipped part of the bone is fixed in the anatomically correct position using knitting needles and wire structures. After surgical correction, the patient should walk in a cast for about six weeks. Knitting needles are removed only three months after surgery.
- In case of neck and head fractures, a plaster cast is applied for three weeks. The shift is corrected in a conservative and operational way. If the fragment fragment cannot be corrected, an operation is performed during which a bone fragment is excised.
- Damage to the coronoid process requires immobilization of the limb for a period of 4 weeks.
A fracture of the ulnar articular-bone structure requires a two-month rehabilitation. The main point in the struggle to restore the functions of the hand is physiotherapy. In addition, physiotherapy and massage are used, but exercise therapy can prevent the loss of joint mobility.
The first stage
- In the first days after receiving an injury, you need to begin to actively move your injured limb with your fingers and shoulder joint;
- after 10 days, you can give a static load, contracting and relaxing muscles without performing movements.
The second stage
When the patient begins to walk without gypsum, you can proceed to the second stage of exercise therapy, which is aimed at restoring the functions of the immobilized limb.
- The hands close into the lock and the hands are “thrown” forward along an arc-shaped path (similar to casting a fishing rod);
- hands, locked in a lock in the hands, slowly rise up and wind up behind the head;
- palms are closed behind the back, after which movements up and down (with small amplitude) are made;
- “Sipping” is carried out with the brushes locked in the lock, which slowly stretch upward, palms to the ceiling;
- sprinkle croup on the table and collect it, actively moving the damaged hand with a brush;
- bend the elbow at an angle of 90 degrees and rotate the forearm;
- roll the ball with a damaged hand.
An intraarticular fracture of the elbow joint can provoke contracture and arthrosis, so the exercises should be performed carefully, at least three times a day, bringing to 15 repetitions.
After the fracture, you will have to eat in such a way as to replenish the trace elements used by organisms as a building material for bone tissue regeneration. The base products should be protein and high in collagen.
Meat contains a lot of collagen, especially turkey and duck, salmon fish, oysters and shrimp. It is good to eat vegetables: cabbage of all sorts, tomatoes, bell peppers, herbs and peas. Vitamin C-rich fruits will help the joint recover faster.
Healthy fats are a must. They can be found in eggs, nuts, flaxseed oil and pumpkin seeds.
If the patient is overweight, you will have to keep a diet, as excess pounds put pressure on the joints.
Fracture of the elbow (especially if children are the victims of the situation) is a rather complex injury that can lead to complications. But modern medicine easily corrects such injuries, so the patient only needs to adhere to the doctor’s recommendations for successful recovery.
What is the danger of injury to the ulnar fracture of the humerus and how long it heals
Elbow injuries deserve special attention because of the high risk of complications. The complex structure is not protected by the muscular skeleton, it is vulnerable to damage. Early recognition of the ulnar fracture of the humerus, timely treatment eliminate the serious consequences leading to disability of the patient.
The elbow joint is an anatomical formation connecting the bones of the shoulder and forearm. Through this area pass vessels, nerves, providing mobility of the entire limb. Ligaments, tendons, form a stable position of the joint. In a healthy state, motor activity is manifested in flexion-extension of the limb, rotation of the forearm, squeezing the palm. Any injury to the movable joint makes it difficult to perform even simple movements. Fracture of bones in this anatomical area leads to a functional disorder of the forearm, wrist, hand.
The cause of damage to the elbow is falling, the shock load on this area due to traffic accidents. Injured athletes of contact sports, children with a high degree of activity are often injured. Fracture of the humerus in the elbow joint in childhood can affect the overall development of bone tissue if growth zones are involved in the injury.
Restoration of the functions of the elbow is possible only when the bone returns to the anatomical position, correct fracture fusion. The methods of treatment depend on the characteristics of the injury, the age-related characteristics of the patient’s body.
Types of fractures
Injuries to the bone tissue of the elbow joint are distinguished by the location of the damage – extra-articular, intra-articular.
Among extraarticular fractures are:
- supracondylar – a fracture passes over the condyle, does not affect the articular part. More than half of cases of fractures of the epicondyle of the humerus occur in children of preschool, primary school age, almost never occur in adolescence;
- tear-off – the ultimate tension of the ligaments leads to damage to the medial epicondyle. Damage is called basketball injury, more often than others injured during shots or direct shots.
Intra-articular pathologies are treated longer, more complicated. They are associated with a risk of developing arthrosis.
- pericondylar fracture – breaking off the protrusions of the joint. Adult injury is due to
- falling on a limb;
- fracture of the humerus, condyle head;
- damage to the articular head, neck of the radial bone;
- fracture of the appendix of the elbow.
A fracture of the humerus of the elbow joint with or without displacement is distinguished. Neurovascular damage with damage to arteries and nerves is recognized as the most common complication of elbow injury.
Acute pain in a fracture from the elbow to the shoulder is a clear sign of damage to the joint. Gradually, a hematoma appears in the front of the injured area, and edema appears. A sound similar to the crunch of branches is a symptom of rubbing bone fragments. The manifestations indicate a fracture:
- loss of ability to bend, extend the arm;
- an increase in pain passing into the shoulder, forearm;
- deformation of the elbow, atypical mobility in the lateral direction;
- numbness of the hand, tingling (neurological symptoms).
With a fracture from the shoulder to the elbow, stiffness of the muscles is felt. Violation of the skin indicates ruptures of tissues, blood vessels. Open wounds require urgent action.
A certain algorithm of actions has been developed, following which will facilitate the condition of the victim before providing medical care:
- you need to stop bleeding with a tourniquet, if an open fracture is detected, raise your hand above heart level;
- give an analgesic analgesic;
- apply cold to the swollen area;
- immobilize a damaged limb with a tire from improvised means;
- call an ambulance.
It is impossible to straighten, straighten bone fragments even with severe deformation. Any manipulations will lead to damage to other structures – nerves, tendons, blood vessels.
A physical examination of a patient with an elbow joint injury is performed by an orthopedic traumatologist. The mobility test is carried out under the condition of anesthesia. Sometimes a full examination is impossible – the doctor visually assesses the injury, possible deformations, the work of blood vessels, nerves. X-rays in a direct, lateral projection reflect an accurate picture of the condition of the elbow joint. If necessary, perform laboratory tests, if the patient has chronic diseases, take additional pictures.
Diagnosis of a child’s arm fracture from the elbow to the shoulder is performed by comparing images of two joints: injured with an intact elbow of the second limb. The problem is growing cartilage, which forms bone tissue, which makes it difficult to diagnose a fracture. A complete overview of the damage is given by ultrasound, MRI, and computed tomography studies.
Closed forms of fractures are subject, most often to conservative treatment. After the anesthesia procedure, if necessary, fluid accumulations are pumped out of the joint, which significantly reduces pressure and pain in the area of injury.
Then a fixing bandage is applied to the arm:
- splint – with the use of gypsum;
- bandage – from elastic fabric with fastening straps.
In practice, plaster casts are often attached to the back of the hand. The purpose of the latch is to hold your hand in the correct position. A solid dressing can hide swelling, the appearance of which is likely in many cases.
At first, you need to avoid a large load on the damaged limb. It is recommended to wear a hand on a scarf or a special bandage in order to reduce the swelling of tissues that compress blood vessels and nerves. If the gypsum will press, and the hand will swell, then it is necessary to loosen the gypsum in the first two three days. As the bone tissue fuses, they begin to develop the joint. The gypsum dressing is changed to a hard latch with adjustable range of motion.
The treatment of open fractures, injuries with displacement of fragments, detachments of fragments, damage to blood vessels, nerves is carried out by the surgical method, or open reposition. Internal fixation of fragments is a complex procedure, preparation for which includes the study of the entire patient’s body.
Restoring the integrity of the bone is carried out using special devices. Therapy consists in tightening the tissues with a special wire loop. The presence of fragments complicates the process, as it leads to shortening of the surfaces. In such cases, compression plates are applied. In especially severe injuries, prostheses are used – implants made of plastic and metal. Checking the success of the operation is carried out by x-ray.
Successful treatment does not do without an important stage of rehabilitation, which includes:
- a complex of physiotherapy exercises;
- physiotherapeutic procedures.
Joint development begins 2–3 days after limb fixation. The first exercises are aimed at removing edema, activating the outflow of lymph from the tissue. This movement of the wrist, fingers, raising the hand to the head, the tension of the muscles of the shoulder and forearm.
After removing the plaster cast, they begin to perform measured movements without complete flexion-extension of the limb. Classes in therapeutic gymnastics are based on a gradual increase in the load under the supervision of an exercise instructor.
Massage sessions, physiotherapy procedures alternate with therapeutic exercises. Restorative treatment is aimed at eliminating the pain syndrome, strengthening atrophied muscles, and returning the amplitude of movements. Electrophoresis, magnetotherapy, UHF, mud therapy courses are repeated periodically until the limb is completely restored.
Possible complications arise not only due to severe trauma, but also the patient’s neglect of the doctor’s recommendations. Treatment of children requires constant monitoring of adults. Sudden movements, premature loading can lead to a repeated fracture.
An elbow fracture, in general, is successfully treated under the condition of active interaction between the doctor and the patient.
About rehabilitation for injuries of the elbow joint