Fracture in the elbow

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.

The content of the article
  1. Causes of violations
  2. Types of damage
  3. Symptoms
  4. Diagnosis of a fracture of the elbow joint
  5. What treatment is prescribed?
  6. Conservative
  7. Surgical
  8. Rehabilitation
  9. Gymnastics
  10. Physiotherapy and massage
  11. Do I need a diet?
  12. Aftermath
  13. Prevention
  14. Fracture of the elbow
  15. > Elbow fracture happens:
  16. Symptoms of an elbow fracture
  17. First a >After the injury, it is important to provide first aid to the victim as soon as possible. recovery will depend on this. It is recommended that you call a doctor, and before his arrival, immobilize the injured limb to the patient so that he can be transported to a medical facility.Immobilization (immobilization) consists in imposing tires from improvised dense materials on the arm. These can be pieces of plywood, fiberboard (fiberboard), boards. They are fixed to the limbs with a wire or a tight dressing made of fabric. To do this, the victim needs to bend his arm at an angle of 90 ° and, pressing it to the body, put a splint fixed by the above materials on the area above the humerus and radius.
  18. Elbow fracture treatment
  19. Conservative treatment
  20. Surgery
  21. Aftermath
  22. Possible complications
  23. Elbow fractures: types, symptoms, treatment, rehabilitation
  24. Causes of Injury
  25. Types of fractures
  26. Symptoms
  27. First a >
  28. Conservative treatment
  29. Operative therapy
  30. Possible complications
  31. Rehabilitation
  32. In conclusion
  33. Elbow joint fracture treatment methods, causes and symptoms of injury, rehabilitation rules
  34. Causes of Injury
  35. Types of fractures
  36. Symptoms
  37. Treatment
  38. Conservative treatment methods
  39. Surgery
  40. Rehabilitation period
  41. Possible complications
  42. Popular groups
  43. Elbow fracture
  44. Arm fracture in the elbow joint: signs, methods of treatment
  45. Causes, types, symptoms of injury
  46. Types of fractures
  47. Fracture of the elbow joint in a child
  48. Signs of a fracture
  49. Elbow fracture treatment
  50. Conservative treatment
  51. Operative therapy
  52. Rehabilitation period
  53. Conclusion

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.

Symptoms

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?

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

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Conservative

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.

Surgical

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.

Rehabilitation

Gymnastics

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:

  • electrophoresis;
  • magnetotherapy;
  • laser heating;
  • UHF;
  • 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;
  • seafood;
  • sea ​​kale;
  • buckwheat, oatmeal;
  • vegetables and fruits;
  • eggs.

Aftermath

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;
  • thrombosis;
  • infectious complication;
  • arthrosis.

Prevention

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.

Fracture of the elbow

A fracture of the elbow joint occurs with an intense blow to the forearm and appendix of the elbow or a fall on the arm. More often, a limb injury is formed in people with a weak ligamentous apparatus or with osteoporosis. Since the arteries and veins that supply blood to the arm pass through the movable junction of the bones, their damage by the sharp edges of the bone can not only cause severe bleeding, but also lead to other complications.

>
Elbow fracture happens:

In case of incomplete damage, a crack or break is formed in the bone. When fully bone is divided into several parts. This type of injury happens with displacement and without it. In the first case, the habitual position of the fragments in relation to each other changes. One part of the bone can move (go away) from another fragment. In case of injury without displacement, the divided bone sections are in the same plane.

Elbow injuries are divided into:

  1. Closed (soft tissues are not injured).
  2. Open (the sharp ends of the fragments can shift, damage blood vessels, muscles and protrude above the skin of the limb, disrupting it).

In the mobile joint of the upper limb there are several large bones and three small ones. You can break a section of any of them, for example, the epicondyles (protrusions) of the humerus, the coronoid process of the ulnar, the neck or the tip of the radius.

If bone tissue is injured in the elbow, then such a fracture is called intraarticular (damage to the processes). If the beam or shoulder section of the arm breaks down (the pineal gland, i.e. the rounded and thickened part of the bone), such an injury is called periarticular.

Less often (1% of all clinical cases) the integrity of the ulnar process is violated. During an accident or a fall to the ground, damage to the radius and neck of the humerus is more common.

Symptoms of an elbow fracture

If a person gets injured in the elbow, her signs will be:

  1. Intense and sharp pains radiating to the forearm, wrist and fingers.
  2. Tingling or numbness in the limb, indicating nerve damage.
  3. Swelling of the soft tissues and the accumulation of blood in them (hematoma) is the result of internal hemorrhage.
  4. Deformation of the limb (characteristic fracture of the elbow joint with displacement).
  5. Fragments protruding through a bleeding wound in the soft tissues and skin (with an open type of injury).
  6. Inability to move a hand or difficulty, stiffness when trying to lift it.

Symptoms may vary slightly depending on which part of the joint of the bones is damaged.

If the neck and extremity of the radius are broken, a person will not be able to move his forearm up, down and to the side, there will give pain, more felt in the front of the joint. If the displacement of fragments occurs, outwardly this will not appear, and the damaged parts themselves will almost not crackle when the hand moves. Edema and hematoma will also be small.

If the integrity of the bone of the ulnar process is violated, the back of the joint joint will hurt, discomfort will be felt in the shoulder. The injured person will be able to rotate his forearm, but he will not be able to extend his arm at the elbow, because with such a fracture, the triceps, the muscle that extends the limb, is damaged.

A hand hanging by a lash is the main sign of injury to the ulnar process. Other symptoms of this damage will be swelling with a hematoma on the posterior and anterior surfaces of the junction of the bones. When the fragments are displaced, the limb is deformed; when it is felt, their crunch will be heard.

If the victim is tormented by severe pain when trying to straighten the arm at the elbow, and discomfort manifests itself on the front side of the joint, the coronary process of the bone is injured. Then the tissues swell a little over the joint, but the hand does not change its shape. It is difficult to bend and unbend a limb.

First a >After the injury, it is important to provide first aid to the victim as soon as possible. recovery will depend on this. It is recommended that you call a doctor, and before his arrival, immobilize the injured limb to the patient so that he can be transported to a medical facility.

Immobilization (immobilization) consists in imposing tires from improvised dense materials on the arm. These can be pieces of plywood, fiberboard (fiberboard), boards. They are fixed to the limbs with a wire or a tight dressing made of fabric. To do this, the victim needs to bend his arm at an angle of 90 ° and, pressing it to the body, put a splint fixed by the above materials on the area above the humerus and radius.

If a person who is near the injured person does not know how to make a tire, he can fix the injured hand with a kerchief or piece of cloth tied around the patient’s neck.

When the ulnar process is fractured with and without displacement, the person is in severe pain, so he needs to be given Diclofenac or Analgin to reduce discomfort. In this case, the victim does not bend the arm, but immobilize it in a position convenient for him, tied to the torso.

It is forbidden to correct displaced fragments before the doctor arrives, as soft tissue and blood vessels can be injured even more.

Elbow fracture treatment

Elbow Fracture Treatment ”w />
After the victim is delivered to the hospital’s emergency room, he is assigned an instrumental diagnostic method such as x-rays. With its help, the exact location of the damage is determined. With a complex fracture of the elbow with displacement (the presence of multiple fragments, fragmentation of bones, etc.), the patient is additionally prescribed CT.

When an accurate diagnosis is made, a conservative or surgical treatment is prescribed. After the cast is removed, the patient will need to develop the arm for a long time so that it can flex, flex and rotate well.

Conservative treatment

With conservative treatment, a bandage of gypsum is applied to the fracture in the elbow joint, which should be worn from 2 to 6 weeks (the period depends on the complexity of the injury). For example, the extremity (head) and the neck of the radius without immobility signs are immobilized for 14-20 days. If the coronoid process is damaged, you need to immobilize the arm for 1 month. And the ulnar process is fixed with gauze and gypsum solution for 6 weeks.

The limb begins to develop 2-3 days after its damage, and the full recovery period lasts from 1 to 3 months.

At first, the patient can move his fingers, then the shoulder joint. After a week, he should strain the muscles on his injured arm. After 14 days, the clinic’s doctors prescribe magnetotherapy to the patient. After the patient has the plaster removed, physiotherapy continues and is supplemented by electrophoresis, UHF. When the inflammation passes and the pain subsides, you can gently massage the damaged joint.

To develop a limb, therapeutic gymnastics is needed. Exercises with dumbbells are recommended to be performed when the hand can be easily moved in different directions and wave it, and at first prescribed cautious actions: closing both hands, putting your hands behind your back and behind your head, raising a gymnastic stick, playing with the ball.

Surgery

Fracture in the elbow joint is treated and operatively by:

  • damage to the open;
  • large (from 6 mm) bone displacement;
  • strong fragmentation of bone tissue.

Before surgery, prescribe drugs that relieve inflammation. If the victim has an open injury, they will urgently operate on it.

Doctors open the affected area, set and return the fragments to their previous position. If the bones are broken in several places, their parts are fastened with knitting needles and plates. Crushed and badly damaged heads are replaced with dentures. Having eliminated the violations and suturing soft tissues, a plaster splint is applied to the limb.

After the operation, physiotherapeutic procedures, massage and exercises for limb development are prescribed. To accelerate recovery, patients are recommended to eat foods rich in collagen, vitamins C and E (seafood, turkey, fresh vegetables, herbs, nuts, buckwheat, eggs).

Aftermath


With timely access to a doctor and the correct implementation of all his recommendations, a person is fully restored after an injury. If the fracture was intraarticular, movements in the elbow joint may be limited (this phenomenon is called contracture). After 2-3 years, arthrosis develops (damage to cartilage).

Possible complications

If the patient does not develop the arm or begins to take heavy objects with it early and subject it to strong physical exertion, this can lead to a number of complications. There is a risk of edema in the area of ​​damage, pain in the arm and muscle contractions in it. In some cases, the joint is deformed, because the bones are fused incorrectly.

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:

  1. 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.
  2. 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.
  3. 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.

Symptoms

  1. The presence of sharp sustained pain, which gives to the hand and wrist.
  2. Limited limb mobility or its complete paralysis.
  3. Unhealthy, unusual for a person mobility of the arm in the area of ​​the elbow joint, for example in the lateral direction.
  4. The occurrence of edema, the formation of bluish hematoma, subcutaneous bruising.
  5. Neurological symptoms – numbness of fingers and hands, tingling of the forearm.
  6. 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 >

Conservative treatment

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.

Operative therapy

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.

Possible complications

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.

Rehabilitation

  • massage;
  • 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.

In conclusion

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.

Symptoms

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.

Treatment

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.

Surgery

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.

Trauma surgery

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.

Rehabilitation period

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:

  1. Joint development already on the 2nd day after the injury. The goal is the removal of edema and pain, the restoration of blood flow.
  2. 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.

Possible complications

Incorrect treatment, rehabilitation and too much physical exertion lead to complications:

  • recurrence of injury;
  • swelling
  • 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.

Elbow fracture

In terms of anatomy, the elbow joint is a complex biomechanism that consists of many parts. It is formed by the humerus, radius and ulna, a large number of nerves and blood vessels. Due to the complex structure, a fracture of the elbow joint is most often accompanied by complications. Such an injury can be treated only by surgical intervention, moreover, repeated.

From the statistics it follows that 20% of fractures occur precisely in the ulnar region. Such injuries belong to the category of heavy and complex and are divided into: periarticular and intraarticular, closed and open. In addition, a fracture can be combined with a dislocation.

The most common cause is weakness of the elbow tendons and ligaments. Well stretched tendons are the main prevention of such injuries.

The first blow, as a rule, receives the ulnar process, which does not have a muscular frame. However, it rarely breaks (0,85 – 1,5%). This injury is accompanied by separation or displacement of fragments, which additionally injures blood vessels, ligaments and nerves.

A fracture of the radius or neck is possible when a person falls on an outstretched arm. These types of injuries are divided into fractures:

marginal with offset;

The coronoid process rarely breaks, but is combined with injuries of the forearm, dislocations, displacement of fragments. Most often, the proximal ends of the bones of the forearm and the distal ends of the humerus break down.

In children and adolescents, severe injuries of the external or internal humerus along with the displacement of the internal epicondyle are most often encountered. In this case, detached bone fragments can be pinched between the humerus and the ulnar process.

sharp pain in the elbow and forearm, which can also spread to the wrist joint and fingers;

significant limitation or impossibility of movement;

mobility not characteristic of normal functioning, for example, pathological lateral mobility;

edema and nemethrosis, accompanied by severe hematoma;

with an open fracture as a result of damage to muscles, blood vessels, nerves and skin, bleeding and gaping of bones may appear.

palpation along the line of injury to feel fragments;

attempts to bend the forearm to determine if it causes pain (if the fracture is not displaced, movements are only limited);

X-ray in direct and lateral projection;

with an intraarticular fracture, computed tomography is required.

The choice of treatment tactics depends on the degree of violation of the joint structure. The very first is immobilization, which can be of two types:

prehospital (first aid) – tire overlay;

stationary (after diagnosis) – the application of plaster casts.

Before applying gypsum, it is most often necessary to restore the joint structure (when displaced) or a surgical operation, which is accompanied by the fastening of bones with the help of special screws, knitting needles or other

fixtures. If the bone head is badly damaged, it is replaced by an endoprosthesis.

The plaster cast is overlaid for four weeks. Then it must be worn for another week, periodically removing for 15 – 20 minutes, in order to develop movements – bend and unbend your arm at the elbow several times.

With a periarticular fracture of the ulnar region without fragments, conservative treatment is indicated. Immobilization is carried out using a hinged orthosis. All rehabilitation measures are required.

If surgical intervention is necessary, then prior to surgery, it is necessary to immobilize the joint at an angle of 30-60 degrees and drug treatment aimed at reducing edema and reducing hematoma. With an open fracture, the operation should be performed within the first days after the injury. After surgery, all points of the rehabilitation program are required.

Venous outflow can be improved by the elevated position of the elbow joint. In this case, edema and hematoma are also reduced.

During the immobilization of the ligament and tendon have time to atrophy. After removing the cast, therapeutic gymnastics, physiotherapy and water procedures are immediately prescribed. Their goal is to restore mobility. Rehabilitation can take from two weeks to one and a half months. Duration depends on the type of injury.

The development of the elbow joint after the fracture occurs in three periods:

consists of two stages:

during immobilization, breathing exercises and exercises for the shoulder joint and fingers begin to reduce swelling and pain

a broken arm is laid behind the head on a pillow to strain the muscles of the shoulder and forearm;

begins after removal of the cast and includes gentle bending and extension of the arm at the elbow.

The second period consists of the following exercises:

the patient sits, the hand is on the table, in this position the hand is bent and unbent;

exercises are carried out with a stick or ball in a sitting or standing position;

bending and unbending at the same time the sick and healthy hands in the elbow by raising the head, holding the hands together in a lock;

exercises in a bath with warm water;

In the third period

there is a transition to pronation and supination in water, which is supplemented by physiotherapeutic procedures (paraffin, mud, currents, ozokerite) and drug treatment.

The number of repetitions of any exercise is five times. But classes should be held several times a day. A sick hand should not be tired.

In the first period of rehabilitation, massage is contraindicated. In the second and third periods, back massage and arm massage above and below the damaged area can be performed. In the third period, gentle procedures begin, aimed at restoring motor functions, resolving the hematoma, preventing muscle atrophy and strengthening ligaments.

During rehabilitation, weight transfer, emphasis, overwork of muscles, visas, movements causing pain, leading to reflex muscle contractions and an increase in bone deformities in the form of “whiskers” or “spurs” are contraindicated.

Prevention of injuries of the elbow joint

Injuries and illnesses are much easier to prevent than to treat. To prevent fractures in the elbow, it is necessary to strengthen and nourish the ligaments. This requires exercises:

in a standing position, pick up the dumbbells and lift until the elbow is bent at an angle of 90 degrees, return to its original position;

take dumbbells, lift up on biceps and hold as much as possible;

adopt push-up positions and hold the body in that position for as long as possible.

To strengthen the ligaments, not only exercises are important, but also the diet. It should include vitamins C and E, as well as callogen. Vitamin C contains ordinary and cauliflower, tomatoes, sweet peppers, green peas, lettuce, spinach, parsley, black

currants, gooseberries, rose hips, kiwis and citrus fruits. Vitamin E contains cereal grains, lettuce, carrots, beets, celery, parsley, garlic, sea buckthorn, pumpkin seeds, vegetable oils, egg yolks, rosehips.

To replenish body reserves with callogen, you should consume:

meat, especially turkey poultry;

fish, especially salmon;

oatmeal, barley, buckwheat, peas, beans.

The main goal of the diet is weight loss. Overweight creates an additional burden on all joints, which disrupts the metabolic processes in them. If the menu has an excess of one component (for example, fat) and a lack of others, the condition of all tendons and ligaments worsens.

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;
  • plural;
  • fragmented;
  • comminuted;
  • 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:

  1. The presence of a hematoma or bruising.
  2. Swelling in the area of ​​injury.
  3. Deformation of the articular region, its increase in size.
  4. Impaired mobility not only in the elbow, but also in the shoulder.
  5. 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.
  6. If nerve fibers are affected, the patient may feel numbness, tingling, and other unpleasant sensations in the hand.
  7. 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.

Conservative treatment

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.

Operative therapy

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.

Rehabilitation period

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:

  1. Upper extremities interlocked in the lock lead behind the head.
  2. Cautious flexion and extension in the injured limb.
  3. Smooth rotational movements in the elbow.
  4. 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.

Conclusion

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.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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