Fracture of the elbow in a child

Due to their injustice, children spend most of their time in active motor mode. Younger preschoolers, studying the world around them, make mistake after mistake, the price of which is health. It would seem that out of the blue the fidget can catch, fall and injure his hand. Inadequate care or a complete absence of such by loved ones can lead to traumatic situations.

Older children in the gym during training and active play have a risk of getting a strong direct blow to the arm, entailing a joint fracture with or without displacement. Adolescents often get the same injury during mass uncontrolled events. Road traffic situations can be one of the causes of hand fractures of varying severity, leading to a long-term health disorder.

All joint fractures in the elbow can be divided into:

During an injury, one or more bones may be affected. In some severe cases, there are multiple injuries with injuries of the elbow joint of varying degrees. Fractures also qualify as:

  • open with tears of the skin and soft tissues;
  • closed;
  • with offset;
  • fragmented.

Symptoms

Fracture in the elbow is accompanied by characteristic symptoms:

  • crying and increased agitation of the affected child;
  • pronounced pain;
  • complete or partial immobility of the hand;
  • swelling of the joint caused by the accumulation of fluid and blood in its cavity;
  • discoloration of the skin;
  • bone deformation (determined visually in comparison with a healthy hand);
  • lack of the usual bone tubercle;
  • the presence of a hematoma on the opposite side of the arm;
  • painful palpation of the appendix;
  • soft tissue ruptures with bare bones are rarely observed.

The sick hand of the victim hangs down, I want to support her with the other hand. If nerve fibers are affected, then the baby feels numb in the injured limb. You may experience a tingling sensation in your fingers or burning skin. A clearly defined fracture requires emergency care.

  • See also: a child broke a finger on his arm or leg

First aid

In the presence of symptoms of a fracture of the elbow joint, it is first necessary to provide the arm with complete immobility. From improvised materials: boards, planks, cardboards, a tire should be built, fixed to the injured hand with a cloth, bandage, scarf. A fracture requires fixing the arm at an angle of 900 with the palm of the hand facing the body. Shoulder, elbow and wrist joints should remain motionless.

An open wound must be washed with dirt and a sterile cloth. In the absence of suitable conditions, the wound should be left as it is, in order to avoid infection. If bleeding is open, then the injured arm should be raised up. If you have the necessary skills, you can stop the bleeding by holding the fingers of a blood vessel below the fracture site.

Ice must be applied to the edema, it will reduce inflammation and relieve pain. The kid experiences severe pain during the injury, so it must be reassured and set up for treatment. Adult behavior should not be fussy, nervous, confused.

With all your looks, show that the situation is under control and the baby will soon become better. No matter how guilty he is, punishment, clarification of the causes of injury, moralizing in this case are inappropriate. An ambulance team must be called in before or after emergency events. If there is no connection, the victim should be delivered to the emergency room on his own.

For an accurate diagnosis of a “fracture of the elbow joint”, the doctor should interview the parents, witnesses of the circumstances in which the injury was received.

An X-ray examination will be required to establish the type, complexity of the fracture, and its location. In some cases, it will be necessary to do a computed tomography. The fracture treatment and rehabilitation technique is determined by the attending traumatologist, orthopedist.

Complications

Due to the complex structure of the elbow joint, its fracture can cause complications if neglected treatment and recovery process. Most often diagnosed:

  • infection of the open wound of the elbow;
  • partial or complete immobility of the hand;
  • bone congestion;
  • inaccurate fusion;
  • hypersensitivity to cold, provoking inflammatory processes.

Rehabilitation

It is sometimes difficult to restore the original mobility of the joint, even if the treatment was correct.

We need a whole range of measures for the anatomical and physiological rehabilitation of the baby. A fracture can provoke bone growths, compressing nerves, soft tissues, blood vessels, which leads to a prolonged pain syndrome.

Therefore, after the victim’s discharge from the hospital, parents must strictly follow the doctor’s recommendations on the course of exercise therapy, not rush with the load on the injured arm. The only way to avoid possible complications and a joint fracture will not let you know in the future.

Prevention

In order to avoid various fractures, preschoolers and primary schoolchildren should always be in the field of view of their parents. It should always be remembered that:

  • children must play in playgrounds free of dangerous traumatic objects;
  • parents and teachers should exclude traumatic situations at home, at school, during active leisure time and minutes of rest for children;
  • gaming and sports equipment must have a certificate of quality and be tested for safe operation;
  • children should not be allowed to jump from a height;
  • while riding bicycles, rollers, ice games, personal protective equipment must be used: helmets, shields, elbow pads;
  • children should be taught safe driving practices. Young children must cross the street, holding the hand of an adult;
  • sports games should not be long and tiring, physical activity should be appropriate for age.

Repeated reminder of the rules of safe behavior outside the home with video consultations, examples from medical statistics will help children consolidate the lessons of a healthy lifestyle and independently control traumatic situations. Adult control of children’s free time should be constant, effective and efficient. .

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This article will examine in detail how to recognize a fracture of the elbow joint in a child, as well as how to provide first aid to the victim. Children, by virtue of their age, are very restless, this is a key cause of all falls, which sometimes result in injuries.

Causes of trauma

A joint fracture in the elbow is the most common damage to the hands in children, and different situations can happen due to this:

Types of Elbow Injury

Elbow fractures can be divided into types:

The types of fractures are also distinguished:

With an open fracture, damage to the skin occurs, thereby infection of the wound site can occur during trauma. An open fracture requires special attention, handling and proper fixation of the hand. With a closed fracture, infection of the skin site does not occur.

A fracture of the elbow joint with a displacement means that the fragmentation parts of the joint have changed their original position. With a fracture of a fragmented type, a joint is split, as well as possibly an adjacent bone into several fragments.

Distinguishing a serious fracture is not difficult, since all the symptoms are on the face. It is difficult to put the clinical picture when the joint is not hurt very much, and also when there are injuries even more serious than this.

Symptoms of an elbow fracture

If the child has a fracture in the elbow joint, this condition may be accompanied by the following symptoms:

  • strong, incessant crying after a fall or other sudden movement;
  • the hand becomes motionless;
  • pronounced pain in the elbow;
  • the appearance of severe swelling of the tissues around the injured place;
  • discoloration of the skin in the area of ​​a broken joint;
  • a change in the position of the bone, which is visible to the naked eye;
  • when you click on the arm anywhere, the pain intensifies;
  • the appearance of a bruise under the skin on the back of the limb;
  • the arm hangs involuntarily;
  • numbness is possible, if nerve endings are affected;
  • tingling and burning sensations can be felt in the integument of tissues;
  • limb cooling;
  • rarely, tissue rupture occurs, with the exit of the joint.

Urgent care

A fracture of a child’s arm at the elbow requires an urgent arrival of an ambulance to clarify the diagnosis and provide all necessary services.

  1. Rest of a damaged arm. It is necessary to ensure an immovable position in case of joint injury, for this you can use the tools that are at hand: ruler, thin, light board. With the help of a bandage and a ruler, you can make a tire. To fix a hand is very careful, hanging it on the neck.
  2. If the hand is in an inverted position, then you do not need to straighten it, pull it and put the tire on its own. It is better to leave everything as it is until the arrival of medical workers.
  3. Give the child an analgesic, age-appropriate, in the prescribed dose. Be sure to notify doctors about taking the medicine. You can use Nurofen children or Ibuprofen and Paracetamol tablets. They will have a slight analgesic effect for a while.
  4. With an open fracture, a bleeding wound is formed. It is necessary to stop the blood, treat the affected area with an antiseptic.
  5. Apply ice to the damaged area.
  6. Calm the child with distractions, calm the parents. No need to strongly express emotions, get upset with a child, fuss. This behavior will further excite and scare the baby.

Treatment for fracture of the elbow joint

After the victim is taken to the hospital, they will take an x-ray to determine the structure of the fracture, whether there is an offset. In difficult situations, they can have a CT scan. The doctor will examine the hand of the sick child for wounds, according to the results of an X-ray examination, he will determine what type of dressing to apply.

If the fracture is mild, without displacements, then the arm will be fixed with plaster splints, covering the arm not on all sides. At the same time, the child is released home and he spends the entire period of treatment at home.

In children under 8 years of age, bone fusion occurs very quickly. With the correct attachment, the pain goes away almost immediately, and then the baby does not bother.

If a fracture with a shift occurred, then surgical intervention, with anesthesia, is absolutely necessary. The fragments will be aligned in the correct position and cast. The procedure is short-lived, but after the child requires medical supervision in a hospital.

It may be necessary to fix the bones with knitting needles when the fracture is not the first time, in the same place. This procedure and recovery after it takes place in a hospital setting, the dressing changes periodically under the supervision of a doctor.

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

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Possible complications after an injury

A fracture in a child’s elbow can cause complications in case of a violation in the treatment and recovery period:

  • the development of infection with an open fracture;
  • improper intergrowth of parts;
  • difficulty in moving;
  • complete non-growth.

TIP: After removing the cast, you must insist on a good x-ray control. It may show an abnormally fused joint on time. In this case, it is better to break it again so that the correct fusion occurs. In this way, dangerous consequences such as joint deformation can be avoided.

Rehabilitation period

After the treatment and discharge from the hospital, the victim needs to provide conditions for the quick recovery of the arm. Plaster is removed, on average, after 1,5 months, but it all depends on the complexity of the damage and the age of the patient.

It can be difficult to develop a damaged joint if a child has a fracture of the ulna. To do this, during the recovery period, you need to visit various procedures daily to help restore muscle tone:

Table – Procedures for joint restoration:

NameDescription
Exercise therapyPhysical therapy allows you to engage in moderate exercise, to stretch the muscles.
SwimmingSwimming develops the work of the joints of the hands, and also strengthens the immune system.
MassageMassage perfectly helps to increase blood flow in the injured hand, thereby accelerating the development of mobility.
PhysiotherapyAssign electrophoresis with calcium to damaged areas.
FoodAn increase in the body of dairy products, fish, jelly, fruits and vegetables, for the replenishment of calcium, vitamins, macro and trace elements.
Oxygen treatmentAssign with open fractures when blood circulation is disturbed. The metabolic process in the body improves, as well as the prevention of the development of infection in the tissues.

The instruction that the doctor gives when discharging with regards to rehabilitation should be fully observed, only then you can think about returning to your previous life. At first, you need to completely protect the baby from stress on the sore joint, so that the incident does not happen again.

Joint fracture prophylaxis

After the incident, parents should take care of preventive methods that will not allow the situation to recur:

  1. When playing games at home and on the street, there should not be near traumatic objects;
  2. No need to let your child jump from a great height;
  3. Must be present special protection when riding a bike, scooter and roller skates.
  4. Cross the road only under the supervision of an adult.
  5. The burden on the child should be assigned in accordance with his age.
  6. All toys used, as well as sports equipment must have a certificate of quality, the price of them should not be underestimated.
  7. Young children should be constantly supervised by their parents.
  8. It is required to constantly conduct educational lectures with the child on safety rules in order to avoid all unpleasant consequences.

You can learn more about this topic if you watch the video in this article.

Frequently Asked Questions

The arm does not extend in a child

Hello, my name is Albina. 2 months ago, a child had an elbow fracture with a displacement. The son is 5 years old. Gypsum was removed, a control shot was taken, everything grew together correctly, but he still can’t straighten his arm to the end, sometimes he complains of pain. What to do in this case?

Hello Albina! The fact that the child cannot still normally move the elbow joint is a normal situation. Not so much time has passed before the muscles are stretched and everything has returned to its normal course.

It is necessary to develop a damaged elbow daily, since the child is small – do it in a playful way to distract him. You need to bend and unbend your arm for 10 minutes up to 6 times a day. I can also offer swimming with an instructor, warning him of an injury or hire a good masseur.

Consequences of the time not extracted needles?

Hello, my name is Tatyana. The child had a fracture in the elbow joint, with a displacement. Knitting needles were inserted, and after the plaster was removed, they said they would remove the knitting needles after 2 weeks. During this time, the child fell ill with rubella, and he received a medical allotment for six months from the upcoming operation to extract the needles. Tell me, can he walk with them for so long?

Hello, Tatyana. There is nothing wrong with this delay. With spokes they live, it does not harm health. In due time they will be removed, and everything will be as usual. The only clarification – do not forget to carefully develop the joint all this time.

Fracture of the ulna in children

Fracture of the ulna – violation of the integrity of the ulna, resulting from mechanical action on the bone and characterized by edema, severe pain, limited movement of the arm, hematoma, crepitus, pathological mobility of the fragments.

Causes

Such a fracture occurs very often. It mainly occurs due to a fall on the arm, bruise of the forearm, direct blows to the elbow, an accident, strong and sharp muscle contraction (for example, with electric shock, with high physical exertion). All these are mechanical damages. In the appearance of bone fractures, pathological factors should also be considered. These include:

  • Osteomyelitis;
  • Rickets;
  • Osteoporosis;
  • Cancerous neoplasms in the skeletal system (e.g., osteosarcoma);
  • Metastasis of malignant tumors in the bone;
  • Imperfect osteogenesis;
  • Lack of vitamin D, calcium, phosphorus.

Symptoms

The clinical picture depends on the location of the fracture.

  • Ulnar process. A fracture of this bone is determined by severe edema of the joint area, hemarthrosis appears (pathological accumulation of blood in the joint), inability to perform flexion and extensor movements, crepitus and pathological mobility of bones are noted;
  • Coronoid process. It appears in a small edema, mobility is limited, the arm is extended along the body, hematoma. Damage to nerves is possible, this will be manifested in loss of sensation, tingling. If there is a hematoma, pulsation can be felt. On palpation revealed crepitus, mobility of bones at the fracture site;
  • The ulnar process and dislocation of the forearm. This fracture is combined, as it is accompanied by a dislocation of the bones of the forearm. The first signs are a half-bent state of the hand, with the palm facing forward. Joint deformation occurs, its enlargement, swelling, movements are difficult or impossible;
  • Elbow bone with dislocation of the beam head. Such a fracture appears in a bent arm that hangs along the body, movements are limited. The brush can be located inward, outward, neutral. This will depend on the type of bone dislocation. Joint deformation is possible. The damaged arm is shortened, there is a “protrusion” from the side of the radius, retraction from the side of the ulna. This type of fracture is rare;
  • Elbow joint. When it is damaged, a bruise is noted, the joint is deformed. The child is not able to bend and straighten his hand on his own;
  • Diaphysis of the ulna. A diaphyseal fracture is manifested by severe pains, movements are disturbed, painful, swelling, hematoma, deformation.

If the fracture is open, then there will be damage to the skin, bleeding, numbness.

Diagnosis of a fracture of the ulna in a child

The following methods are used to diagnose this type of fracture:

  • X-ray diagnostics is carried out in two projections with the obligatory capture of joints;
  • MRI (magnetic resonance imaging);
  • CT (computed tomography);
  • Consultation of a neurologist, neurosurgeon, neurologist is indicated for suspected violation of the integrity and damage to nerves;
  • Ultrasound diagnosis;
  • Intra-articular puncture is performed to detect hemarthrosis.

Complications

Complications and consequences include:

  • Incorrect fracture fusion;
  • Impaired functioning of the hand;
  • Disability;
  • Necrosis;
  • Osteomyelitis;
  • Purulent-inflammatory processes due to the “dirty” operation;
  • Infectious processes
  • Rejection of fixing tools (plates, knitting needles, pins);
  • Long fusion fracture.

Treatment

What can you do

First you need to find out by visual inspection which fracture is open or closed. Only then try to provide first aid to the victim. With an open fracture, the actions should be as follows:

  • It is necessary to stop bleeding by applying a tourniquet 5 cm above the wound;
  • Carefully try to wind the bandage (ideally aseptic, if not, then a clean handkerchief, cloth);
  • If possible, reassure the patient by giving sedatives and painkillers;
  • Put on a tire, a span from improvised materials. It is also necessary to immobilize the joints;
  • Call an ambulance.

With closed fractures of the ulna, it is necessary:

  • Try to reassure the patient;
  • To give an optimum comfortable and convenient position for the victim;
  • Wrap a damaged hand to the body at an angle of 90 degrees or put it in a bent form on a scarf thrown over the shoulder;
  • Call an ambulance brigade.
  • Independent reduction of the fracture;
  • Applying heat to the fracture site;
  • Flexion and extension of the arm;
  • Stretching a damaged arm.

What does the doctor do

The doctor examines the patient, conducts all necessary tests and examinations, prescribes treatment. It consists in the following:

  • With simple fractures, the application of a plaster cast is indicated, soon for a month;
  • Reduction of dislocation and reduction of fracture;
  • Skeletal traction;
  • Osteosynthesis;
  • Recovery and rehabilitation therapy, which includes massages, exercise therapy, electrophoresis, development of the arm and joints.

Prevention

Preventive methods include:

  • Timely identification and subsequent competent treatment of diseases that affect bone strength;
  • Vitamin therapy;
  • Prevention of possible injuries;
  • Do not leave the child alone on the street;
  • Follow his game in the playgrounds;
  • Explain the rules of behavior on the street;
  • Use protection when rollerblading, biking, scooter, skateboard and more.

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Fractures in the elbow joint, fracture of the ulna and radius with displacement in the child.

Sunday, June 11, 2017 00:39 a.m. + in quote book

According to statistics, about 20% of all intraarticular injuries are due to damage to the elbow. This is one of the most complex joints of the human skeleton. The elbow joint is formed by the union of three bones: the humerus, ulnar, and radial. In addition, several small articular joints are located inside it. All of them are connected by ligaments and muscles. A lot of vessels pass in the elbow joint, as well as nerve fibers. Thanks to this, the mobility of the hand and its ability to perform complex movements are ensured.

But due to the anatomical and physiological complexity of this joint, a fracture of the elbow joint is a serious injury, as it often causes complications. Heals such damage for a long time and may not respond to conservative therapy. Therefore, a fracture of the elbow requires surgical intervention to compare fragments, sometimes even repeated. In addition, the rehabilitation period is difficult and takes a long time to restore arm mobility.

With any fall, a person instinctively puts up his elbow. Therefore, he is so often injured. This may occur in such cases:

  • when falling on the elbow or on an outstretched arm;
  • with a strong blow to the joint;
  • during car accidents and disasters;
  • athletes when playing tennis, volleyball, golf.
  • The most common fracture of the elbow joint occurs in children and the elderly. This is due to weak ligaments and fragility of bones. This is especially noticeable in patients with osteoporosis – in such cases, a fracture can happen even with the slightest blow.

    Most often, a fracture of the elbow joint occurs when falling on a bent or straightened arm

    Like all other similar injuries, fractures of the elbow joint are divided into closed and open, intraarticular and periarticular, with and without displacement, multiple, fragmented and comminuted. A bone fracture can be combined with a dislocation. Due to the complexity of the structure of the elbow, the classification of damage at the site of localization has some features.

  • In most injuries, the elbow is the first to take the blow. It is not protected by soft tissue. But a fracture of the ulnar process itself is rare. Much more often, a fall causes the separation of fragments from it. Such an injury is usually complicated by displacement of fragments, damage to blood vessels and muscles.
  • When a person falls on an outstretched arm, a fracture of the head or neck of the radius is possible.
  • Повреждение венечного отростка чаще всего сочетается с травмами предплечья или плеча, вывихом в суставе, смещением отломков.
  • With a fracture of the humerus, a dislocation in the elbow joint and damage to the condyle of the shoulder can occur.
  • In children and adolescents, bones at growth points often break. Their bone tissue is still fragile, and falls often occur. In addition, the structure of the elbow joint in the child is slightly different than in the adult, since it is not yet fully formed. For example, it is very difficult to diagnose a fracture of the ulnar process, which fuses with the bone by the age of 15-16. Often in children there are intraarticular injuries of the elbow, especially a fracture of the condyle of the humerus.

    The presence of a fracture can be judged already by visual inspection

    After a serious injury, pain always appears. But with a fracture, it becomes very strong, spreading to the wrist and fingers. In addition, other symptoms may indicate such an injury:

  • severe swelling and deformation of the joint, often increasing in size;
  • severe hematoma or bruising;
  • inability to move the arm even in the shoulder joint;
  • if the vessels are damaged, there may be no pulse on the injured hand, blue or cold fingers;
  • numbness of the limb or a tingling sensation is sometimes observed;
  • fracture of the ulnar process causes the spread of pain on the shoulder, as well as the inability to bend the arm.
  • The first task in treating a damaged limb is to provide it with immobility. The joint needs to be fixed already at first aid, especially if the fracture is with bone displacement. After all, fragments can damage tendons, nerves and blood vessels. The elbow is fixed in a bent and slightly raised position using improvised means. But you can’t take this position if it leads to increased pain.

    In a medical institution, the joint is fixed with a plaster cast, which is applied from the fingers to the middle of the shoulder. This is done after diagnostic procedures. In order to determine the nature of the fracture, it is necessary to do an x-ray in two projections. If the damage is intraarticular, computed tomography is also required. In case of a fracture without displacement, application of gypsum for a period of at least a month is sufficient.

    With bone displacement

    The main thing in the treatment of an elbow fracture is to combine the bones and provide the joint with complete immobility

    With simple injuries of single bones without displacement, conservative treatment is possible. It consists of wearing a plaster cast. Additionally, other methods may be used.

    The main objectives of the treatment are to ensure the immobility of the bones for their fusion, to improve venous outflow, to prevent swelling.

    In many cases, a fracture of the elbow joint requires surgery. The main thing for normal bone fusion is to precisely combine their fragments. And with intraarticular injuries and multiple fractures, this can only be done with surgical intervention. With an open fracture, the operation must be performed no later than a day after the injury.

    After reposition, the bones are fixed with pins, bolts or knitting needles. Sometimes osteosynthesis is required. Shards of bones are removed, and if necessary, the head of the damaged bone. In this case, it is replaced by an endoprosthesis. Sometimes it is required to sew torn muscles and ligaments. Fracture of the ulna, especially with fragments that have fallen into the joint, requires the use of bone grafting and the use of fixing plates.

    You can also read: Lateral elbow epicondylitis

    The most difficult thing is the development of the elbow joint after the fracture. In this place, contractures often form with improper rehabilitation. While wearing a plaster cast, atrophy of the muscles and ligaments occurs. To prevent this, it is necessary to do special exercises a few days after the injury.

    In addition, paraffin baths, mud therapy, UHF, magnetotherapy or electrophoresis are prescribed. It is important to follow a special diet, including foods rich in vitamin C and collagen.

    In most cases, a complete restoration of joint mobility occurs after 1-3 months. When all the recommendations of the doctor are followed, complications usually do not happen. If, after some time after the injury, the elbows and knees begin to break, this indicates the development of some kind of joint disease.

    Already on the second or third day after the injury, when severe pain has passed, you need to start doing exercises. First for the shoulder joint and fingers. The hand should be raised periodically to prevent swelling. Very useful during this period is breathing exercises.

    After removing the plaster, exercise therapy consists in bending and unbending the arm at the elbow several times a day. You can do this with a second hand, locking them into a castle, rolling balls or a toy car with your fingers on the table.

    Special exercises will help restore joint function

  • flexion and extension of the arm using a special block;
  • raise your arms clasped into the lock up and get behind your head;
  • exercises with a gymnastic stick or with a ball;
  • slow rotational movements in the elbow joint;
  • useful activities in the pool.
  • Due to the complexity of the structure of the elbow, rehabilitation after an injury should take place under the guidance of a specialist. After all, you need to know some features of the restoration of mobility in this joint. If they are not observed, the risk of developing arthrosis is great.

  • force movements during exercise therapy, passive movements, exercises causing pain are prohibited;
  • it is contraindicated to bear heaviness and hang on the crossbar until the joint is completely restored;
  • after a fracture, massage of the elbow area is not prescribed.
  • Any injury in the elbow joint requires the attention of a specialist. Only with timely fixation of damaged bones and the implementation of all the recommendations of a doctor can complications such as arthrosis, bone growths in the joint or the appearance of contractures be avoided.

    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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