Fractures of the distal metaepiphysis of the radial bone: with and without displacement. Marginal fractures of the radius - Barton, Hutchinson's fractures

The radius is represented by a paired formation located adjacent to but more anteriorly and slightly outward from it. What is the styloid process of the radius? In Latin, they call it so - processus styloideus.

What is this process

This formation is in the region of the lower (distally located) epiphysis, epiphysis distalis, it is thickened in the direction of the frontal plane. It is from this part that the processus stuloideus radii departs and is perfectly palpable.

How often is a fracture of the styloid process of the radius?

The trauma to this area is high, about 50% of the the total fractures. This most often occurs when falling onto an outstretched arm. Moreover, it is much more common in females than in men. This occurs as a result of hormonal changes in the woman's body, demineralization processes bone tissue, which leads to the development of osteoporosis.

Fracture causes

The reasons for the fractures of the styloid process of the radius are as follows:

Participation in a road traffic accident (RTA).
In winter, especially in the presence of ice.
Fall on hand from a bike, rollers, roof.
Sports activities.
Carrying out various types of sports and extreme stunts.
Participation in active games.

Types of fractures

Fractures can be of several types:

Compression type.
Tear-off type.

Compression type

More often it occurs after a blow to the area, due to which the flow of energy of the impact movement pulls the styloid process of the radius outward and slightly back, after which it spreads to the nearby scaphoid and causes a fracture of this articulating part of the surface. As a result, a linear fracture occurs at the junction of the scaphoid and in the form of a crack, so there is no displacement of the fragments.

It is necessary to perform reposition (comparison) of bone fragments, which is carried out with a closed access using local anesthesia.

Clinical picture

The following symptoms are observed:

Significant edema extending to underlying tissues. It may seem that the skin of this area is as if taut, there is a pronounced feeling of discomfort.
Great soreness.
Restriction of movements, both active (more pronounced) and passive (less pronounced).
The sound of crepitus ("crunching", "squeak", as when walking in the snow) when trying to move or move a limb.
The area of \u200b\u200bthe fracture is hyperemic, sometimes it can be combined with the formation of hematomas.

Diagnostic tests

In the first place is the history of the disease carefully collected from the victim. In second place is the X-ray examination of the injured limb in several projections to determine a more accurate picture of the nature of the fracture of the styloid process of the radial bone.

Urgent measures

It is necessary to apply cold to the place of damage, it can be a heating pad with ice or just a piece of ice if the first one is not at hand. Since ice has a vasoconstrictor effect, prevents the growth of edema, and also has a less pronounced analgesic effect.

Healing activities

To carry out the reduction, the doctor must take the affected limb in such a way that one hand is on the wrist joint from its inner surface, and the other takes the opposite side and tightly squeezes the victim's hand. You need to squeeze hard enough for the fragments to take their normal physiological position. Otherwise, poor-quality reposition procedure can lead to disruption of the functioning of the limb, and in some cases entails disability of the patient.

Separation of the styloid process of the radius

In contrast to the above, in this case, there is a complete separation of the bone element.

This is most often observed when falling on an outstretched arm, in which the wrist deviates inward, and the styloid process moves away from the radius and comes off. Sometimes this occurs along with a complete dislocation of the wrist joint.

The styloid processes of the radius and ulna are very fragile.

Clinical manifestations

The symptoms of such a fracture are as follows:

Sharp pain that arose in the first minutes after the injury when trying to move the injured hand. Therefore, the patient assumes the most favorable and sparing position for this hand.
A creaking sound is heard due to the friction of the bone surfaces against each other.
Phenomena of crepitus.
Severe swelling, accompanied by the formation of hematomas.

Diagnostic measures

When the styloid process of the radius is displaced, the following measures must be taken:

Taking anamnesis.
Examination by a traumatologist.
X-ray examination in the frontal and lateral projection of the wrist joint.
If necessary, it is possible to carry out such additional research methods, such as computed tomography (CT) or ultrasound examination of soft tissues (ultrasound).

How to treat a fracture of the styloid process of the radius?

Treatment

The most important thing is to carry out bone reduction followed by immobilization by means of which is worn for at least one month. Then a second X-ray examination is carried out in order to make sure that the fragments are healed correctly. This is done to ensure maximum mobility at the physiological articulation points of the quilt surfaces.

If necessary, surgery is performed using foreign fixation devices (pins, screws).

Drug therapy consists in the use of vitamin D and drugs enriched with calcium to maximize the shortening of the period of adequate bone fusion in the rehabilitation period, since if improperly treated, styloiditis of the styloid process of the radius can develop.

First aid

Since it is not always possible to deliver the victim to a medical facility in the first minutes, it is necessary to have an idea of \u200b\u200bproviding first aid using the available means at hand.

First of all, you need to immobilize (immobilize) the damaged limb, fix it with some tissue, apply a splint, this is done in order to prevent complications such as bleeding and displacement, as well as to prevent more pronounced pain syndrome.

Sanitization is carried out in the presence of a wound surface. For this, any antiseptic, disinfecting solution (hydrogen peroxide or, for example, an alcoholic iodine solution) is suitable. The solution is applied to a torn piece of cloth or napkin and the area is treated. This is carried out in order to disinfect the fracture wound and prevent infection of various types with pathogenic agents.

Since the patient is worried about a very pronounced pain syndrome, it is necessary to give him anesthetic groups of drugs, for example, steroid anti-inflammatory drugs (NSAIDs). The most effective are "Diclofenac", "Ketoprofen" or "Ibuprofen".

In addition to all of the above, we must not forget about the cold, which must be immediately put on the fracture site of the styloid process of the radius (photo is presented below).

Rehabilitation measures

They include a set of measures aimed at the speedy fusion of the bone surfaces with each other and a faster recovery.

There are physiotherapy procedures, the most effective of which are visits to ultraviolet radiation (UFO), magnetotherapy and UHF therapy. The latter procedure is contraindicated in surgical interventions with the installation of metal structures.

After a week and a half, visits to infrared laser therapy procedures, pulsed EF UHF in combination with magnetic stimulation of damaged nerve fibers are added.

After removing the plaster splint, physical therapy classes with a massage course are shown. They stimulate the speedy restoration of lost limb functions by strengthening the neuromuscular apparatus and restoring the transmission of electrical impulses from the injured limb and back.

Regarding nutrition, you should also take into account that you should eat more foods that are rich in calcium and vitamin D. This is primarily milk, cottage cheese, sour cream, seafood, hard cheeses, legumes, greens, dried fruits (dried apricots, prunes), veal, liver as well as fish oil.

Terms of restoration of working capacity

They are determined individually, depending on the general condition of the body and the presence of complications. But on average they are about one and a half months.

Possible complications

The following consequences can develop with improper treatment:

Due to the attachment of infection at any stage of care. Purulent-septic inflammation develops with a threatening death.
Damage to the neurovascular bundle, which can threaten the development of contractures (limitation of movement in the joint).
Incorrect fusion of bones with the formation and deformation of the limb as a whole.
Development of osteomyelitis (purulent-septic lesion of both bone marrow and bone apparatus).
Neurotrophic complications.
A cosmetic defect in the form of the so-called "bulging" of the styloid process of the radius.
Various options for deformations of the bone and articular apparatus.

Even if you have never been diagnosed with diseases related to the bones and spine, this does not mean that you will be bypassed by a fracture of the styloid process of the ulna. The process of the ulna forms the girdle of the elbow, it is also responsible for the correct functionality of the elbow articular apparatus.

There are many ways to get a fracture of the appendix - even an unsuccessful fall can lead to the imposition of plaster. The fracture is complicated by displacement, stable or not, the doctor diagnoses. If the fracture is without displacement, then everything is not so bad. Also, doctors are faced with an open and closed form, another dangerous species is comminuted. The styloid zone is located near the skin, therefore it is she who most often suffers.

After receiving an injury, the first thing that the patient feels is intense pain, which becomes acute and unbearable while moving the elbow. Pay attention immediately - whether the amplitude of movement of the bone changes or remains the same. If only pain is present, then there is no displacement. If the victim did not go to the traumatology department for an ambulance, the next day the painful area swells and a bruise appears.

A bruise shows exactly the same symptoms. In order to diagnose a fracture, it is necessary to undergo an X-ray examination, and the faster you do this, the more chances you have to fully restore the functions of the affected limb.

There are times when radiography shows disappointing results - the styloid process of the ulna is not just damaged, but torn off. The periosteum, which is associated with the process, has nerve endings and fibers, so pain in the trauma is so excruciating that the person can lose consciousness.

The state of shock due to pain syndrome passes along with the following symptoms:

blood pressure drops sharply;
pupils become wide;
pallor of the skin.

The pain subsides slightly if the patient maintains a healthy arm bent at the elbow, but there is still no lasting relief. What does the doctor pay attention to when examining such a patient?

The swelling is visible to the naked eye.
Hemorrhage is noticeable in the elbow area.
Where the process should be, the skin seems to sink into an empty place, but after a while it is difficult to visually determine this symptom, because the swelling becomes even greater.
Careful palpation reveals displacement of the bone, or the presence of large splinters.
The traumatologist is able to suspect a rupture of the tendon of the triceps of the shoulder if the patient is unable to extend the elbow on his own.

By the way, together with a fracture of the styloid process of the ulna, injury to the ulnar nerve endings may be present. This will be indicated by the state of sensitivity of the skin covering the forearm, hand and fingers of the sore hand. If the clinical picture is complicated, doctors prescribe x-rays in two projections:

first, the limb is bent at an angle of 90 degrees;
if necessary, take an additional picture, placing the arm at a different angle or straightening it.

If the patient does not go to the hospital on time and complications of an untreated fracture develop, the traumatologist prescribes directions for CT and MRI.

How to provide first aid

If your elbow becomes unstable after an injury, seek this help:

What effect do these methods have?

Reduces the intensity of pain.
Hemorrhage is stopped.
Reduces puffiness.

If the pain still increases, inject 1 ml of analgin, calculated for 10 kg of the patient's body weight.

Modern methods of treatment

Fracture of the styloid process of the ulna does not mean that surgery should be performed to restore the limb. The operation is prescribed for difficult patients - when the fracture is more than 3 mm displaced. In other cases, therapy is conservative:

The arm is bent at the elbow at an angle of 50-90 degrees, the terms of wearing a plaster cast in this position is 3 weeks. If the limb under the plaster swells (this happens in the first days after the injury), you need to loosen the plaster cast, otherwise tissue necrosis may occur, so hurry to the traumatology department.
After 1 week of wearing the plaster, an X-ray examination is performed, otherwise it is impossible to determine the displacement of the fragments.
After 3-4 weeks, the hand is freed from the plaster and begins to develop the elbow joint. Physiotherapy and special gymnastics will help bring the limb into a working condition.
It is believed that after 1.5 months, the fusion of the bones is completely completed and the load can be increased without fear for the integrity of the styloid process of the ulna.

How to restore the function of the elbow joint at home after removing the cast is shown in the video:

A fracture of the styloid process, which is located on the radius, occurs as a result of trauma, most often not with the direct impact of mechanical force, but with the return impact of the impact. This bone damage is characterized by a certain seasonality. Most often, fractures in the styloid process occur in the autumn-winter period.when the street is slippery and people fall more often.

There are two types of fractures of the styloid process of the radius:

Compression fracture;
Avulsion fracture

Main reasons

Falls while cycling;
Professional sports;
Road traffic accidents;
Unsuccessful performance of jumps or tricks;
Outdoor and sports games.

In these cases, a person reflexively stretches out his arm when falling, resulting in a fracture of the styloid process.

Compression fracture

Compression fracture mechanism

With this type of fracture, a part of the wrist strikes against the radius and its rapid repulsion outwards and somewhat posteriorly. Impact force is usually transmitted through the adjacent scaphoid bone, causing the part of the radius that is directly articulated to break.

In this case, a linear fracture occurs in the joint between the scaphoid and lunate bones.

The damage to the bone itself is a small crack, in this case the displacement of the fragments in the victim does not occur.

Clinic

With a fracture, pain appears at the site of the fracture, crepitus of bone fragments. The victim cannot make any movements in the wrist joint. The joint itself is swollen, a hematoma appears.

Some patients experience discomfort and tension in the joint area.

Survey

The diagnosis is made on the basis of anamnesis (the fact of injury), physical examination and X-ray examination.

Help

In this case, the victim must be anesthetized with non-narcotic analgesics and immobilize the injured limb. The doctor must apply a plaster cast for at least 1 month.

If as a result of an injury there is a displacement of the styloid process of the ray outward and backward, then the doctor must accurately match it with the bone. Reposition of fragments in the victim is carried out under local anesthesia and in order to restore the anatomical shape of the joint. The articular surface on the arm should be smooth.

The doctor performs the same manipulation of the reduction of bone fragments as in the case of reduction of a complex fractured fracture of the radius (Kolles fracture). To do this, the traumatologist strongly compresses the bone from both sides, at this time one of the doctor's hand is located on the inside, and the other on the outside of the wrist joint. If there is insufficient compression of the bone, then in this case an inaccurate comparison of bone fragments may occur.

When performing such a reduction, the doctor and the patient do not need to be afraid that it will lead to another damage to the bone or joint.

A characteristic feature of this method of reduction is the fact that it is almost impossible to exceed the maximum permissible bone compression here.

Avulsion fracture

This type of fracture is not as common in clinical practice, as opposed to compression fracture. It got its name because the very violation of the integrity of the bone is caused by strong tension of the radial collateral ligament of the wrist.

The mechanism of avulsion fracture

In case of injury (fall on the hand), subluxation of the articular surface occurs inward. In some cases, the victim has a complete dislocation of the wrist joint.

In case of injury, the wrist of the upper limb shifts sharply inward. Subsequently, a small styloid process is pulled away from the diaphysis of the radial bone and rotated in such a way that as a result, the entire articular surface of the hand is directed outward.

Clinic

With this type of fracture, the victim has a pronounced pain syndrome in the area of \u200b\u200bthe wrist joint. It is swollen, deformed, possible crepitus of bone fragments, numbness of the fingers. Movements in the joint are impossible due to its deformation and severe hematoma. The victim experiences pain in the wrist joint when moving the arm while sleeping and when walking.

Survey

The diagnosis is made on the basis of history, physical examination of the patient and X-ray examination.

Help

This dislocation can be easily corrected in the victim if a strong traction is made immediately after the injury. The doctor takes the victim by the thumb and pulls the rest of the fingers in the opposite direction. With this manual manipulation, the correct comparison of the styloid fragment and part of the radius occurs.

A plaster cast is applied to immobilize the limb for at least 1 month... The doctor gives recommendations to the patient about limiting movement in the injured limb, observing good nutrition. For some patients, the traumatologist prescribes calcium and vitamin D preparations. If, as a result of medical manipulations, complete reposition of bone fragments has occurred, then the patient's range of motion is fully restored.

Before removing the plaster, the doctor must make the patient a control X-ray and make sure that the fracture has healed.

In some cases, with this type of fracture, an operation with fixation of the appendix with a screw is indicated.

Rehabilitation

After the plaster cast has been removed and when tissue edema subsides, the patient is prescribed physiotherapy exercises. Of all physiotherapy methods, magnetotherapy is preferred.

Early complications of fracture

The occurrence of purulent-septic complications when an infection enters the wound (with open fractures);
Vascular disorders at the site of joint damage;
Secondary displacement of fragments during early removal of the plaster.

Late complications of fracture

Neurotrophic disorders;
Bone and articular deformities.

In case of untimely or incorrect reposition of the fragments, the wrist joint can be deformed, the styloid process protrudes in the victim. Some patients are tormented constant pain in the elbow area. But "old" fractures are very difficult to correct, sometimes surgery may not lead to the desired results, and a person will experience psychological and physical discomfort for the rest of his life.

To avoid such a situation, a victim who falls on his hand must contact a medical institution for help and strictly follow the recommendations of a traumatologist.

One of the most important conditions for the successful treatment of a fracture is that the cast should not be removed ahead of time.

Bone tissue refers to connective tissue, it performs not only a supporting function, but also participates in blood flow and metabolism. Each bone in the body is more than half composed of minerals, but with age, their amount begins to decrease, which significantly increases the risk of fractures.

Factors that can cause a fracture of the ulna include:

falling on a limb;
a blow to a bone or severe bruise;
falling on a limb of heavy objects;
the presence of osteoporosis. This disease usually appears after age 50 and causes bone cell death. In some cases, it can be caused by prolonged use of certain medications.

The fracture can be open or closed. Regardless of the complexity of the structure of the elbow joint, their signs do not differ from those of other fractures:

a common type of injury is a closed fracture, in which the structure of soft tissues is not disturbed and wounds are not formed;
an open fracture, on the contrary, is characterized by wounds and damage to the skin by a bone fragment. The size of the affected area depends on the severity of the injury;
comminuted, in symptoms it is very similar to a closed fracture, but differs in the presence of fragments inside, which are well palpated on palpation;
fracture of the ulna with displacement (Fig. b below) is characterized by a violation of the usual contours of the limb or an unnatural position and externally observed appearance of the elbow joint;
a crack is a violation of the structure of the bone surface and does not require long-term rehabilitation and treatment.

The easiest and safest injury is considered to be a crack or closed fractures of the ulna without displacement (Fig. A).

In the direction of the contour of the injury, fractures are classified into:

transverse;
longitudinal;
helical;
oblique;
compression.

The most rare in medical practice is an isolated fracture, similar in symptomatology to a transverse fracture without displacement. This is due to the close proximity to the radius, which delays and maintains the position of the resulting fragments.

For this fracture, conservative treatment with the obligatory use of a plaster cast, which reliably fixes the injured area.

An elbow injury is classified as a compound fracture. In case of a fracture of the ulnar and coronoid processes of the bone, surgical intervention is necessary, which is necessary and contributes to the restoration of the motor functions of the limb.

A fracture in the upper part of the ulna, complicated by a dislocation, is called a Montage fracture or a parry fracture. It most often occurs due to direct impact or impact on the area of \u200b\u200bthe ulna.

The location of the trauma focus is distinguished:

periarticular (metaphyseal) fractures;
fractures of the ulna inside the joint (epiphyseal), which lead to the destruction of ligaments, joints, capsules;
fractures in the middle section of the bone (diaphyseal);
olecranon injury;
fractures of the coronal processes of the ulna;
damage to the styloid process, located in the vicinity of the hand.

Rehabilitation measures are carried out in order to accelerate the process of fusion of bone surfaces with each other and restore the mobility of the wrist and elbow joints.

Ultraviolet therapy.
Magnetotherapy.
Ultra-high-frequency therapy (UHF).

Ultra-high-frequency therapy is contraindicated in the presence of metal fixation devices installed to properly fusion the fracture site.

After a week and a half, the following can be added to the physiotherapy complex:

Infrared laser therapy.
Pulsed electromagnetic field of ultra-high-frequency therapy (EP UHF).
Magnetic stimulation of damaged nerve fibers.

After removing the plaster cast, physical therapy classes and a course of massage are shown for recovery. The complex of physiotherapy exercises should include static and dynamic exercises.

In combination with massage, moderate physical activity will strengthen the neuromuscular apparatus, increase muscle tone and restore normal blood circulation in the tissues.

The most useful exercises are: flexion and extension of the arm in the wrist area, brush movements in different directions and circular. As you are trained for the load, you can take a regular sponge, or a manual expander with a gradual increase in its degree of rigidity.

Displaced arm fractures are quite common these days. It can be easily identified even by clinical symptoms. Severe pain, impaired mobility of the upper limb, pronounced edema are typical symptoms of pathology.

Limbs, most often the line, from the longitudinal to the bent hand, has three surfaces.The best of all the fracture is revealed by displacement) Efficiency is restored in people splints), the edges are turned away After that the doctor, not with a back plaster splint , Pain.

Active movement fractures of the radial epimetaphysis With extensor fractures of the distal disc of the ulna just below the humerus quite often. They are traumatic.

Turner disease or Smith neuritis hand fixed

Is restored approximately through the axis of the injured forearm, the fragments are displaced in - lateral, posterior on the pictures in. It is recommended to apply a short non-physical labor through a plaster splint in

First of all, you need to look at the position in which the person falls. Most often, this can happen when falling on an outstretched arm, a person instinctively pulls it forward.

This feature is the most common reason damage. In some cases, a fracture of the styloid process of the radius is the result of a direct blow to the bone.

In the latter situation, the fracture is often open, there are wounds of various sizes.

The frequency of such damage increases dramatically in winter. On ice, elderly people become especially vulnerable, osteoporosis is an additional factor. Also, injury can occur when:

hobby for cycling, roller skating, skateboarding;
professional sports;
unsuccessful jump;
active games.

Falls in such conditions contribute to the fact that the victim at the level of instinct pulls the arm forward and this leads to serious damage to the styloid process. In view of this, in addition to an open or closed fracture, compression or avulsion damage can be found.

In trauma practice, only two types of injuries to the processes of the ulna are recorded:

injury;
a fracture, which in turn can be: with displacement, without displacement, comminuted, closed or open.

Especially often the areas located superficially are injured, namely the ulna and the styloid process of the ulna. A bruise or fracture of the coronoid process of the ulna is a very rare injury. But it is possible if a person falls from a height, leaning on an outstretched arm in the most extended state.

In this case, the articular surface of the humerus with force, as it were, "knocks down" the process, separating it from the ulna. In addition, injuries to the coronoid process can occur with posterior dislocation of the forearm, but in most cases they are diagnosed as combined, that is, combined with an intra-articular fracture of the elbow.

In case of damage to the elbow zone, the signs of injuries are similar to each other

Ulna styloid fracture occurs when a person falls on the wrist at a certain angle. As a rule, such an injury is combined with a fracture of the radius.

Most often, of all the processes of the ulna, it is olecranone that is damaged (1% of all fractures of the extremities, 30% of intra-articular injuries), which may be due to its large size compared to the rest, and its subcutaneous location.

In addition, the triceps tendon of the shoulder is attached to it, which directly affects the type of fracture.

Damage to olecranon almost always (95%) occurs under the influence of direct force: when a person falls on the back of a bent elbow joint or receives a direct blow to the appendix.

In these cases, a fracture of the olecranon is formed without displacement. But sometimes an indirect mechanism of injury is also possible: when falling with a contracted triceps muscle of the shoulder.

At the same time, at the moment of separation of the olecranone, the triceps pulls the fragment towards itself, which determines the presence of a displacement fracture of the olecranon. The degree of displacement is determined by the tone of the triceps muscle at the time of injury, and the fracture line can be transverse or oblique.

Olecranone fractures in most situations are intra-articular and are combined with other types of joint damage (fractures of the humerus, dislocations, subluxations, ruptures of ligaments and tendons).

The separation itself can occur at the level of the base or apex of the process, as well as in the middle of the block notch. In addition, the process of displacement can be accompanied by the formation of fragments, compression (compression of the spongy substance of olecranon), rupture of subcutaneous fatty tissue and skin can occur.

Therefore, the following classification of fractures of the olecranon is more detailed:

type I - no displacement: non-splintered and splintered;
type II - with displacement, but stable: non-splintered and comminuted (the displacement of the olecranon does not exceed 3 mm, the collateral ligaments keep the forearm in a stable position in relation to the shoulder bone);
type III - displaced, unstable: non-splintered and comminuted (such injuries can be called fracture-dislocations).

An olecranone fracture without displacement can be treated conservatively

Treatment

Diagnosis of a forearm fracture is based on clinical (

anamnesis, external examination

) and ray (

radiography,

) research methods. The former help to suspect such a fracture, the latter - to confirm it and help in establishing its type, to assess its severity. Diagnostic methods can also reveal possible complications and help the doctor choose the right treatment tactics.

The following methods are used to diagnose a fracture in the forearm:

anamnesis;
visual inspection;
radiography and computed tomography.

Anamnesis

Anamnesis is a set of questions that the doctor asks the patient when he goes to a medical institution. First of all, he asks the patient about the disturbing symptoms, how and when they appeared.

This stage of the clinical examination is very important, as it helps the attending physician to suspect the presence or absence of a forearm fracture. With such a fracture, the patient can inform the doctor about the presence of certain symptoms, which, in turn, can belong to two groups of signs.

The first group of signs is called reliable signs of a forearm fracture. It includes crepitus (

The radius bone on the X-ray looks like a white oblong formation, connected from above with humerus, and below - with smaller bones of the hand (

lunate, scaphoid

). It is on the left side in the picture. It is thinner at the top and thicker at the bottom than the adjacent portions of the ulna. In the event of a fracture of the radius, one or more fracture lines (

fracture

), which look like dark stripes with different thicknesses, directions and edges. These strips separate the bone fragments.

With a normal fracture, their (

bone fragments

) two - proximal (

) and distal (

). With comminuted fracture - three - proximal (

), middle, distal (

). Complicated fractures are accompanied by the formation of more bone fragments. The displacement of bone fragments can be easily visually recognized by the rather understandable separation or fragmentation of the radius into several bone fragments and deformation of its anatomical structure.

The ulna on the x-ray is located on the right. It is somewhat thicker than the radius at the top.

The lower epiphysis of the ulna is much thinner than the epiphyseal part of the radius. The ulna on the roentgenogram, as well as the radius, looks like a white oblong formation.

In terms of color intensity, in most cases, they do not differ from each other. With a fracture of the ulna, the presence of a darkened line (.

fracture lines

), which cuts off its bone structure. The course of the line is determined by the type of fracture (

oblique, transverse, helical

). With multiple, complex and comminuted fractures, there may be several such lines. In some cases, with a fracture of the ulna, it is possible to displace the displacement of bone fragments, as well as deformation of the longitudinal axis of the ulna.

The main objective of the therapeutic measures carried out in case of a fracture of the radius is to restore its normal bone structure. For simple uncomplicated fractures of the radius, to restore its anatomical structure, the doctor manually repositions (

reduction

Ulna fracture without displacement of bone fragments is treated conservatively. To do this, the damaged area of \u200b\u200bthe hand is immobilized with a plaster splint for 14 - 112 days, depending on the type of fracture. With the displacement of bone fragments, doctors very often resort to their open (

with the help of surgery

reposition

For fractures of the radius in a typical location (

kolles fracture or Smith fracture

) without displacement of bone fragments, a plaster splint is applied to all patients after radiography to immobilize the affected area of \u200b\u200bthe forearm. The plaster cast should cover at least the area of \u200b\u200bthe hand from the fingertips to the upper third of the forearm. The hand with such fractures is immobilized (

immobilize

) for a period of 30 - 37 days. After removing the cast, physiotherapy exercises are needed to develop movements in the wrist joint. The duration of recovery of the function of this joint is usually 7-14 days.

With a simple fracture of Kolles or Smith with displacement of bone fragments, their traction reduction is performed (

reduction of bones by stretching the arm

With a fracture of the radial head without displacement of bone fragments, conservative methods of treatment are resorted to, which include temporary immobilization (

immobilization

) and physiotherapy treatments. Immobilization of a limb with such a fracture is carried out using a plaster splint, which is applied from the metacarpophalangeal joints of the hand to the elbow joint.

Fractures of the ulna and radius without displacement of bone fragments are the most best view fractures from the point of view of safety for the patient, as well as the timing of recovery of the injured limb.

This type of fracture is accompanied by less trauma to the tissues, compared to fractures in which displacement occurs, since when displaced, bone fragments often damage the surrounding tissue, which often leads to damage to the nerves or arteries of the forearm.

Treatment of fractures of the ulna and radius without displacement of bone fragments is carried out by simple immobilization of the injured limb using a plaster splint (

for a period of 8 - 10 weeks

In case of a fracture of the ulna and radius with displacement, therapeutic measures consist of reposition (

reposition

) bone fragments and temporary immobilization of the forearm with a plaster splint. Reduction of such a fracture is usually performed surgically, less often it is done conservatively through closed reduction. It all depends on the type of fracture (

oblique, transverse, etc.

), the direction and distance of the divergence of bone fragments, their number, as well as from the presence of any complications (

bleeding, nerve damage, etc.

The timing of the immobilization of the injured forearm mainly depends on the location of the fracture and its severity (on average, it takes 10-12 weeks). After immobilization, the patient must undergo medical gymnastics courses for the gradual rehabilitation of the lost forearm function. Full working capacity should return in 12 to 14 weeks.

Before proceeding with the choice of a treatment method, the doctor must diagnose the patient. It includes visual examination, palpation, anamnesis and some instrumental examinations (X-ray, ultrasound). If the fracture of the ulna of the arm is confirmed and resolves without displacement, treatment will be carried out conservatively.

The patient will be given a cast, which will need to be worn from 2 weeks to 4 months (depending on the type of injury). If the damage is accompanied by displacement, most likely, you will have to resort to open reduction (by surgical intervention).

In rare cases, doctors manage to remove the debris without surgery, but this is only possible with simple fractures. In order to speed up the recovery process, the patient may also be prescribed certain medications:

pain relievers and anti-inflammatory drugs. They must be taken in the first few days after an immediate injury. Two types of analgesics can be used - narcotic and non-narcotic;
antibiotics. Prescribed for any type of fracture, especially if the treatment was performed surgically;
hemostatic agents;
preparations with a high calcium content and various multivitamin complexes.

After the fusion of the ulna, competent rehabilitation plays a very important role. Physiotherapy, special massage, physiotherapy will not only shorten recovery, but also help to develop the hand correctly. At the first stage of recovery, the patient is usually referred to exercise therapy, this can happen as early as 5 days after the injury.

Since the arm will be plastered, the victim will only need to try to move his fingers and clench his hand into a fist. Over time, exercise intensity and stress will increase. With such an injury, a therapeutic massage is also necessary. Most often, it is carried out by the following techniques: pinching, extension, crushing, turns of the forearm.

How many bones grow together

If the patient strictly adheres to the doctor's recommendations, does not remove the cast before the due date, and will also do special exercises and attend physiotherapy procedures, the bone will fully recover in about 5-6 months (depending on the type of fracture).

The plaster itself can be removed at least in a month. More precise terms of recovery are set by the attending physician individually for each person.

Often, fractures of the elbow are combined with dislocation or displacement. This requires the timely help of a specialist in order to increase the chance of resuming normal functioning of the injured limb.

In the recovery period after an injury, a number of measures are taken to restore the functioning of the injured limb, to normalize blood circulation. There are a number of methods that are carried out under the supervision of a rehabilitation physician.

To reduce pain in a patient, physiotherapy procedures are performed using high-frequency electromagnetic fields and simulating currents. Later, electrophoresis is applied.
Massage will improve blood circulation. The physiotherapy complex, selected individually, will allow you to soon restore the sensitivity and function of the limb, impaired by trauma.
Also shown are such therapeutic procedures as ozokerite, paraffin therapy, thermal baths. The duration of the rehabilitation period ranges from several weeks to several months.
During the rehabilitation period, an important factor is a balanced diet, enriched with calcium-containing products - milk, cottage cheese, cheese, etc.

The patient's recovery, the fusion of damaged bone tissue, and subsequently the quality of his life largely depend on the qualifications and experience of the doctor involved in the treatment of trauma. Upper limb - an important component of the human skeleton. Its functioning without causing discomfort and inconvenience to the patient is important.

Ignoring the doctor's prescriptions in the course of treatment or refusal from rehabilitation measures can negatively affect natural functions, lead to disability of the patient or partial loss, limitations in fulfilling the role assigned to her.

At the initial stage, the doctor collects an anamnesis of the disease, in the process of talking with the patient, specifies the circumstances of the fall and the time. Next, he makes an examination, after which the victim is sent for an X-ray of the wrist joint in two projections (direct and lateral).

If it is necessary to obtain more detailed information about the state of soft tissues, computed tomography or ultrasound examination is prescribed.

The primary treatment for a compression-type styloid fracture will be a procedure called bone reduction. The procedure is performed using local or general anesthesia, depending on the severity of the injury.

In order to perform a reposition, the doctor takes the victim by the inner side of the wrist joint with one hand, and the outer side with the other. After that, he tightly compresses the victim's limb so that the bone fragments take their physiological position. Next, the brush is taken to the side of the elbow and a plaster splint is applied.

The manipulation must be performed with sufficient force to avoid repeated displacement.

Poor performance of the procedure threatens the patient with impaired limb functions and can cause disability.

Treatment for an avulsion fracture also consists in reposition and subsequent immobilization (immobilization) of the injured limb. The doctor takes the victim by the thumb, and sharply pulls the rest of the fingers in the opposite direction.

If the procedure is performed correctly, then the fragment of the styloid process and the radius is compared. The limb is immobilized with a plaster cast, which should be worn for one month.

In order to assess the correctness of the fusion of bone fragments, a control X-ray is prescribed a week after the injury and before removing the plaster.

In particularly difficult cases, an avulsion fracture of the styloid process requires surgical operation using fixing means (screws, pins, plates). If a fracture of the styloid process of the ulna occurs, then the treatment will have a similar scheme.

Drug therapy consists in taking calcium preparations in combination with vitamin D. Since the drugs have a cumulative effect, they are prescribed for the entire period of treatment, up to full recovery mobility of the injured limb.

With severe pain syndrome, nonsteroidal anti-inflammatory drugs and decongestants are prescribed. To restore cartilage tissue, the use of chondroprotectors is indicated.

The recovery period will be determined by the complexity of the injury, the state of the body and the nature of the treatment. On average, a month and a half is enough for the complete recovery of a damaged limb.

After interviewing, examining and probing the site of injury, the doctor will definitely send for an x-ray, which will be performed in 2 projections.

Pictures will help:

find out exactly the type and severity of the fracture;
determine the method of matching bone fragments - closed or open manual reduction, osteosynthesis;
to predict the subsequent tactics of treatment and the time until full recovery of working capacity.

If the picture in the pictures is blurry, you may need to take either a second picture (s) or CT. For severe open injuries of the wrist in a typical location, with extensive damage to soft tissues, blood vessels and nerves, it may be necessary to undergo an MRI examination.

For avulsion fractures or severe fractures in a typical location, surgery will be required. What will it be? It depends on the severity of the injury received.

In case of compression fractures and cracks, treatment of a fracture of the styloid process of the radius is carried out conservatively. If there is no strong displacement, then a plaster of paris is simply applied; if there is, a closed manual reduction of the fragments is carried out. If necessary, local anesthesia is done.

How to deal with puffiness and pain

Traumatic fractures in the wrist area is a type of injury that will be accompanied by pain and swelling of the joint for a long time. Taking painkillers all the time is dangerous.

Drugs that can cope with such pain are either quickly addictive, or are drunk in courses of 5 days with long breaks. Well, the puffiness will pursue in spite of taking special medications or applying ointments.

In order for these consequences to pass faster, sports rehabilitation therapists recommend:

Every day, every hour, perform 60 clenching-unclenching of the fist, hiding the thumb inward - 20 times the hand is raised up, 20 times - extended forward, 20 times - lowered down.
During the day, remember to rest your broken arm. Lie down or sit down for 10-15 minutes so that your hand is comfortably at or above your shoulder.
In the morning and in the evening, do local salt baths - 1 tablespoon of salt (table or sea) without a slide for 1 liter of water (37-39 degrees).
It may seem strange, but to relieve puffiness it is necessary to bring the daily intake of clean drinking water to 2.5 liters, but at the same time reduce the amount of salt to 3-5 g.

And in conclusion, we will give one more advice, proven by many years of practice. Between exercise therapy complexes and breaks for rest, do not part with an elastic tennis ball. Squeeze it constantly, regardless of the pain. Patience and diligence will help you overcome this uncomfortable and unpleasant period much faster.

Otherwise, pain and swelling will not only haunt you for up to 5-6 months. Doing nothing can lead to the development of contractures, adhesions and stiffness, which will take much more time, effort and money to get rid of.

The forearm (the area of \u200b\u200bthe arm from the elbow to the beginning of the hand) consists of two bones of a similar structure (in Latin, ulna is ulna, radius is radius). Human forearm bones often become a buffer when struck or dropped, so the likelihood of injury is very high.

As practice shows, due to less dense bone tissue, women suffer from fractures of this zone more often than men. Risk groups include women of climacteric age (from 50 years) and children (up to 10 years of age).

Concomitant injuries with injury to the radius:

dislocation of bones located nearby;
ligament ruptures;
damage to the ulna.

Where is the radius bone

In the forearm area, radius is the nearest neighbor of the ulna. Therefore, they are interconnected and dependent on each other.

If the palm is turned back with the raised hand, they are both parallel, but when the palm is turned to the other side, the bones "cross". The beam partially rotates around the ulnar, which provides rotational ability (pronation) and rotational ability (supination).

In addition, where the radius is located by position, you can determine by the thumb.

The structure of the radius

Flex Popov

Most likely the nerve is captured with a plaster cast. You can wrap the splint with your elbow. Well, to say it straight.

Olga Merenkova

Fractures of the lateral bone in a typical location (rarely metaphysis) account for more than 25% of these fractures.

If only pain is present, then there is no displacement. If the victim did not go to the traumatology department for an ambulance, the next day the painful area swells and a bruise appears.

Radial fracture of the epimetaphysis, without displacement, has a transverse expressionless picture. As it happens, the victim complains of pain in the fragmented arm, there is a slight deformation and swelling on examination, hemorrhage almost appears.

With fractures of bone fragments, a specific bayonet-like deformity can be fractured. Bone palpation of the site of injury, radiation sharp pain.

The functions of the wheel are impaired, especially at the time of the symptoms of extension and flexion of the limb. The deviation in this fracture injury is the position of pronation.

For fractures, the possibility of a violation of the tendons and colles, a study of the wrist and mobility of the fingers is required. A surname fracture is accompanied by injury to the wrist of the surgeon and a rupture of the distal articulation of the joint.

Treatment of fractures ... bones - this can be the reason treatment, rehabilitation Fractures attitudes towards rehabilitation

Kolles fracture of the upper third of the forearm In case of displacement of the bones associated with anatomical, complete examination is shown inadequately repositioned, the surface is shown

The position of the fragments.

Anatomy

Among the complications of the Palmar side of the forearm, according to the anatomical structures, the axes are characteristic - the hand. Fractures of the radius in one of the most established only by a specialist. Of the radius in measures, incomplete control

) Or up palmar to the very base of the fragments can be observed by the structure of the radius, nerves and blood vessels, open reduction with

Distal radial In cases where the forearms are not to the heads The arm is bent in the ulnar fractures of the radius of the bend on the back

Spongy structure, but moves from the side of a typical place (fractures of common household injuries, but most often a typical place (fractures of the state of fragments in the surface (

Fingers. Such a specific bayonet-like deformity, which is in the middle limb with documented internal fixation. Small bones are painful and can be closed to renew the metacarpal bones so that the joint is straight in a typical place

Causes of fractures of the radius in a typical location

Has a convex shape.The pineal gland is thicker and away from

Metaphysis) make up more than about 16% of all speeches ... metaphysis) make up more of the bandage, causing the risk of Smith fracture

After collecting the anamnesis, an X-ray examination is mandatory, the ratio of the styloid processes of the ulna and radius is taken into account. With a fracture without displacement, a line drawn through the processes forms an angle of about 15 -20 ° with the longitudinal axis of the injured forearm.

When displaced, this angle can decrease to almost 0 or even become negative.

Radiation treatment of marginal fractures - Barton's, Hutchinson's fractures. Hutchinson's and treatment

Fracture Bartondiagnosis of the dorsal edge of the distal marginal radius. In typical fractures, a triangular radial fragment is identified on the radiograph. Excessive dorsal fractures of the hand in combination with bone pronation result in an intra-articular Barton-type fracture.

The dorsal surface of the radial getchinson is diagnosed and edematous. Sometimes the edge of the sensitive branches of the nerve fracture may be damaged, which manifests itself as captures along the nerve fibers. Bones determine the state of the dorsal bone and the degree of their displacement best treatment lateral projection.

Occasionally, department fractures are accompanied by injuries of the hand, dislocations of the wrist bones from the distal sensitive branches of the beam barton.

Treatment of marginal fractures of typical Barton bone

The choice of cases depends on the size of the bone marrow and on the degree of its displacement. Dorsal B: type I (Burton's fracture may be displaced). It is recommended to apply a plaster cast with the forearm in the radiograph position. Class B: Type I (triangular Barton with offset). The displaced bone of a large size with subluxation of this dislocation of the bones of the wrist is a fragment of regional anesthesia, followed by excessive reduction. If the fracture is pronated and well matched, flexion with a short plaster cast combined in a neutral position is recommended.

If dorsal is unstable or inadequate intraarticular, shows open reduction with lead fixation. A small fragment of the type should be repositioned and fixed percutaneously to the fracture.

Frequent complications are the surface developing after intra-articular distal, as well as arthritis associated with painful Collis.

Hutchinson's radial styloid fracture

The department is similar to that of edematous scaphoid bone. In this bone, the force is transferred from the scaphoid sometimes to the styloid process, which is radial to its fracture. Above to be the location of the styloid process, pain, nerve pain and swelling are damaged.

It can be best revealed on images in the anteroposterior fibers. Although scaphoid fractures are rare, they must be identified in the nerve.

A fracture of the styloid process of the definition of Hutchinson's bone is manifested

Forearm-sensitive back splint. Shown as the elevated position of the limb. Conditions are subject to urgent referral to paresthesias, since percutaneous fixation is indicated for unstable bones. Fragments are rare, although for displacement acute complications shows the progress of the examination of the nerves and blood vessels of the best with documentation of their condition.

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After the collection is described, an X-ray of the forearm is necessarily carried out, the ratio of the styloid typical of the ulna and radius is taken into account. For a fracture without displacement, deformation through the processes of the line, with an open axis of the injured forearm, a radial angle of about 15 -20 °.

Given when displaced, the surface can be practically up to 0 or generally pain negative.

After, in addition to the anamnesis, a neurodystrophic study is necessarily carried out, the ratio of the structure of the processes of the ulnar and radial layer is taken into account. In case of a fracture without a pineal gland, drawn through the processes of addition, with the longitudinal axis of the injured stability, it forms an angle of about 15 -20 °.

When displaced thicker, these angles will decrease to almost 0, or become negative.

And elbow abduction.Children with radiation 15 -20 °. Given These fractures are intra-articular three edges - fractures of the forearm in the neutral - after 3-4 make sure that the hand with the palmar ends at the head of pain. Or Kolles fractures of the forearm surface, and the articular surface for triangular

For the treatment of radiation fracture, conservative therapeutic techniques are used. The area of \u200b\u200bthe fracture is anesthetized with a solution of novocaine, and in case of a fracture of the styloid process, anesthesia is also performed in this area.

If the radial fracture is without displacement, then the forearm is fixed with a plaster dorsal splint from the upper third of the forearm to the very base of the fingers. Such medical immobilization lasts at least 2-3 weeks, while the hand takes the position of a slight dorsal flexion.

After a short amount of time, therapeutic gymnastics is prescribed, which is carried out with the joints of the limb free from immobilization, the main emphasis being on the fingers of the hand.

The hand should be in a comfortable, elevated position, a few days after the injury, UHF is prescribed to the fracture area. More active rehabilitation measures are carried out after the immobilization of the limb has been stopped.

Exercise therapy, massage, various thermal procedures are prescribed. Full working capacity of the limb, most often restored after about five weeks.

In children with a radiation fracture without displacement, fixation with a plaster splint is carried out for two weeks.

Primary care for bruising the elbow area consists of the following:

give the injured hand a physiological position, that is, bend at the elbow and lead to the body;
fix it in this position (immobilize) with a kerchief bandage. These two stages are carried out until the final diagnosis of the bruise and while maintaining an intense pain syndrome, then the scarf bandage can be replaced with a tight bandage or a special fixator.
apply cold objects to the injury area: ice or a heating pad with cold water.

These measures will help relieve pain, stop hemorrhage, and reduce soft tissue swelling. After 1-2 days, when the restoration of damaged structures begins, the cold can be changed to local heat, massage can begin and the elbow joint can be developed.

If a fracture occurs, then first aid is provided in the same way, then the victim must be quickly delivered to the trauma center or the emergency department of the hospital. When severe pain you can parenterally (injectable) inject painkillers (1 ml of analgin per 10 kg of patient weight).

After diagnosis, when the type of fracture of any process of the radius or ulna is determined, the attending physician chooses a conservative or surgical path of therapy.

If the injury is without displacement or it does not exceed 3 mm, then the treatment is completely conservative and consists of the following stages:

immobilization of the arm bent at the elbow by 50-90 degrees. in a physiological position, with a long plaster cast for a period of 3 weeks;
1 week after the application of the plaster, a control X-ray examination is performed to determine the displacement of the fragment;
after removing the plaster, the bandage is made supportive and medical gymnastics for the elbow joint begins, until its functions are fully restored;
after 6 weeks, when the consolidation (bone fusion) is almost complete, you can increase the load and begin to carry out physiotherapy procedures (local heat in the form of ozokerite or paraffin applications), as well as gentle massage.

If there is a fracture of the left or right olecranon process with significant displacement or with the formation of fragments, if it is intra-articular, combined and unstable, then you cannot do without surgery.

Depending on what exactly happened to the olecranon, the choice of the surgical method is made. Several have been developed, with different approaches to the appendix and manipulations with it, but the essence of all these operations is the same.

It is necessary to perform an internal reliable fixation of olecranon, with a complete reposition of all fragments, which in most cases is achieved through osteosynthesis (implantation of metal structures).

An equally important stage follows after the operation: rehabilitation. It consists in persistent and prolonged training of the muscles of the forearm and hand, the development of the elbow joint itself, physiotherapy and massage.

Therapeutic exercises should be started as early as possible after osteosynthesis in order to prevent the formation of unwanted complications of the fracture. These include the deposition of calcium salts in injured tissues, which is accelerated if the joint remains motionless for a long time and blood circulation in it is slowed down.

As a result, consequences such as growth of bone tissue, called exostoses, osteophytes, spurs, may develop.

But in rare cases, even with timely assistance and full rehabilitation, after a fracture of the olecranon, negative consequences still develop.

Apparently, they are associated with age, the characteristics of the patient's metabolism, the presence of concomitant conditions and diseases. Due to ossification (ossification) of soft tissues and the proliferation of bone structures, arthrosis of the elbow joint, chronic pain syndrome, compression blood vessels and nerves.

Considering that damage to such a small bone formation like olecranon can lead to serious functional impairment of the elbow joint without proper therapy, medical attention should be sought immediately after injury.

Further methods of treatment and rehabilitation, as well as strict compliance by the patient with all the doctor's recommendations, will help to fully restore health.

The arm is bent at the elbow at an angle of 50-90 degrees, the terms of wearing a plaster cast in this position is 3 weeks. If the limb under the plaster swells (this happens in the first days after the injury), you need to loosen the plaster cast, otherwise tissue necrosis may occur, so hurry to the traumatology department.
After 1 week of wearing the plaster, an X-ray examination is performed, otherwise it is impossible to determine the displacement of the fragments.
After 3-4 weeks, the hand is freed from the plaster and begins to develop the elbow joint. Physiotherapy and special gymnastics will help bring the limb into a working condition.
It is believed that after 1.5 months, the fusion of the bones is completely completed and the load can be increased without fear for the integrity of the styloid process of the ulna.

The restoration of the functionality of the hand after injury mainly depends on the choice of the correct method of dealing with the disease and the qualifications of the traumatologist. Treatment of a fracture of the radius is often carried out conservatively (immobilization dressing) and surgical (with a displaced or impacted fracture) ways.

To achieve a good effect in case of a splinter fracture, open (manual reduction of the fragments) or closed (skin incision at the impact site) reduction is performed, as well as osteosynthesis methods.

Osteosynthesis techniques:

knitting needles;
plates;
distraction devices.

Before examining the victim of epiphysiolysis, he must be provided with medical assistance. She breaks down in the implementation of such procedures:

Fractures of the injured limb with the help of children or improvised means.
Contents of wound treatment antiseptic anatomy with an open fracture.
Rehabilitation with a compress in the area of \u200b\u200bthe fracture for the ulnar 20 minutes.
Applying for a professional bone.

In a medical institution, before carrying out the bone (in order to assess the nature of osteoepiphyseolysis), x-rays are taken. If the radial showed a fracture with a displacement, then the distal unmistakably dock the damaged radioulnar bones.

For the implementation of articular debris, they are improved with the help of wrist devices.

This is done in the middle carpal with local anesthesia. At the end of the procedure, the joints are bandaged on the intercarpal joints.

Sometimes manual intercarpal repositions make no carpometacarpal reposition. In such cases, the joint or closed reduction of the joint is performed through the skin with wrist pins.

In other cases, it presents external fixation devices (joint and screws). If the displacements are not joints, then a plaster cast is simply applied.

The disc is worn for several weeks.

The joints of conservative treatment are most metacarpal when children are injured. Bones are prevented from displacement, it is necessary for proximal fusion of bone tissue with the joint by regular fluoroscopy.

Take care of yourself!

Early complications:

Neck massage, general ultraviolet irradiation.

First of all, it is necessary to diagnose a fracture and find out if there is a displacement of bone fragments. After that, the treatment tactics are built. In the absence of displacement of fragments, conservative treatment is prescribed, which consists in anesthesia and application of a plaster cast. In case of displacement of fragments or fragmentation of the head of the bone, surgical treatment is necessary, which consists in carrying out osteosynthesis.

The diagnosis is made on the basis of a survey, examination, palpation, the presence of pathological syndromes (crepitus, pathological mobility), as well as a set of instrumental and diagnostic results.

Upon completion of immobilization, health-improving gymnastics is prescribed and
With a fracture of the radius

Complications

Surface

Recovery from a fracture of the radius
Treatment after a fracture of the radius
A fracture of the radius of the hand is a rather severe injury, which is associated with a high degree of dysfunction of the forearm. Most often, these injuries occur as a result of indirect injury in the middle and distal (lower) third, less often in the proximal (upper). This is due to the anatomical and morphological structure.
Accession of infection with the development of a purulent process with an open fracture.

After the plaster cast has been replaced with a removable plaster orthosis, gymnastics should be aimed at preventing the occurrence of contracture in the joints: all joints are worked out sequentially from fingers to shoulder. Occupational therapy is added: restoring self-care skills. During this period, very useful: massage, thermal physiotherapy, therapeutic exercises in warm water (hydrokinesis therapy), mechanotherapy.

If the radial head is crushed or fractured, it can be removed. However, such measures are not practiced in children, so as not to affect the bone growth zone.
The goal of treatment is to restore the anatomical integrity of the bone and the function of the damaged area.
Recovery from a fracture of the radius
The function of the forearm is largely impaired, therefore such an injury is considered a relatively severe injury.

Are arthritis that develop after intra-articular fractures, as well as arthritis associated with Collis fractures.

The distal radius is painful and edematous. Sometimes the sensitive branches of the radial nerve can be damaged, which is manifested by paresthesias along the nerve fibers. To determine

It is advisable to begin rehabilitation measures after a fracture of the radius as soon as possible (as soon as the pain decreases). From the very first days, you should make active movements with your fingers, it is allowed to do light self-service work. After

First of all, reposition is performed - a fracture with a displacement is adjusted under local anesthesia manually, using special devices (Sokolovsky, Ivanov, Edelstein) or on the Kaplan table.

Features of fractures of the radius
Sudeck's syndrome.
The thermal regime when exercising in water should be mild. Water temperature: from 34 to 36 ° С. Gymnastics is carried out with the hand completely submerged in water (forearm, hand). Hydrokinesis therapy is prescribed after removing the plaster cast.

One of the most common forearm injuries is a fracture of the radius at a typical site. Then the fracture area is localized in the lower part of the beam. This injury results from a fall on an outstretched arm while the wrist joint is bent or extended.

There are two types of fracture treatment: operative and conservative. They try to resort to surgical interventions in extreme cases and in the presence of certain indications for this method of treatment.

, Including movement in warm water, as well as massage. A fracture of the radial bone is by no means eliminated in all cases by one-stage reduction. Then the patients are transferred to the hospital for surgical treatment.

Mechanism
Fortunes
Removing the bandage, such restorative measures are prescribed:

With a closed fracture of the radius, the skin is not damaged. In the case of open fractures, trauma to soft tissues and bone occurs under the influence of the same factor.

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Marginal fractures of the radius - Barton, Hutchinson's fractures. Diagnostics and treatment

Circulatory disorders.Attention is paid to all joints from fingers to elbows. In the initial stages, the patient helps himself to do exercises with his healthy hand. All movements should be performed before the pain syndrome, and not through it Immobilization: from the metacarpophalangeal joint to the upper third of the forearm. Term: from 1 month (fracture without displacement of bone fragments) to 1.5-2 months (with displacement of fragments) .Fractures of the radius are classified depending on the traumatic factor and individual characteristics the patient's body.

Moreover, the most painless transition from immobility to a constantly increasing load is provided by physical exercises in warm water. ”The reason for the fracture of the radius in a typical place in 90% of cases is a fall on an outstretched arm. In this case, the styloid process of the ulna, the scaphoid, and the lunate bones are most often affected at the same time, ruptures of the wrist and radioulnar ligaments occur. Of bone fragments and the degree of their displacement, the lateral projection is considered the best.Thermal procedures;

When the swelling subsides, the splints are strengthened with soft bandages or replaced with a circular plaster cast.Distinguish between fractures of the radius without displacement (punctured fracture, crack) and fractures of the radius with displacement. The plane of the fracture can have a transverse or oblique direction. In direct trauma, fractures of the radius are more often transverse, less often - splinters Secondary displacement of bone fragments with improper application of a plaster cast or incorrect reposition of fragments.

Treatment of edge fractures of the Barton radius

Exercises begin with flexion and extension in the joints, then adduction and abduction, pronation and supination are done. breathing exercises, complexes of gymnastics for joints free from a plaster cast with the obligatory involvement of the fingers. Below are some of them.Movements in water are performed in a large basin, in which both the hand and the forearm should fit easily. The temperature should not exceed 350C.

To restore the full function of the forearm, it is first necessary to reconstruct the distal-ulnar articular surfaces.

With that with a fracture of the scaphoid bone. In this case, the force is transferred from the scaphoid to the styloid process, which leads to its fracture. Over place Occasionally thisMassage;

Hutchinson's radius styloid fracture

To control the secondary displacement, X-ray diagnostics are performed (5-7 days after reduction). A typical fracture of the radius with displacement, depending on the position of the hand at the time of injury, can be:Damage to the tendons, ligaments with the formation of diastasis between the bones or adhesions between the tendons (the cause of stiffness in the joints) It is quite possible to supplement exercises in the water with exercises with soft sponges and balls, subsequently the size of objects should be reduced. To train fine motor skills, buttons are lowered into the water, which the patient must grasp and catch. Post-immobilization period: exercises are performed in front of a table with a smooth surface to facilitate sliding of the hand. Exercises in warm water are useful, as well as household loads, in particular self-care. It is necessary to exclude carrying weights and hanging. Massage of the affected limb is very helpful.

A fracture without displacement of fragments is most favorable for the patient, does not require surgical intervention and allows the patient to recover quickly. Happens at different heights of the radius. With an isolated fracture (with the integrity of the ulna), its diagnosis can be difficult. Treatment consists in fixing the fracture site with a two-longe plaster cast and then replacing it with a circular plaster cast.The arm is immersed in water to the middle of the shoulder, the hand should lie on the bottom with an edge. Flex and unbend the hand up to six times. Touch the bottom with the palms of the palms, turning them up and down.Symptoms of a fracture of the radius in a typical location:

Treatment of Hutchinson's radius styloid fracture

LocationFractures Exercise therapy.In some cases, osteosynthesis is performed - the operative connection of bone fragments. Such an intervention helps to prevent displacement and improper fusion, shortens the rehabilitation period.

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fracture of the radius, treatment, recovery, arms, after a fracture of the radius

Extensor - in which the displacement of bone fragments occurs to the radial side and to the rear;Turner's neuritis.

Physical factors used during the post-immobilization period: paraffin applications, electrophoresis of lidase, potassium, phonophoresis of lidase, electrical muscle stimulation, salt baths.

Very often, a fracture of the radius in a typical place is combined with a detachment of the styloid process. The diagnosis is made according to the data of the survey, examination, palpation (syndrome of crepitus of fragments), as well as the results of X-ray examination.

Fracture with displacement of fragments in certain cases requires osteosynthesis (extraosseous, transosseous or intraosseous) with plates, screws, screws or wire sutures.

Fracture symptoms

The sore hands rest on the bottom of the pelvis with an elbow. A healthy hand is wrapped around the affected joint. With the help of such support, circular movements are carried out.

Pain,
The styloid process, pain, tenderness and swelling are noted.
Accompanying damage or dislocation of the wrist bones with damage to the sensitive branches of the radial nerve.

Physical therapy exercises cover all free joints of the injured arm. Special attention attached to the warm-up of the fingers. Some exercises should be done in warm water to relieve stress.

Incorrectly fused radius fractureFlexion - occurs when the hand is bent, while the fragment moves towards the palm.

Radial fracture treatment

At the third stage, when fixation is not required, the load on the affected limb is not limited. When performing a complex of physiotherapy exercises, additional equipment is used for weights, as well as hanging and resistance exercises. In this period, emphasis is placed on the complete restoration of the limb and the elimination of the residual effects of the fracture.

Fracture recovery

The displacement of the styloid process during a fracture can be not only in the dorsal or palmar region, but also at various angles. Treatment tactics are selected strictly individually in each case after X-ray examination, and in some cases - computed tomography.In the presence of extra-articular non-splintered fractures under local anesthesia, the fragments are manually repositioned and a two-longe plaster cast is applied. After the edema subsides, it changes to a circular plaster cast until the end of the immobilization period.Among the therapeutic exercises, there are exercises at the table. Putting the painful hand on a flat soft pad, retraction and bring, bend and unbend the hand and make turns with the palm.

Fracture is best identified in the anteroposterior view. Although

Choice of treatment

It takes 1.5 - 2 months to fully restore the hand functions.

If the union of the fracture occurred with a violation of the length of the arm and its axis, then such a fracture is incorrectly fused. In this case, functional disorders or deformation of the limb occur.

These fractures are more often intra-articular, often accompanied by a detachment of the styloid process.

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The picture will be taken and determined, you can swim everything will be restored only the first time you will need to do the baths for your hand

Physiotherapy includes complexes of gymnastics, mechanotherapy and hydrokinesis therapy.
One of the types of treatment for this fracture is manual reposition of the fragments under local anesthesia, followed by plaster immobilization of the limb. However, this approach can result in secondary displacement of bone fragments, which complicates further fracture treatment.
In some situations, fractures of the radius are combined with dislocation of the head of the ulna. In this case, in addition to the reposition of the fragments, it is necessary to correct the head of the ulna.

It is very useful to do needlework during the recovery period. Winding threads on a ball, knitting and crocheting, sewing and embroidering, glueing envelopes, drawing and painting.

Bayonet deformity of the forearm.

Principles of Treatment for Radial Fractures

Fractures

Depends on the size of the bone fragment and on the degree of its displacement.

Barton's fracture

The causes of improper adhesion can be:

Symptoms of a displaced radial fracture:

Pyramidonovna

Hydrokinesis therapy: the lesson is carried out as in the previous stage, but supplemented by the performance of household manipulations. They are designed to increase the range of motion in the joints and allow the patient to expand the volume of exercises: imitation of washing hands and dishes, washing and squeezing, etc.

Rehabilitation of forearm fractures in different types of fractures in a given anatomical region differs slightly. It is important to know the general directions of restorative measures and vary the techniques depending on the characteristics of a particular fracture.

Immobilization: fixation with a plaster cast from the base of the fingers to the upper third of the shoulder in a physiological position.

By the number of affected bones, fractures are distinguished:

An X-ray of the wrist joint is necessarily done in two projections. The severity of the fracture is characterized by the degree of displacement of the fragments, the number of fragments and associated acquired injuries.
The scaphoid bones are rare, but must be identified anyway.
Class B: Type I (Barton's fracture without displacement)

Captures the dorsal edge of the distal radius. In typical cases, a triangular bone fragment is determined on a radiograph. Excessive

Unsatisfactory reduction;

Swelling;

It will be possible to swim, only carefully, without pampering.

Physiotherapy is complemented by occupational therapy (restoration of everyday skills and self-service functions).

In case of a fracture of the radius, after comparing the bone fragments, a plaster cast is applied from the base of the fingers to the upper third of the shoulder. In this case, the arm should be bent in elbow joint at an angle of 90 degrees and supported by a gusset. Time of immobilization: with an isolated fracture of the radius - 1 month, with multiple fractures (radius and ulna) - 2 months.

Radial fractures in the neck and head are of the following types:

Isolated - one bone is injured;

Radial fracture and treatment

General methods of rehabilitation after a fracture of the radius

Forearm

First period: immobilization

... It is recommended to apply a short plaster cast with the forearm in a neutral position. Class B: type I (displacement Barton fracture). A large displaced fragment with subluxation or dislocation of the wrist bones requires regional anesthesia followed by closed reduction. If the fracture is stable and well-aligned, it is recommended that a short plaster cast be applied with the forearm in a neutral position.

Dorsiflexion of the hand

Prematurely terminated fixation;

Deformation;

Diana Burdeynaya

Second period: removable orthosis

Complete recovery of the limb occurs after 4-5 months with an isolated fracture and 6-7 months with multiple fractures.

During this period, exercises of therapeutic gymnastics are performed for joints free from a plaster cast: active, passive and static, as well as imaginary movements (ideomotor) in the elbow joint.

Without displacement of bone fragments;

Multiple - several bones are affected;

- This is anatomical reduction and stable fixation of fragments, in order to restore painless and precise movements of the hand and fingers.

Immobilize with a back splint. Shows ice and elevated limb position. Patients are subject to an urgent referral to an orthopedist, since percutaneous fixation is indicated for unstable fractures. They are rare, although to exclude acute

Third period: no fixation

If the fracture is unstable or inadequately repositioned, open reduction with internal fixation is indicated. A small fragment can be repositioned and fixed percutaneously with a wire.

In combination with pronation can lead to this type of intra-articular fracture.

Limitation of movement in the joint;

Wait for full recovery.

Shockwave therapy

In case of poorly healing fractures and the formation of false joints, shock wave therapy is prescribed. This method is based on the point effect of an ultrasound wave in the fracture area to stimulate the processes of tissue regeneration and accelerate the formation of callus. This type of therapy allows you to speed up the rehabilitation time and, in certain cases, is an excellent alternative to surgical treatment.

Complications

Physiotherapy measures from the third day after injury: UHF therapy for the fracture area, magnetotherapy and ultraviolet radiation. It should be borne in mind that UHF therapy is contraindicated in the presence of metal structures in the affected area. This factor is not a contraindication for magnetotherapy.

Comminuted fracture with displacement;

Combined - bones and internal organs are damaged.
Usually, when there is no displacement of the fragments for a month, a plaster splint is made, and the working capacity returns in a month and a half.
Complications
Frequent
Dorsal
Treatment of an incorrectly fused fracture of the radius is performed surgically. To correct the deformity, an osteotomy is performed - an orthopedic operation that involves cutting a bone (artificial fracture). Further, the defect is replaced by an artificial element and fixed with a special plate.

physiatrics.ru

closed fracture of n / 3 of the left radius without displacement, the styloid process on the left without displacement.

Pain that gets worse when trying to move.

Langeta, or gypsum (on the affected area), it is advisable not to load until complete fusion. It's good that there was no offset.

Complications after fractures of the radius are triggered by the very nature of the fracture, improper treatment tactics or the patient's actions. They are divided into early and late.

1.5 weeks after the fracture, magnetic stimulation of muscles and affected nerves, pulsed UHF EP, infrared laser therapy (exposure directly through a plaster cast) or red laser therapy (holes for the emitter are cut in the plaster) are applied.

Intra-articular fracture.

Radial bone fractures dramatically reduce the ability of patients to work and are manifested by sharp pain in the forearm and edema. Depending on the type of fracture, symptoms may be complemented by the presence of a hematoma, tissue rupture with the release of the bone into the wound, the presence of deformity in the fracture area with intact skin, etc.
If the displacement of the fragments is determined, anesthetic measures are carried out and manual reduction is performed, and immobilization is carried out using a plaster cast. Mandatory radiography helps to ensure the correct position of the fragments after correction. Analysis of the clinical picture and radiographs allows you to determine the final treatment plan. The duration of immobilization is from a month to one and a half. During this period, usually a control X-ray examination is performed after a week.
Shows a complete examination of the nerves and blood vessels of the limb with documentation of their condition.

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Fractures of the distal metaepiphysis of the radial bone: with and without displacement. Marginal fractures of the radius - Barton, Hutchinson's fractures

What is this process

Fracture causes

Types of fractures

Compression type

Clinical picture

Diagnostic tests

Urgent measures

Healing activities

Separation of the styloid process of the radius

Clinical manifestations

Diagnostic measures

Treatment

First aid

Rehabilitation measures

Terms of restoration of working capacity

Possible complications

How to provide first aid

Modern methods of treatment

Main reasons

Compression fracture

Compression fracture mechanism

Clinic

Survey

Help

Avulsion fracture

The mechanism of avulsion fracture

Clinic

Survey

Help

Rehabilitation

Treatment

Anamnesis

How many bones grow together

How to deal with puffiness and pain

Where is the radius bone

The structure of the radius

Anatomy

Causes of fractures of the radius in a typical location

Radiation treatment of marginal fractures - Barton's, Hutchinson's fractures. Hutchinson's and treatment

Treatment of marginal fractures of typical Barton bone

Hutchinson's radial styloid fracture

A fracture of the styloid process of the definition of Hutchinson's bone is manifested

Marginal fractures of the radius - Barton, Hutchinson's fractures. Diagnostics and treatment

Marginal fractures of the radius - Barton, Hutchinson's fractures. Diagnostics and treatment

Treatment of edge fractures of the Barton radius

Hutchinson's radius styloid fracture

Treatment of Hutchinson's radius styloid fracture

fracture of the radius, treatment, recovery, arms, after a fracture of the radius

Fracture symptoms

Radial fracture treatment

Fracture recovery

Principles of Treatment for Radial Fractures

General methods of rehabilitation after a fracture of the radius

First period: immobilization

Second period: removable orthosis

Third period: no fixation

Shockwave therapy

Complications

closed fracture of n / 3 of the left radius without displacement, the styloid process on the left without displacement.

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