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Fracture of the forearm with displacement

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Fracture of the bones of the forearm are the most common injury of the skeleton. According to statistics, the incidence of such injuries is 11% -30% of the total number of closed fractures and fractures of the diaphysis (body) bones of the forearm accounted for 53.5% of the injuries to the bones of the upper limbs. To get injured maybe elderly, and the young man and the child.

A little anatomy. Forearm is formed on the basis of two bones: the ulna and radius. Among themselves they are connected by the interosseous membrane. To determine the location of these bones just on the side of the little finger is the ulna, and beam – on the opposite, there where your thumb. Can break one bone or both. The severity of the fracture and its treatment directly depends on which part of the damaged bones of the forearm: the upper third, middle or bottom.


The symptoms of fracture of the forearm

Signs of this damage depends on what kind of fracture had to face.

  • Body fractures of the ulna. Human movement is limited. Observed deformation and swelling. Squeezing and probing of the forearm causes severe pain.

  • A distal radius fracture. Forearm strain, the patient experiences a sharp pain on palpation of the affected area, the observed mobility of fragments. People cannot actively rotate the forearm.
  • Fracture of the diaphysis of both bones. Common injury, almost always accompanied by displacement of fragments of bones. Pronounced shortening and deformity of the forearm. Usually the injured person holds the injured limb with his good hand. Probing, lateral compression of the forearm causes intense pain all over with amplification at the site of fracture. Observed mobility of fragments.
  • The fracture of a radial bone in a typical place. This injury is specific to older women. The wrist area of the forearm swollen. Visible deformation. Axial load and probing causes a lot of pain. Can be detected by the violation of the sensitivity in the fourth finger, which indicates concomitant damage to the nervousbranches.

Common causes of fracture of the forearm

Break the bones of the forearm can be the result:

  • fall on the upper limb, bent at the elbow or a blow to the area;
  • direct blow to the forearm;
  • falling on a straight arm;
  • impact protection bent and raised arm;
  • fall on the hand resting on the palm of the hand, or rarely, on the back of the hand;
  • sharp angular deformity of the forearm.

Diagnosis

For diagnosis the doctor enough clinical examination (visual inspection, probing the localization of the injury) and the results of radiographic studies.


Treatment of fractures of the forearm

With isolated diaphyseal displaced fracture of the ulnar and radial bones, treatment begins with reduction. This procedure is necessary for all types of fractures with displacement. Its detailed description is below.

When the repositioning is carried out on bent forearm of the patient is superimposed plaster splint, which should capture the region radiocarpal and elbow joints. A period of immobilization with the fracture of the ulna is 4-6 weeks radius from five to six weeks.

Treatment of fracture of the forearm with displacement of fragments of bones to this day is one of the most difficult problems of modern traumatology. Simultaneously reposition when such localization of the fracture is extremely complex. More difficult prolonged retention of fragments of bones in the correct position.

Repositioning begins with a study of radiographs. It can be done manually or by using special apparatus and is performed under local anesthesia.

For rotational installation of fragments is tension, then the surgeon manually maps the ends of broken bones. After remaining thrust in the position achieved by repositioning, the damaged area is applied splints. To check the results perform radiographic. If the reposition is successful, then the armband is converted into circularly.

If the patient has massive edema, splints remains before his disappearance. When the swelling's gone down, the patient needs a follow-up x-rays to prevent re-displacement of fragments of bones. Then you can impose a circular plaster bandage for 10-12 days.

Starting from the second day, the patient will have to move your fingers, and 3-4 days is the shoulder joint. In addition, the patient must learn to perform rhythmic relaxation and muscle tensionforearm, concealed plaster cast.

At the end of the period of immobilization plaster cast is removed and the patient is prescribed physiotherapy and physical therapy. The average period of rehabilitation between 12 and 14 weeks.

However, in the vast majority of cases, the doctors resort to surgical treatment of such fractures, as removal of all primary offsets and secondary prevention is often not possible. The problem is that due to the tension of the interosseous membrane fragments ulna and radius are still closing.

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Surgical treatment consists in carrying out open reduction and osteosynthesis. The operation is best done on the second-fourth day after the injury. It is performed under General anesthesia.

Access to the bones is provided by two independent slits. First, surgery is performed on the ulna. Allocate all of its fragments and release, followed by osteosynthesis with metal clamps (metal plates, rods, wires, wire joints, etc.). Then carried out a similar manipulation on the radius.

The completion of osteosynthesis on the bent at a right angle limb is superimposed plaster bandage. Usually a period of immobilization is 10-12 weeks, sometimes it can increase.

After the bandage is removed, the patient is appointed gymnastics, massage, physio - and hydrotherapy. The rehabilitation takes from 14 to 18 weeks.