Why follow up after repositioning? Reposition of the radius with displacement

Injuries to the distal metaepiphysis (DME) of the radius account for over 16% of all pathologies of the skeletal system. Fractures of the radius are common in all age groups, but women over 45 years of age are common victims of injury. Doctors attribute this to a weakening of the skeletal system and hormonal changes. A fracture of the radius in a typical location is not a dangerous disorder, but the speed of recovery is determined by the individual characteristics of the body and the age of the victim.

Classification

A fracture of the distal metaepiphysis is often accompanied by complications. These include the presence of many fragments and their displacement relative to each other, damage to the muscles of the nerve fibers. A comminuted fracture of the radius is aggravated by muscle activity - arm movement is accompanied by muscle tension. Each pulls the fragments in its own direction, the functions of the limb are impaired. Damage to the lower third of the radius is often accompanied by dislocation.

The most common fracture is the radial head. It occurs when a fall occurs with simultaneous movement of the forearm. Trauma is typical for the distal head. This type of damage can be regional or central. Among fractures of the radius in a typical location, a special place is occupied by injuries that split the bone in half. Another group of injuries includes fractures of the neck of the radius, and in childhood, injuries to the periosteum with pathology of the growth plates are observed.

Among displaced fractures, the impacted fracture stands apart. It occurs due to a fall on the hands, when one bone seems to enter another. The two elements form a single bone with a connection at the bend. Often this is a closed fracture of the radius without significant soft tissue contusion.

Injuries to the left hand account for fewer injuries, and intra-articular fractures of the right bone are observed more often due to the fact that the hand is the leading one, that is, the supporting one. With reverse recoil, a fracture of the styloid process occurs.

According to the specifics of injuries, they are distinguished:

• oblique injuries - occur when falling on a bent palm;
• spiral - characterized by displacement as a result of bone movement;
• longitudinal - are the result of compression effects;
• transverse - occur due to a direct blow.

A closed fracture of the radius without displacement is characterized by bruises, but without tissue rupture. An open fracture is quite common and is accompanied by displacement of fragments.

Trauma code according to ICD 10

In the international classifier, such injuries are assigned code S52. For a fracture of the radial head, S52.1 is assigned. If there is an injury to the diaphysis of the ulna or radius, then codes S52.2 and S52.3 are assigned, respectively. Other types of unspecified damage are designated S52.9.

Causes

Injuries can occur due to accidents, failure to comply with safety regulations at work, or due to negligence. The majority of fractures occur as a result of falls. If there was a fall with support on the palms, then they arise. In the event of a direct blow, a fracture of the radius bone of the arm in the middle is guaranteed. Among the most common causes of injury:

• falling of a heavy object onto an outstretched arm;
• gunshot wounds;
• osteoporosis and bone diseases;
• extreme sport;
• calcium deficiency in the body.

Pathological injuries occur as a result of exposure to minor forces. In such cases, the bones are destroyed even with slight compression. Endocrine disorders, oncology, and osteomyelitis can cause weakening of bones. Fractures of the styloid process of the radius and damage to part of the hand are observed due to some resistance upon impact. A driven fracture occurs as a result of significant force or a fall from a great height.

The causes and types of fracture determine the symptoms and first aid. with displaced fragments are accompanied by severe pain and are more difficult to treat. These fractures occur as a result of serious accidents or while working with heavy equipment.

Symptoms

Hand injuries are often combined with dislocations, bruises, and hemorrhages. One of the most characteristic signs of destruction of the integrity of bone tissue is deformation of the limb. In some cases, cracks in the bone diaphysis occur. In this case, the anatomical shape of the hand is preserved. Signs of a fracture include:

• swelling and swelling at the site of injury;
• pain on palpation and movement;
• hematomas;
• decrease in blood pressure.

If the arm is swollen, this is not always a symptom of a fracture. This is how a bruise or... When numbness is added to the swelling of the arm after a fracture of the radius, damage to nerve fibers and muscle tissue is possible. The symptoms of an open fracture are more pronounced. Rupture of blood vessels and skin increases the risk of infection. In this case, the fingers also become numb and the bone is severely deformed.

A fracture of the radial head leads to pathological mobility and crepitus. Swelling in the area of ​​the injury may spread to the entire arm. The functioning of the limb is severely limited. If accompanied by rupture of blood vessels, then it is not possible to feel the pulse in the artery.

Due to a violation of the outflow of venous blood, the hand may turn blue. This condition is especially dangerous as soft tissues and blood vessels begin to die.

Symptoms largely depend on the location of the fracture. With an impaction injury, the injured limb becomes shorter. The functions of the entire arm are impaired, the patient cannot move his fingers, or efforts are difficult for him and result in unbearable pain. The situation is aggravated with fragmented trauma. Thus, fragments destroy internal tissues and damage blood vessels. It is necessary to minimize the negative effect of the traumatic factor on the bone and provide adequate assistance to the victim.

First aid

With minimal trauma, the patient can be transported to a medical aid station independently. In case of serious injury, an ambulance is called. Before the arrival of specialists, the injured arm is immobilized. Basic care and rehabilitation are carried out in a hospital setting. On the spot, you can give the victim a pain reliever and apply ice to reduce swelling.

First aid for suspected fractures involves fixing the elbow. All jewelry should be removed from the hand; the hand should be held at an angle, unless we are talking about an impacted fracture of the radius and ulna. Select a suitable splint, apply it from the elbow to and bandage it. In case of damage to the hand, a splint will help out.

If a fracture of the head of the radial bone is accompanied by a rupture of the skin, then antiseptic treatment is carried out, which avoids infection. In case of an open injury, protruding fragments stick out, but no manipulations can be performed with them, otherwise the fragments will move.

To prevent complications from arising after a fracture of the radius, it is necessary to provide rest to the limbs. When the vessels and nerves of the forearm are damaged, arterial or venous bleeding may occur. In the first case, you cannot do without applying a tourniquet. For a thief, a pressure bandage is enough. To avoid possible consequences, the victim is urgently taken to the hospital. The tourniquet is not left on the limb for long, since necrosis begins after 2 hours of bleeding.

Diagnostics

The main method of instrumental diagnosis for a fracture of the radius in a typical location is radiography. In the photographs in two projections it is possible to see the localization of the damage and associated injuries. X-ray diagnosis of radial bone fractures is considered an informative method, on the basis of which the optimal treatment is selected.

The traumatologist palpates the arm, assesses the condition of the muscular and vascular systems, and feels the pulse. MRI is recommended for suspected distal epimetaphyseal fractures with extensive damage to the radius. Ultrasound is prescribed for hematomas and edema to detect blood accumulation.

CT and radioscopy are considered informative methods. With their help, it is possible to see accompanying disorders and the smallest defects, which eliminates diagnostic errors.

Treatment

Only a traumatologist can tell you how to cure a fracture in a specific situation. You should not rely on folk remedies to treat a fracture. Due to the lack of qualified assistance, complications arise. A consolidated fracture is a typical manifestation of inadequate therapy. As a result, the fragments splice on their own, but not always correctly, which is why. It reduces the functionality of the hand and makes the bone tissue vulnerable. Due to improper fusion, contracture occurs - stiffness or complete immobility.

For uncomplicated wounds, closed reduction of the fragments is performed, followed by the application of plaster. This is the most common treatment for radius fractures. The fragments are compared under radiological control, which eliminates errors and improper fusion. Plaster application is carried out after reposition. The arm is bent at the elbow and brought towards the body. Further treatment takes place at home.

An avulsion type fracture of the styloid process requires precision in the comparison of fragments. Fracture reduction may be open if the injury passes through the joint. The main treatment method is long-term immobilization with X-ray control. During surgical reduction, an orthosis rather than a cast is used.

Surgical treatment

It is injuries to the styloid process of the radius that often require surgical treatment. The operation involves fixing the fragments with screws or plates. With severe fragmentation, not all the fragments can be collected. In this case, part of the bone is artificially grown.

Indications for the operation are:

• associated damage to blood vessels, muscles, nerves;
• comminuted fracture of the radius with significant displacement;
• fracture of the radial head with dislocation;
• improperly healed fracture.

One of the methods of surgical treatment is restoration of the radius using the Ilizarov apparatus. After the operation, the needles remain in the hand. They are removed after the fragments have fused. Repeated surgery is required if the reduction is incorrect. In this case, the healing time of the displaced fracture of the radial bone of the arm will be longer, but the arm will still retain a certain vulnerability.

Long-term immobilization for a fracture of the head of the radial bone of the elbow joint is not required. In the case of a fracture of the ulna and radius, the healing period will take 2-3 times longer. The general terms of treatment, as well as accompanying procedures for recovery, are determined by the doctor based on the clinical picture.

How long to treat and wear a cast

The healing time for a fracture of the radius of the arm with conservative treatment takes from 4 to 10 weeks. How quickly the hand can be restored to health is determined by the specifics of the injury, the patient’s age and the individual characteristics of his body. In young people, the healing time of a radial bone fracture is always shorter, as are the negative consequences. In old age, tissues recover more slowly, and in the presence of diseases of the skeletal system or increased fragility, problems arise.

The plaster can be removed when the bone has completely healed. If the radius is damaged, it takes 8-10 weeks. In case of simultaneous dislocation and complicated wounds, the plaster is left for 2 months. If the radius bone is not displaced during an arm fracture, 6 weeks of immobilization is sufficient.

How long to wear a cast for an open fracture of the radius depends on the treatment method. Surgical reduction does not require long-term immobilization. Traditionally used, which limits movement mainly in the hand.

If your arm hurts after a fracture, then analgesics are prescribed, but obsessive pain indicates problems in therapy. If your broken arm hurt after the operation, then after a few days the discomfort should go away. Pain can be caused by inflammation. That is why antibiotics and immunity drugs are prescribed for open reduction.

Rehabilitation

In the case of surgery, rehabilitation after a multiple fracture of the radius with displacement takes 6-8 weeks. Not least important are the scale of damage and the complexity of surgical procedures. Fractures heal more easily after falls. The recovery period after road accidents and disasters is more difficult. Rehabilitation methods influence hand recovery. Patients are recommended to develop the limb under the supervision of a specialist.

At the first stage of rehabilitation after a fracture of the radius bone of the arm, minor loads are given. Forcing the process leads to repeated injuries, because the bone remains vulnerable to external influences. . Correct nutrition.

At this time, the body needs protein foods, vitamins and minerals. It is especially useful to consume aspic, fermented milk and seafood after a fracture of the radius. The best source of vitamin D for humans remains fish oil.

Physiotherapy, balneotherapy, and gentle massage will help speed up recovery after a complicated fracture of the radius. If the radial nerve is damaged, the rehabilitation period increases. How long it takes to fully recover depends on many factors. But immediately after removing the cast, you should develop your hand, restore blood circulation, and train weakened muscles.

Physiotherapy

Physical factors are fundamental at the rehabilitation stage. Physical therapy for an uncomplicated fracture of the radius is mandatory. But physical therapy techniques for fractures are so diverse that they deserve special attention.

Hardware therapy gives excellent results during the recovery phase. Physiotherapy after a broken arm includes:

• low frequency magnetic therapy– activates molecular and cellular restoration. Anesthetizes, soothes, relieves inflammation and prevents swelling. Indicated after removal of the plaster. Conducted in a 10-day course of 30 minutes;
• UHF exposure– treatment with a high-frequency electromagnetic field promotes the fusion of bones. The method is indicated on the 3rd day after the fracture. 10 sessions are enough for recovery. During the procedure, the tissues warm up, blood circulation improves, and atrophic processes are inhibited. Regeneration increases, bones grow together faster and without complications;
• electrophoresis– calcium is traditionally used to increase the effectiveness of the main treatment. If radial bone fractures are caused by weakening of the musculoskeletal system, then this method is indispensable. The procedure is carried out from the second week after injury. Minimum duration of exposure – 20 minutes;
• UV therapy– physiotherapeutic irradiation enhances capillary blood circulation, activates the production of vitamin D, prevents swelling and inflammation. Only 3-4 sessions are performed with an interval of 3 days.

Deserves special attention mechanotherapy. It helps develop the hand and restore its functionality. Exercise machines are selected taking into account the permissible load and the desired result. Hydrokinesitherapy has a similar effect, but it is not carried out in all institutions. Therapeutic gymnastics in the first days after injury is excluded, but therapeutic physical training techniques do not exclude passive gymnastics, which helps maintain finger activity and normalize blood supply to the injured limb.

How to develop an arm after a fracture of the radius

Gymnastics is aimed at developing muscles that have been immobilized for a long time. All techniques are available to patients. If it is better to do the exercises for the first time with a specialist, then during subsequent training sessions the help of a doctor is not required. It is important to follow a work and rest schedule so that the hand recovers gradually.

A set of exercises after a fracture of the radius includes:

• clenching your hand into a fist - after removing the cast, this exercise will be the most useful. It allows you to disperse the blood, use muscles that were at rest, and without harming the joint. Working with a small ball or plasticine will help increase the effectiveness of classes;
• fingering objects - it would seem that this is a simple exercise, but how many benefits it brings! Firstly, the accuracy of movements is honed. After the cast, the fingers, and the hand as a whole, do not want to obey. Fine motor skills training eliminates this problem. Secondly, the load on the joint is minimal, and the muscles work very well. As a result, blood supply improves and strength appears in the hands;
• circular rotations - they help restore hand mobility. But you should rotate your hand smoothly and slowly. There should be no pain, but a slight crunch may accompany the workout. He will subsequently leave;
• Raising and lowering the shoulders - this exercise can be done synchronously and alternately. The shoulder girdle is not directly related to the site of injury, but working it out will increase the motor activity of the limbs and relieve stiffness;
• flexion at the elbow - you should alternately bend and straighten your arm, but this exercise is done after the limbs are functioning well. Such training is necessary to increase the functionality of the joint and relieve muscle tension during prolonged immobilization of the arm in a bent position.

When the first stage of recovery is completed, it is worth incorporating exercises such as clapping in front and behind you, raising your arms to the sides and up, interlocking your fingers behind your back. The load, like the training time, increases gradually. There should be no pain or discomfort during training.

Massage

If the radius bone is damaged, massage becomes the main element of training immediately after the injury. It is aimed at stimulating blood circulation, preventing atrophy, increasing muscle tone and relieving pain. Due to immobilization, tissues do not receive enough oxygen, which has a bad effect on bone healing and skin condition. In case of a fracture of the radius in a typical place, it is advisable to perform a gentle massage:

• The injured hand is stroked with gentle movements up and down. There is no pressure. The fingertips gently run over the surface of the skin. This technique allows you to maintain sensitivity, improve capillary blood circulation and activate nerve receptors;
• rubbing – involves more intense movements along the arm. We do not deprive attention of the side of the dorsal surface of the forearm. After the procedure, the hand turns slightly pink, which indicates improved blood supply to the tissues. There should be no aggressive movements;
• pinching and pressing - they are best carried out using special massagers, for example, needle rollers. Since the cast eliminates the movement of internal and external rotation of the hand, there is no need to worry about possible damage to the hand during the massage. It will remain lying on a flat surface, and applicators and rollers with “bumps” will intensively affect the surface tissues, preventing stagnation;
• at the final stage of the massage they return to stroking. They calm and relax. You can use special oils for massage, which will make skin care more effective and make it easier to glide during the procedure.

Massage can be done in case of a fracture of the radius in a typical place already on the 3rd day. But the doctor will tell you about all the necessary manipulations after the patient is discharged home. The main development of the arm will begin as soon as the plaster is removed, although the recovery period can be accelerated at the immobilization stage.

Complications and consequences

Due to improperly healed fracture of the radius, the majority of negative consequences occur. The functionality of the limb decreases sharply. Often the problem cannot be solved either by physiotherapy or intensive gymnastics. The injury has to be re-opened and repositioned. Secondary displacement occurs after restoration of bone fragments. An accidental movement of the patient's hand or a muscle spasm can cause fragments to come off. In the case of open reduction, such manifestations are excluded, because the fragments are fixed with metal structures.

The consequences of a displaced radius fracture also include stiffness. For example, the hand is not able to make a full rotation or there are problems with clenching the fingers into a fist. Damage to muscles and nerves are responsible for this. Post-traumatic dystrophy in medicine is called Sudeck syndrome. Most often it appears precisely after a trauma to the radius (more than 60% of cases). Early removal of the cast, application of a too tight bandage, or intensive exercise immediately after the immobilization regime can lead to such a complication.

This syndrome after a fracture of the radius in a typical place causes severe pain and causes immobilization of the joint. Bone structures and nerve tissues are involved in the pathological process. Severe swelling is observed, the skin changes color from red to bluish, and the bone becomes brittle. Drug therapy allows you to cope with the complication.

Negative manifestations of fractures of the radius in a typical location include: If healing does not heal properly after a fracture, a bone callus is formed. Bone fragments are smoothed out by friction, forming a false joint or pseudarthrosis after a fracture. The disorder is detected using radiography. The image shows pathological tissue and the gap between the fragments. Traditionally, the problem is solved surgically.

Among the complications after a fracture of the radius, synostosis is rare, but still occurs - fusion of the ulna and radius bones. Post-traumatic synostosis limits mobility. It is treated primarily surgically.

In the case of an open injury, infection cannot be ruled out. Pathogenic microorganisms multiply rapidly in soft tissues. Microbes can cause purulent inflammation and bone destruction. Osteomyelitis is considered a particularly dangerous complication of a fracture. That is why they try not to resort to open reduction in case of injury unless there is an urgent need for it. The vast majority of episodes of post-traumatic osteomyelitis are associated with surgical treatment.

Dear readers of the 1MedHelp website, if you still have questions on this topic, we will be happy to answer them. Leave your reviews, comments, share stories of how you experienced a similar trauma and successfully dealt with the consequences! Your life experience may be useful to other readers.

Hello, control radiographs are not much different from the initial ones taken after reposition. The control photographs again show no elbow joint. The elbow joint must be monitored in case of fractures of the forearm bones in children. Perhaps he was assessed clinically upon admission and did not find any changes, but still the image is more reliable, especially since performing radiographs with the capture of two joints does not contradict, but exactly follows the principles of performing these same radiographs. When the child was admitted, I made sure that the head of the radius bone occupies its correct position in the elbow joint and sleep peacefully and don’t remember anything else. At the age of 10 years, the body can independently repair a lot of such damage. Only rotational displacements (when one fragment is twisted relative to the other) and angular displacements of more than 15 degrees are not corrected (although some authors give even up to 30, but from experience I can say that angular displacements exceeding 15 degrees can surround themselves with a “retinue” of unpleasant complications. Conventionally, there is a concept of "acceptable displacement", however, anything that is "acceptable" increases the risk of re-displacement and, as a result, the likelihood of repeated interventions. Therefore, the doctor always strives to perform the best possible reposition. In your case, you need to weigh everything carefully. If If you perform repeated reduction without fixation, then there are no guarantees that the fragments can be kept in the correct position. If this does not work, then you cannot do a closed reduction for the third time without fixation - you need to fix it. Any repeated reduction means additional tissue trauma. Therefore, it is logical to consider the issue from doing it once and for all reliably. If the fragments maintain their current position without repeated manipulations, then most likely the child will recover over time and all residual deformations (which currently exist) will be corrected. However, the decision still needs to be made during an in-person examination. It is important to consider current symptoms with mandatory assessment of neurological and vascular deficits. Insisting on something that the doctor does not want to do or does not consider necessary is a thankless task. It is your right to get advice from another specialist. It is your right to receive complete information from your doctor. Parents must understand what, according to the doctor, is happening to their child, what the doctor plans to do, why he plans to do it, what possible consequences await the child after action or inaction. Usually this is all discussed with the doctor and, with an adequate attitude towards each other, does not cause any communication difficulties.
Sincerely.

Bone fracture is a pathological condition in which a partial or complete violation of the integrity of its anatomical structure occurs under the influence of an external force. Forearm fractures may develop as a result of mechanical injuries ( when falling on your hand, hitting the forearm area, when something heavy falls on your hand, etc.) or result from certain diseases ( osteoporosis, rickets, osteomyelitis, bone tumor, etc.), accompanied by a violation of the incorporation of minerals into bone tissue.

Forearm fractures are a fairly common pathology, characterized by a wide variety of clinical symptoms. With such fractures, pain, swelling at the site of injury, external bleeding, bruising, impaired skin sensitivity, deformation of the forearm, dysfunction of the elbow and wrist joints with limitation of active and passive movements may occur. With open fractures, bone fragments can often be seen in the wound.

For forearm fractures, some serious complications are possible, such as osteomyelitis, malunion of bone fragments, fat embolism ( blockage of blood vessels by fat droplets), bleeding, nerve damage, suppuration in soft tissues, etc.

The ulna and radius form the bony base of the forearm, so when they are damaged, there is a permanent disruption of the functioning of almost the entire arm ( hand, wrist joint, forearm, elbow joint). This greatly affects the daily activities of patients. However, despite the severity of such fractures, they are quite easily diagnosed, and their treatment mainly consists of reduction ( reduction) bone fragments and application of a plaster splint ( bandages) on the injured hand. Such patients usually return to work within a few weeks or months. It all depends on the type and severity of the fracture, as well as the presence of any complications.

Anatomy of the forearm region

The forearm is the middle region of the arm, extending from the elbow joint to the wrist joint. The bony skeleton of the forearm is formed by two bones - the ulna and the radius. These bones are covered on top with muscles, subcutaneous fat and skin. The ulna and radius bones in their upper part take part in the formation of the elbow joint, and in the lower part - the wrist joint. Therefore, these joints can be classified as the forearm area.

The forearm includes the following anatomical structures:

• forearm bones;
• muscles;
• skin and subcutaneous fat;
• vessels and nerves;
• elbow joint;
• wrist joint.

Bones of the forearm

There are only two bones in the forearm ( ulnar and radial). These are long tubular bones, each of which has a lower, middle and upper part. The lower and upper portions of the radius and ulna are called the distal and proximal epiphyses, respectively. The middle part of these bones is called the diaphysis ( or body). Between the epiphyses and the diaphysis there are border areas called metaphyses. Thus, each bone of the forearm has two epiphyses ( top and bottom), two metaphyses ( top and bottom) and one diaphysis.

The bones are covered on top with periosteum, and inside they contain yellow bone marrow ( adipose tissue) and red bone marrow ( hematopoietic organ). Yellow bone marrow is localized in the middle part of the bones of the forearm, red - in the epiphyseal ( in the area of ​​epiphyses). In the metaphyseal zone there are bone growth layers that allow the radius and ulna to grow in length. Between the red bone marrow and the periosteum in the epiphyses there is spongy bone substance ( textile). In the diaphyses of bones, between the yellow bone marrow and the periosteum there is compact bone substance ( textile). Compact bone tissue is denser and stronger than cancellous bone tissue. Therefore, the bones of the forearm are most resistant to mechanical loads in their middle part ( in the area of ​​the diaphysis).

The ulna is located on the inside of the forearm ( when turning the hand with the palm facing the face). The radius is located near it and parallel to it - with the lateral ( external side) sides of the forearm. They are approximately the same length. The bones of the forearm have an unequal and uneven shape. The upper epiphysis of the radius is thinner than the upper epiphysis of the ulna. Its lower epiphysis, on the contrary, is thicker compared to the lower end of the ulna.

Upper end ( pineal gland) of the ulna is called the olecranon, next to it, on the opposite side, is the coronoid process of the ulna. Bottom end ( pineal gland) the ulna consists of the head of the ulna and the styloid process. The radius in its upper part is represented by the head of the radius and its neck. In its lower part there is a bone thickening, which plays an important role in the formation of the wrist joint ( connection between hand and forearm), as well as the styloid process of the radius.

Muscles

The muscles of the forearm are divided into three main groups. The first group of muscles helps the hand move closer to the forearm, that is, bend at the wrist joint ( flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis, etc.). Also, some of them are involved in flexing the forearm at the elbow joint ( brachioradialis muscle, superficial flexor digitorum, etc.). These muscles are called flexor muscles.

The second group of muscles allows the forearm and hand to rotate around their longitudinal axis. Inward rotation ( inwards) pronator muscles help ( pronator teres, flexor carpi radialis, pronator quadratus, etc.). Rotation to the outside ( outward) is provided with the help of the supinator muscles ( brachioradialis muscle, supinator, etc.). The third group includes the extensor muscles. These muscles allow the hand to extend at the wrist ( extensor carpi radialis brevis, extensor carpi radialis longus, etc.), and the forearm - in the elbow ( extensor carpi ulnaris, extensor digitorum, etc.) joint.

Skin and subcutaneous fat

The skin, together with subcutaneous fat, covers the entire forearm area. In its structure, the skin of the forearm is no different from the skin of other parts of the body.

Vessels and nerves

The main main vessels of the forearm are the radial and ulnar arteries. These arteries begin at the elbow, branching there from the brachial artery. The radial artery has a longitudinal course and is located deep in the muscles with the lateral ( external side) sides of the forearm. Most of this artery throughout the forearm is located very close to the radius. The largest vessel originating from the radial artery in the forearm is the radial recurrent artery, which participates in the formation of the ulnar arterial network.

The ulnar artery, in turn, is located closer to the ulnar artery. It follows the course of the ulna and is localized closer to the inner surface of the forearm. In the area of ​​the forearm, the ulnar recurrent artery departs from it, which contributes to the formation of the ulnar arterial network, as well as the common interosseous artery. This artery separates from the ulnar artery in the upper third of the forearm. A little lower it bifurcates and divides into the anterior one ( located anterior to the interosseous membrane) and back ( localized posterior to the interosseous membrane) interosseous arteries that follow distally ( down), to the hand, located in the space between the bones of the forearm.

The venous network of the forearm is represented by deep and superficial veins. The deep veins of the forearm include the radial and ulnar veins. These veins are located next to the main arteries ( radial and ulnar) and completely repeat their course. They begin in the area of ​​the hand, and in the area of ​​the elbow they pass into the brachial veins. The superficial veins of the forearm include the medial ( inner side) and lateral ( outer side) saphenous veins, intermediate vein of the forearm and intermediate vein of the elbow.

The lymphatic system of the forearm consists of deep and superficial lymphatic vessels. The first follow from the hand to the elbow along with deep arterial and venous vessels. The second ones are located higher and follow the course of the superficial veins of the forearm.

In the area of ​​the forearm there pass the main nerve trunks - the radial, ulnar, median nerves, as well as additional ones - the lateral and medial cutaneous nerves of the forearm. The radial and ulnar nerves are located closer to the bones of the same name. The median nerve occupies an intermediate position in the forearm. All three nerves follow along the front surface of the forearm from the elbow towards the hand. The lateral cutaneous nerve of the forearm is a continuation of the musculocutaneous nerve ( one of the nerves of the shoulder). The medial cutaneous nerve of the forearm serves as a direct continuation of the medial ( internal side) bundle of the brachial plexus.

Elbow joint

The elbow joint is a formation through which the bones of the forearm and the bone of the humeral region of the arm are united ( brachial bone). The upper parts of the ulna bone ( olecranon, coronoid process), radius ( head, neck) and lower parts ( block and head of the condyle) epiphysis of the humerus. Due to the presence of the elbow joint, the forearm can perform rotational movements ( internal rotation and external rotation), flexion and extension movements.

Inside the elbow joint there is a connection between the bones of the forearm, which is called the proximal joint ( top) radioulnar joint. It is formed by the connection of the head of the radius and the radial notch located on the ulna. Movement in this joint is strictly limited and allows the radius to rotate around the longitudinal axis of the ulna.

Wrist joint

The wrist joint is a formation that connects the forearm and hand. The lower ends of the radius and ulna and the bones of the proximal ( upper) wrist row ( semilunar, triquetral, scaphoid). The articular surface of the lower epiphysis of the radius connects directly to the bones of the wrist, in contrast to the epiphysis of the ulna, which connects to them through a cartilaginous disc. Various movements of the hand are possible in this joint - flexion, extension, abduction, adduction, rotation.

Just above the wrist joint is the distal ( lower) radioulnar joint, connecting the lower ends of the ulna and radius bones. The radiocarpal and distal radioulnar joints are separated from each other by a cartilaginous articular disc. In the distal radioulnar joint, the head of the ulna bone and the ulnar notch on the radius interact with each other. The distal radioulnar joint is a cylindrical joint, so only rotational movements around the longitudinal axis are possible in it. This joint, together with the superior radioulnar joint, allows the radius to rotate around the longitudinal axis of the ulna.

Strengthening the two bones of the forearm among themselves is ensured not only through the elbow, wrist, proximal and distal radioulnar joints. These bones are connected to each other by an interosseous membrane ( interosseous membrane) of the forearm, which consists of dense and strong connective tissue fibers that fill almost the entire gap between the bones of the forearm along its entire length.

What types of fractures can occur in the forearm?

Fractures in the forearm can occur either as a result of a fracture of the radius, or as a consequence of a fracture of the ulna. There are also simultaneous fractures of both bones. Depending on the number of fragments, all fractures can be simple or comminuted. In simple fractures, in the area of ​​the fracture there are two broken sections of bone, bounded by a fracture line. Simple fractures can be transverse ( the fracture plane is perpendicular to the bone diaphysis), oblique ( the fracture plane is not perpendicular to the bone diaphysis), helical ( spiral-shaped).

In comminuted fractures, two broken sections of the damaged bone are bounded by one smaller bone fragment ( a piece of debris), which is located between them like a wedge. With comminuted fractures, there may be several small fragments. Thus, with comminuted fractures, at least three bone fragments are formed.

Depending on the location, all forearm fractures are divided into the following types:

• proximal fractures ( upper
• distal fractures ( lower) segments of the bones of the forearm;
• diaphyseal fractures ( average) segments of the bones of the forearm.

Fractures of the proximal segments of the bones of the forearm

Proximal fractures ( upper) segments ( after all) forearm bones are divided into three main groups. The first group includes fractures of the radius or ulna ( or both at once), which are localized below the articular capsule of the elbow joint. Such fractures are also called extra-articular fractures. The second group includes intra-articular fractures of the forearm bones. The third group includes combined fractures of the forearm bones. In these cases, both bones are damaged at the same time, with one of the forearm bones breaking outside the joint, and the other inside the cavity of the elbow joint.

Types of fractures of the proximal segments of the forearm bones

Fracture type	First type of fractures	Second type of fracture	Third type of fracture
Extra-articular fracture
Intra-articular fracture of one bone			An intra-articular fracture of one bone and an extra-articular fracture of the other.
Intra-articular fracture of both bones	A simple fracture of both bones.	A comminuted fracture in one bone and a simple fracture in the other bone.	Comminuted fracture of both bones.

Fractures of the distal segments of the forearm bones

Fractures of the distal ( lower) segments ( after all) forearm bones are also divided into three groups. The first group includes extra-articular fractures of the radius and ulna, that is, those fractures that occur at their lower ends to the point of attachment of the wrist joint capsule. The other two groups include intra-articular fractures that occur inside the wrist joint. They, in turn, are divided into complete and incomplete fractures.

An incomplete fracture differs from a complete one in that the fracture occurs not in the transverse direction, but in the longitudinal direction. Thus, with an incomplete fracture, the bone fracture line passes through the epiphysis without completely disrupting the contact between the articular surfaces of the wrist joint. The area of ​​the epiphysis ( where the fracture occurred) is not separated in this case, but remains connected to the diaphysis. Among intra-articular fractures, so-called metaepiphyseal fractures may appear. These are fractures in which a violation of the integrity of the bone occurs in the area of ​​the metaphysis and epiphysis of the bone.

Types of fractures of the distal segments of the bones of the forearm

Fracture type	First type of fractures	Second type of fracture	Third type of fracture
Extra-articular fracture	Isolated fracture of the ulna.	Isolated fracture of the radius.	Fracture of the ulna and radius.
Incomplete intra-articular fracture	Sagittal fracture ( a fracture that bifurcates the bone into right and left halves) radius.	Fracture of the dorsal edge of the radius.	Fracture of the volar edge of the radius.
Complete intra-articular fracture	Metaepiphyseal simple and intra-articular simple fracture.	Metaepiphyseal comminuted and intra-articular simple fracture.	Intra-articular comminuted fracture.

Fractures of the diaphyseal segments of the forearm bones

Fractures of the diaphyseal ( average) segments ( plots) forearm bones are divided depending on the type of fracture and the bone that is damaged. In diaphyseal fractures, three types of fracture can occur: simple, comminuted and complex. The first two types of fractures were discussed a little higher. A complex type of fracture is, in general, similar to a comminuted fracture, only in this case the number of bone fragments becomes more than one. They ( fragments) can take on an irregular shape and orientation in space, which makes their reposition much more difficult ( restoration of bone structure).

Types of fractures of the diaphyseal segments of the forearm bones

Types of fracture	First type of fractures	Second type of fracture	Third type of fracture
Simple fracture	Fracture of the ulna only.	Fracture of the radius only.	Fracture of the ulna and radius.
Comminuted fracture	Fracture of the ulna only.	Fracture of the radius only.	Fracture of both bones.
Compound fracture	Fracture of the ulna only.	Fracture of the radius only.	Fracture of the ulna and radius.

When bones are fractured in the forearm, displacement of the fragments relative to each other can very often occur. This can happen either as a result of the action of the traumatic agent that caused the fracture, or as a result of pathological muscle contraction due to severe pain at the fracture site. As a result of this contraction, the muscles pull the bone fragments in different directions, which causes their displacement. Displacement of bone fragments during fractures of the forearm bones can occur in width, length and at an angle.

When the bone fragments shift in width, they move away from each other relative to the longitudinal plane, which passes through the axis of the bones of the forearm.

The following degrees of displacement of bone fragments in width are distinguished:

• Zero degree. At zero degree, displacement of bone fragments during a fracture of the forearm bones does not occur at all. This type of fracture is called a non-displaced fracture.
• First degree. In the first degree, bone fragments move away from each other at a distance equal to half the diameter of the damaged bone. The contact between bone fragments is well preserved.
• Second degree. In the second degree, bone fragments are displaced by a distance of more than one-half ( half) diameter of the affected bone. In this case, the bone fragments are still slightly in contact with each other.
• Third degree. In the third degree, complete separation between bone fragments occurs. They don't contact each other.

With the third degree of displacement of bone fragments in width, their displacement in length is often found. In such cases, bone fragments are displaced relative to each other not only in the transverse direction, but also in the longitudinal direction. This often leads to deformation and partial shortening of the forearm ( especially if both bones are fractured at once).

When bone fragments are displaced at an angle, a certain angle appears between them, the value of which characterizes the degree of displacement and the severity of the fracture. The displacement of fragments in this case occurs mainly in the transverse direction. Some ends of the bone fragments are very far apart from each other, others ( opposite to them) usually either continue to interact with each other, or move slightly away from each other and form the vertex of the angle.

In medical practice, open and closed fractures of the forearm bones are also encountered. With open fractures, significant tissue damage occurs at the fracture site, and bone fragments are significantly displaced from each other ( third degree of shift in width) and are partially in contact with the external environment. Open fractures of the forearm bones are accompanied by damage to a large number of forearm tissues - muscles, blood vessels, nerves, subcutaneous fat, and skin. With closed fractures, bone fragments do not come out, although the surface coverings above them can sometimes be damaged due to the action of a traumatic factor on them.

Depending on the mechanism of development of forearm fractures, traumatic and pathological fractures are distinguished. Traumatic fractures occur when a force acts on the bone that exceeds its resistance ( strength) its bone tissue. This can often be found with various mechanical injuries - falls on the hand, direct blows to the hand, damage to the forearm during road traffic accidents. Pathological fractures occur when the bones of the forearm for some reason ( osteoporosis, rickets, osteomyelitis, bone tumor, etc.) strength decreases. In these cases, even a slight mechanical impact on the bones of the forearm can provoke a fracture.

Main signs of a forearm fracture

The main symptoms of a forearm fracture always depend on its location. With fractures of the radius or ulna in their upper parts, a significant part of the symptoms are associated with disruption of normal mobility in the elbow joint. Violation of the integrity of the bones of the forearm in the area of ​​their lower epiphyses and metaphyses leads to restrictions in mobility in the wrist joint. Fractures of the diaphysis of the radius and ulna are accompanied by classic signs of a fracture of tubular bones ( the appearance of swelling, pain, disruption of bone continuity, etc.), which arise in the middle of the forearm.

Depending on the location, all fractures of the forearm bones are divided into the following types:

• fractures of the upper ends of the forearm bones;
• fractures of the diaphysis of the bones of the forearm;
• fractures of the lower ends of the forearm bones.

Fractures of the upper ends of the forearm bones

When the olecranon process of the ulna is fractured, sharp pain occurs in the elbow joint. It is especially pronounced in the area of ​​the olecranon when palpated. The pain often intensifies with various movements ( flexion, extension, rotation) in the elbow joint. Sometimes these movements are severely limited. The elbow joint is almost always swollen ( in some cases there may be no swelling of the joint). The cause of its swelling is often hemarthrosis ( accumulation of blood in a joint) or inflammation of the articular tissues that develops with such a fracture.

Swelling is also observed in the area of ​​the olecranon process of the ulna. Here it is more pronounced. Passive movements of the elbow joint are usually possible but painful. Active flexion at the elbow is possible, but extension ( active) is often broken ( especially with a displaced fracture) and very painful. When palpating in the area of ​​the olecranon, one can often detect a recess between broken bone fragments. When the olecranon is fractured and displaced, deformation of the elbow joint often occurs.

When the coronoid process of the ulna is fractured, local pain and swelling in the olecranon fossa are observed ( mainly on the inside side). There may also be a bruise in it ( bruise), caused by interstitial bleeding. In some cases, hemarthrosis may develop ( accumulation of blood in a joint). Active flexion movements in the elbow joint are often severely limited. With passive elbow flexion, the maximum ability to bend the arm at the elbow joint is reduced. Rotational movements are usually not impaired. Active and passive extension movements may be limited due to pain.

A fracture of the head or neck of the radius is accompanied by the appearance of local pain and swelling in the elbow, localized mainly on its lateral side in the area of ​​the anatomical projection of these bone formations. All active and passive movements in the elbow joint are limited. This is especially true for extension and rotation ( in particular, external rotation of the forearm) movements during which very intense pain appears in the elbow joint.

Fractures of the diaphysis of the bones of the forearm

Diaphyseal fracture ( middle part) of the radius without displacement of bone fragments is characterized by a rather poor clinical picture ( pain, slight swelling on the outer side), due to the fact that it is localized deep in the muscles. Therefore, such a fracture is quite difficult to diagnose without radiography. When the middle section of the radius is fractured with displacement of the fragments, quite pronounced pain and swelling appear at the site of injury. Deformation of the forearm also occurs there, and crepitus is often detected ( the crunching sound that occurs between broken bone fragments when they rub against each other), bruises ( bruises), pathological mobility ( ).

Pain at the fracture site intensifies with palpation, as well as with compression of the forearm at the site of injury from the sides ( that is, during compression). A distinctive feature of such a fracture is a sharp limitation of active and passive supination ( ) and pronation ( inward rotational movements) movements in the forearm.

A fracture of the ulnar shaft is much easier to detect than a fracture of the radial shaft ( due to the more superficial location of the ulna in the tissues of the forearm). It is accompanied by the appearance of pain and swelling on the inner side in the middle of the forearm. With such a fracture, subcutaneous bleeding and displacement of fragments often occur, which cause slight deformation of the affected area of ​​the forearm.

Due to the displacement of the fragments, it is often possible to detect pathological mobility and crepitus during palpation ( the sound of friction between broken bone fragments). A fracture of the ulna diaphysis is also characterized by limited mobility in the elbow joint in all directions - flexion, extension, pronation ( inward rotational movements), supination ( outward rotational movements).

When both bones are fractured, severe pain appears in the area of ​​the entire forearm ( especially in the fracture zone). Patients with such fractures often cannot move the injured arm, so they support it with a healthy limb. Active and passive movements ( flexion, extension, rotation) in the elbow joint are very limited. Sometimes the function of the wrist joint is impaired. Often with these fractures there is displacement of bone fragments. In such cases, the forearm may shorten slightly in length. At the site of the lesion, significant swelling, pathological mobility, crepitus, bruising, and deformation of the anatomical structure of the forearm occur.

Fractures of the lower ends of the forearm bones

The main types of fractures of the lower ends of the forearm bones are the so-called “radius fractures in a typical location.” These fractures are localized in the metaepiphyseal zone ( that is, the area located in the epiphysis and metaphysis of the bone) 2 - 3 centimeters proximal ( higher) the articular surface of the radius, which takes part in the formation of the wrist joint. The fracture line in such fractures is often located in the transverse or oblique transverse direction. There are two types of “typical radius fractures.” The first of these is called a Colles extension fracture. The second is called a Smith's flexion fracture.

With a Colles fracture, bone fragments are displaced ( which are located closer to the wrist joint) anteriorly and sometimes laterally ( to the outer side) side. Such a fracture often occurs when falling on a hand that is extended at the wrist joint. He is often ( in 50 – 70% of cases) is associated with a simultaneous fracture of the styloid process of the ulna. The main symptoms of a Colles fracture are pain and swelling in the area of ​​the wrist joint, localized mainly on the outer side.

On palpation ( from the palm or back) pain usually intensifies. Also, by palpation, you can identify the distal ( lower) bone fragment on the back of the hand. Proximal ( upper) the fragment is localized behind it, on the palmar surface of the hand. The hand and fingers are often immobilized and displaced in the same direction as the distal ( lower) bone fragment of the radius. Active and passive movements in the hand are sharply limited. Possible crepitus ( the sound of crunching between broken bone fragments) and pathological mobility ( presence of mobility of bone fragments), however, it is not recommended to check for their presence, due to the high risk of damaging nerves and blood vessels.

With a Smith fracture, the distal ( lower) bone fragment ( or debris) moves posteriorly and outward ( sometimes inwards). Proximal ( upper) the fragment is displaced anteriorly and appears in front of the lower bone fragment of the radius. A Smith fracture is observed when patients fall on a hand bent at the wrist joint, which, during a fracture, moves to the same place where the distal ( lower) bone fragment of the radius ( palmar side).

During palpation in patients with a Smith fracture, one can easily detect displacement of the distal and proximal fragments in different directions, as well as detect local pain and swelling. In some cases, such a fracture may cause bruising on the skin. Along with them, one can detect deformation of the wrist joint area and its swelling. With a Smith fracture, as with a Colles fracture, there is a significant limitation of mobility in the wrist joint. In these cases, the hand is immobilized, finger movements are difficult.

A Smith fracture may also be associated with an ulnar styloid fracture. This fracture is characterized by the appearance of additional pain and swelling that occurs in the area of ​​its anatomical projection. With such a joint fracture, pain and swelling become even more diffuse ( common) and cover the entire wrist joint.

Diagnosis of a forearm fracture

Diagnosis of a forearm fracture is based on clinical ( anamnesis, external examination) and radial ( radiography, computed tomography) research methods. The former help to suspect such a fracture, the latter - to confirm it and help in establishing its type, assessing the degree of its severity. Diagnostic methods can also identify 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 facility. First of all, he asks the patient about the symptoms that bother him, 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 tell the doctor about the presence of certain symptoms, which, in turn, may belong to two groups of symptoms.

The first group of signs is called reliable signs of a forearm fracture. This includes crepitus ( crunching sound that occurs when bone fragments rub against each other) bone fragments, pathological mobility ( mobility in a place where it should not normally be) and change in forearm length. If these signs are present, you can immediately suspect a fracture of the forearm bones. These signs are most often detected during external examination. The patient may sometimes report the presence of such signs.

The second group of signs includes probable signs of a fracture. These include pain and swelling at the site of injury, the presence of hematomas ( bruises), abnormal limb position ( forearms, hands), deformation of the forearm area, limited mobility of the adjacent joint. Often the patient talks about these signs in his complaints.

Probable signs, first of all, indicate only the possible presence of a fracture, but do not indicate its presence, unlike reliable signs of a forearm fracture. Therefore, it is not always worth panicking prematurely when possible signs appear. Quite often, the cause of the probable symptoms may be a simple bruise of the forearm.

Secondly, the attending physician usually asks the patient questions regarding the causes of the fracture. Basically, he asks about the circumstances under which these symptoms appeared ( when hit on the forearm area, when falling on the arm, when there is mechanical compression of the forearm, when something heavy falls on the arm, etc.). Most often, after such circumstances, fractures of the forearm bones develop.

In some cases, a forearm fracture can occur with minor injuries, which in ordinary people can rarely provoke it. Therefore, if the patient does not have any serious injuries in the past, the doctor may ask him about the presence of additional pathologies that can cause demineralization ( decreased mineralization) bones. It reduces the resistance of bone tissue to mechanical stress and can cause pathological fractures.

In most cases, bone demineralization can be caused by the following main reasons:

• Rickets. Rickets is a pathology in which a deficiency of vitamin D occurs in the body, which regulates phosphorus-calcium metabolism and the usefulness of bone tissue mineralization.
• Tumors of the bones of the forearm. With tumors of the bones of the forearm, the growth of pathological tissue very often occurs, which disrupts their normal anatomical structure.
• Lack of calcium in food. Calcium is the main mineral component of bone tissue. If it is insufficiently supplied with food, the processes of mineralization of bone tissue in the bones of the forearm are disrupted in the body.
• Malabsorption syndrome. With this syndrome, there is a decrease in the absorption of nutrients ( proteins, minerals, vitamins) in the intestines due to any pathology of the gastrointestinal tract ( chronic enteritis, intestinal lymphangiectasia, Crohn's disease, etc.).
• Endocrine diseases. With endocrine diseases, a violation of the metabolism of phosphorus and calcium in the body, which are essential components of bone tissue, is very often observed. Demineralization of the bones of the forearm can mainly be observed with hypercortisolism ( strengthening the adrenal glands), hyperparathyroidism ( excessive release of parathyroid hormone by the parathyroid glands), diabetes mellitus, etc.
• Long-term use of medications. Demineralization of the bones of the forearm can be caused by long-term use of cytostatics, antibiotics, glucocorticoids, anticonvulsants, etc.

Visual inspection

During an external examination of patients with a forearm fracture without displacement of bone fragments, one can usually detect swelling of the affected area, the presence of one or more hematomas, and limited mobility of the adjacent joint with which the damaged bone interacts. When palpating the fracture site, severe local pain is detected. Reliable signs ( ) in such cases are absent or very weakly expressed, so radiological studies are always necessary to confirm such a fracture ( radiography, computed tomography).

In those patients who came to a medical facility with a forearm fracture with displacement of bone fragments, an external examination most often reveals many signs of a fracture. They are both reliable ( crepitus, pathological mobility, shortening of the forearm), as well as some probable signs of forearm fractures. The latter include bruises, swelling of the fracture site, local pain, forced position of the arm ( most often the injured forearm is supported by the healthy hand), deformation of the anatomical structure of the forearm, absence or limitation of active and passive movements in the elbow or wrist joint. Radiation studies ( radiography, computed tomography) are also done in this case, but here they are necessary, to a greater extent, to assess the severity of the fracture, identify complications and choose treatment tactics.

X-ray and computed tomography

Radiography is a radiation diagnostic method that is based on the use of x-rays. Its use allows the patient's hand to be illuminated and displayed on an x-ray ( image obtained as a result of an x-ray examination) structure of the bones of the forearm ( radial and ulnar), their location, thickness, size, relationship with other bones ( hands, shoulders).

Bone tissue is an ideal structure for X-ray radiation, which is absorbed to a high degree, since it has the highest density compared to other tissues of the body ( pulmonary, hepatic, cardiac, articular, etc.). Therefore, the X-ray method ( like computed tomography) diagnosis is considered the gold standard for diagnosing various fractures.

If one or both bones of the forearm are fractured, X-rays are taken in two mutually perpendicular projections. This allows us to examine the fracture site in more detail, identify bone fragments and the direction of their displacement. On radiographs, the bones of the forearm appear as white longitudinal formations connecting ( through the elbow joint) in the upper part with the humerus, and below - with the carpal bones ( through the wrist joint).

A fracture of the forearm bones looks like a gray or black strip with uneven edges, which completely or partially breaks off ( disconnects) their anatomical structure. This strip is called a break line ( or fracture line). It can have different directions ( transverse, longitudinal, oblique), which depends on the type of fracture. There may be several fracture lines with multiple fractures or with comminuted fractures ( where more than two bone fragments are formed) forearm. In addition to the fracture line for a forearm fracture ( with displacement of bone fragments) on the x-ray you can also see the displacement of bone fragments, deformation of the axis of the limb, and small bone fragments.

A CT scan uses the same X-rays as radiography. However, the technique for conducting it is completely different from x-ray examination. With computed tomography, a layer-by-layer scan of the affected area of ​​the forearm is performed, which provides much more useful information. This test is more accurate than simple radiography. It allows you to identify additional fracture lines, bone fragments unnoticed during radiography, the position and angles of deflection of all fragments, which is very important when planning and choosing treatment tactics.

What does a radius fracture look like on an x-ray?

On an x-ray, the radius appears as a white oblong formation, connected to the humerus above and to the smaller bones of the hand below ( semilunar, scaphoid). In the photo it is on the left side. It is thinner at the top and thicker at the bottom than the adjacent sections of the ulna. In the case of a fracture of the radius, one or more fracture lines can be seen in the area ( fracture), which look like dark stripes that have different thicknesses, directions and edges. These strips separate bone fragments.

With a normal fracture ( bone fragments) two – proximal ( upper) and distal ( lower). With a comminuted fracture - three - proximal ( upper), middle, distal ( lower). Complex fractures are accompanied by the formation of a larger number of bone fragments. Displacement of bone fragments can be easily visually recognized by the fairly clear separation or fragmentation of the radius into several bone fragments and deformation of its anatomical structure.

What does an ulna fracture look like on an x-ray?

The ulna on the x-ray is located on the right. It is somewhat thicker than the radius in its upper part. The lower epiphysis of the ulna is much thinner than the epiphyseal part of the radius. On an x-ray, the ulna, like the radius, looks like a white oblong formation. In most cases, they do not differ from each other in color intensity. When the ulna is fractured, the presence of a darkened line ( fracture lines), which breaks off her 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, a fracture of the ulna can cause displacement of bone fragments, as well as deformation of the longitudinal axis of the ulna.

What to do if you hit your forearm hard and there is a suspicion of a fracture?

With strong impacts to the forearm, there is always a high probability of fractures of the forearm bones. However, in such cases, you should not panic too much and immediately think about a fracture. Quite often, such blows can only be accompanied by a significant bruise of the soft tissues of the forearm, which, according to its clinical manifestations ( severe pain, swelling, deformation of the forearm, limited mobility in the joints, etc.) is similar to a fracture of the forearm bones.

In case of strong blows to the forearm, first of all, it is categorically not recommended to check the bones of the forearm for the presence of a fracture. In particular, in such cases there is no need to try to identify reliable signs of a fracture ( pathological mobility, crepitus of bone fragments). It is also advisable not to feel the place where the injury occurred. If the patient is still sure that the forearm injury resulted in a fracture of one or both bones of the forearm, then he should under no circumstances have it set, since, in most cases, this cannot be done without special skills.

Secondly, you should not judge the severity of damage to the forearm area by clinical symptoms. Since even minor injuries to the forearm can lead to fractures of the radius or ulna, although the symptoms will be quite scarce. This happens especially often in pathological fractures, when the resistance of bones to mechanical loads is reduced due to the presence of pathology in the body associated with impaired mineralization. And, conversely, severe injuries to the forearm, in which severe clinical symptoms appear, cannot always cause fractures of the radius or ulna. This type of misjudgment often causes the patient to avoid seeing a doctor for a long time and think that the forearm injury only led to a bruise.

Thirdly, you should take painkillers. Their use is not necessary in cases of mild and tolerable pain. But usually fractures of the forearm bones are accompanied by severe pain. The drugs of choice should be medications belonging to the group of non-steroidal anti-inflammatory drugs. They could be Flamadex ( adults 12.5 - 25 mg 1 time per day), ibuprofen ( adults up to 1000 – 1200 mg per day in several doses), ketorolac ( adults 10 mg 1 - 3 times a day) and etc.

Fourthly, to be on the safe side, it is worth immobilizing ( immobilize) injured forearm. This requires a rigid, solid and straight object ( board, stick, etc.) oblong in shape, the length of which can cover the hand, the entire forearm and the elbow joint. Next, you need to place this object on the lower surface of the forearm and tightly ( but not tightly, so that after applying it to the radial artery near the wrist, its pulse can be felt) strengthen it to him ( subject) using a sterile bandage. The arm where the forearm is injured should be bent at the elbow at an angle of 90 - 100 degrees. The tilt of the forearm should be such that the patient feels minimal pain at the site of injury. If there are abrasions, scratches, or wounds that occurred along with a forearm injury, it is recommended that before immobilizing the arm, place sterile napkins soaked in some kind of antiseptic on these places ( iodine, brilliant green, alcohol, etc.).

Immobilization of the forearm will ensure minimal mobility of the bones of the forearm ( this will reduce the risk of displacement of bone fragments in non-displaced forearm fractures), will reduce the risk of pain and prevent unwanted complications ( damage to nerves, blood vessels, soft tissues, which can develop when bone fragments are displaced). After immobilization, it is recommended to apply cold to the injured forearm ( ice bag) and hang it on a hanging scarf fastened to the back of the neck. Also, after immobilization, you should try not to move your arm at the elbow and wrist joint and give complete rest to your forearm.

Fifthly, in order to confirm the presence of a fracture ( or deny his presence) you must immediately go for a consultation with a traumatologist at the nearest traumatology department or emergency room. If this is not possible, then you need to call an ambulance, through which the patient will be taken to the traumatology department. In the traumatology department, traumatologists will identify the cause of pain in the forearm and also help you quickly get rid of it.

Treatment of a radius fracture

The main goal of treatment measures carried out for 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 performs a reduction ( reduction), without performing any surgical interventions ( except for pain relief). This type of reduction is called closed reduction. This method is less traumatic and faster compared to open reposition of bone fragments.

Traumatologists resort to open reduction for splintered, severe or complicated fractures of the radius, when the number of fragments does not allow reuniting the original bone structure without resorting to surgical treatment methods. With closed reduction, doctors perform some surgical procedures to gain direct access to the bone fragments. After which doctors produce them ( bone fragments) assembly, restore the structure of the radius and fix the fragments to metal pins or plates to prevent their re-displacement.

In rare cases, areas of bone tissue are partially resected ( delete). Quite often this is carried out in case of necrosis of the head of the radial bone, when, after severe trauma, part of its articular surface cannot normally participate in movements in the elbow joint. Therefore, in such cases it is removed.

For fractures of the radius without displacement of bone fragments ( and after reduction of fractures with their displacement) requires routine immobilization of the injured limb for a short period of time. Sometimes patients may be prescribed painkillers ( ibuprofen, ketorolac, etc.), antibacterial drugs ( antibiotics), as well as immunobiological agents ( vaccines, immunoglobulins). The last two groups of drugs are mainly prescribed for the prevention of infectious complications at the fracture site. In particular, for open fractures of the forearm, the use of antitetanus immunoglobulin is indicated. After removing the plaster, all patients must undergo therapeutic exercises to gradually develop the damaged area of ​​the forearm and normal restoration of the elbow and wrist joints.

Treatment times for various types of radius fractures

Type of radius fracture		Timing of immobilization ( immobilization) injured limb	Time frame for restoration of full mobility in the forearm ( after removing the plaster)
Fracture of the head or neck of the radius		14 – 21 days.	14 – 21 days.
		28 – 35 days.	14 – 28 days.
Diaphyseal fracture (middle part)radius	No displacement of bone fragments.	56 – 70 days.	14 – 28 days.
	With displacement of bone fragments.	56 – 112 days.	28 – 42 days.
Fractures of the lower epiphysis (lower part)radius	No displacement of bone fragments.	21 – 35 days.	7 – 14 days.
	With displacement of bone fragments.	35 – 56 days.	14 – 28 days.

Treatment of a fractured ulna

A fracture of the ulna without displacement of bone fragments is treated conservatively. To do this, the damaged area of ​​the arm is immobilized using a plaster splint for 14–112 days, depending on the type of fracture. When bone fragments are displaced, doctors very often resort to open them ( ) reposition ( realignment). In some cases, these fragments can be set without surgery, this happens with very simple and minor fractures of the ulna. The table below shows the approximate timing of wearing a plaster cast and the rehabilitation time, during which the complete restoration of the lost function of the forearm that occurs after a fracture usually occurs.

Treatment times for various types of ulnar fractures

Type of ulna fracture		Timing of immobilization ( immobilization) injured limb	Time frame for restoration of full mobility ( after removing the plaster)
Fracture of the olecranon process of the ulna	No displacement of bone fragments.	28 – 35 days.	21 – 35 days.
	With displacement of bone fragments.	35 – 56 days.	28 – 42 days.
Fracture of the coronoid process of the ulna	No displacement of bone fragments.	14 – 21 days.	21 – 28 days.
	With displacement of bone fragments.	28 – 42 days.	28 – 42 days.
Diaphyseal fracture (middle part)ulna	No displacement of bone fragments.	56 – 84 days.	14 – 35 days.
	With displacement of bone fragments.	84 – 112 days.	28 – 42 days.
Fractures of the lower epiphysis (lower part)ulna	No displacement of bone fragments.	21 – 35 days.	7 – 14 days.
	With displacement of bone fragments.	35 – 56 days.	14 – 28 days.

Treatment of a radius fracture in a typical location

For fractures of the radius in a typical location ( ) without displacement of bone fragments, after radiography, all patients are given a plaster splint to immobilize the affected area of ​​the forearm. The plaster cast should cover at least a portion of the arm located from the fingertips to the upper third of the forearm. For such fractures, the hand is immobilized ( immobilize) for a period of 30 – 37 days. After removing the cast, physical therapy is necessary to develop movements in the wrist joint. The duration of restoration of the function of this joint is usually 7–14 days.

In case of a simple Colles or Smith fracture with displacement of bone fragments, their traction reposition is performed ( realignment of bones by hand tension) under local or regional anesthesia ( pain relief). The essence of this reduction is that one of the doctor’s assistants pulls the hand towards himself, and the second doctor’s assistant at this time creates a counter-thrust at the opposite end of the arm and holds the affected arm by the elbow. Thus, it turns out that both assistants gradually pull out and slightly move the distal and proximal bone fragments away from each other. At this time, the doctor manually correctly connects ( sets) bone fragments, exerting pressure on them opposite to the direction of displacement.

Immediately after repositioning ( reduction) the doctor must apply a plaster splint to the injured arm ( from the upper third of the forearm to the base of the fingers on the hand). The tension of the arm should remain the same, since there is still a risk of repeated displacement of bone fragments. This tension is gradually released as the plaster dries.

In the absence of successful reduction, the presence of complex comminuted fractures, the appearance of repeated displacements, or excessive damage to the articular surface of the distal epiphysis of the radius, Colles or Smith fractures are treated surgically by osteosynthesis. Osteosynthesis is a surgical procedure in which bone fragments are connected to each other by inserting special plates or knitting needles into the radius bone, holding these fragments next to each other after their reposition. After surgical reduction, a cast is placed on the forearm.

Timing of plaster immobilization for fractures of the radius in a typical location ( Colles' fracture or Smith's fracture) with displacement of bone fragments range from 30 to 45 days. Duration of rehabilitation ( recovery) joint mobility after such fractures takes 14–30 days.

Treatment of radial head fracture

In case of a fracture of the head of the radius without displacement of bone fragments, they resort to conservative treatment methods, which include temporary immobilization ( immobilization) and physiotherapeutic methods of treatment. Immobilization of the limb in case of such a fracture is carried out using a plaster splint, which is applied from the metacarpophalangeal joints of the hand to the elbow joint.

Before applying a cast, if the pain is severe, the patient may be given anesthesia at the fracture site. Also, before applying the plaster, the patient needs to bend the arm at the elbow joint so that an angle of 90 - 100 degrees is formed. The forearm should be in an intermediate position between supination ( outward rotation) and pronation ( inward rotation), that is, it should not be turned too outward or inward. The period of immobilization, on average, is 14–21 days from the moment the plaster is applied. After removing the plaster splint, it is necessary to carry out restorative procedures in the form of therapeutic exercises to develop movements in the elbow. The ability of the affected arm to work is restored after 42–56 days.

In case of a simple fracture of the head of the radius with displacement of bone fragments, they are performed manually ( manual) reposition ( reduction) under anesthesia. In case of comminuted, complex fractures, accompanied by the appearance of a large number of bone fragments, as well as in case of unsuccessful reduction, an operation for their open reduction is indicated. During this procedure, the doctor manually restores the structure of the radius bone and fixes the bone fragments with special knitting needles.

There are cases when the head of the radial bone cannot be straightened during surgery. This usually occurs with comminuted complex fractures. This serves as an indication for its removal. The head of the radius can also be removed if the damage is severe ( caused by a fracture) its articular surface.

After closed or open reduction of the radial head, temporary immobilization is required ( application of a plaster splint from the hand to the elbow joint) forearm for a period of 21 to 35 days. After removing the plaster, therapeutic exercises are performed in the elbow joint. The damaged forearm will be able to fully restore its function within 40 to 60 days.

Treatment of non-displaced fractures of the ulna and radius

Fractures of the ulna and radius without displacement of bone fragments are the best type of fractures in terms of safety for the patient, as well as the timing of restoration of the injured limb. This type of fracture is accompanied by less tissue trauma compared to fractures in which displacement occurs, since, when displaced, bone fragments often damage 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 damaged limb using a plaster splint ( for a period of 8 - 10 weeks). After the cast is removed, patients are advised to undergo therapeutic exercises for several weeks to develop various movements in the forearm. Full working capacity is restored after 10–12 weeks.

Treatment of displaced fractures of the ulna and radius

For displaced fractures of the ulna and radius, treatment measures consist of reposition ( reduction) bone fragments and temporary immobilization of the forearm using 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.), direction and distance of divergence of bone fragments, their quantity, as well as the presence of any complications ( bleeding, nerve damage, etc.).

The timing of immobilization of the injured forearm mainly depends on the location of the fracture and the degree of its severity ( on average it takes 10 – 12 weeks). After immobilization, the patient must undergo courses of therapeutic exercises for the gradual rehabilitation of lost forearm function. Full function should return within 12 to 14 weeks.

What are the possible consequences of a forearm fracture?

After a forearm fracture, various consequences can occur. Their appearance depends entirely on the type and location of the fracture, as well as its severity. For minor fractures ( for example, a simple closed fracture of the forearm bones without displacement), as a rule, the site of damage heals quickly and imperceptibly. Complications in such cases are extremely rare. Another thing is when fractures occur with displacement of bone fragments ( and, especially, this applies to open fractures). In such cases, various consequences usually develop.

A forearm fracture can have the following consequences:

• bleeding;
• nerve damage;
• osteomyelitis;
• pathological fusion;
• fat embolism.

Bleeding
With closed fractures of the forearm, interstitial ( internal) bleeding ( which from the outside is subjectively perceived by the patient as a bruise). This is usually due to the fact that bone fragments, moving in different directions, touch and injure surrounding vessels and tissues. It is worth noting that internal bleeding more often occurs with closed fractures with displacement of bone fragments and very rarely with the same fractures, but without their displacement. For open tissue fractures ( including vessels) are damaged much more severely than with closed ones, because there is a pronounced displacement of fragments of the damaged bone, so in such cases there is often severe external bleeding.

Nerve damage
With fractures of the bones of the forearm, damage to the nerve trunks is common ( nerves), passing nearby them. This usually happens with open or closed fractures with displacement of bone fragments. At the time of fracture, bone fragments mechanically affect nearby nerves and cause disruption of their normal function. This is accompanied by sensory disturbances ( tactile, temperature, pain, etc.) skin at the site of the fracture and beyond, impaired mobility of the fingers, hand, numbness of the limb, blocking the function of the elbow or radial joint, etc.

Osteomyelitis
Osteomyelitis is an inflammation of bone tissue that most often occurs when it is infected with various harmful bacteria. Osteomyelitis can develop in the bones of the forearm after an open fracture, in which bone fragments of these bones are in contact with the external environment for some time ( air, earth, etc.), through which the infection enters the damaged bones. In such cases, not only the bone tissue becomes infected, but also all other tissues surrounding it, after which post-traumatic suppuration of the forearm bones develops. Therefore, when open fractures of the forearm appear, in order to prevent infection, it is necessary to treat the damaged areas of the forearm with some kind of antiseptic ( iodine, brilliant green, alcohol, etc.) until the ambulance arrives or before going to a medical facility.

Pathological fusion
In case of fractures of the ulna or radius, pathological fusion of bone fragments may occur if you do not promptly consult a traumatologist for help. Such fusion often causes discomfort in the movements of the forearm, periodic pain in the area of ​​the fracture, and it also limits the functionality of joint movements.

Fat embolism
Embolism is the blockage of blood vessels by various bodies. It can be caused by gas bubbles ( air embolism), fat drops ( fat embolism), blood clots ( thromboembolism). Quite rarely, fat embolism can develop with fractures of the forearm bones. It occurs due to the release of fat droplets from the yellow bone marrow into the blood ( a collection of fat cells located deep in the long bones), localized in the diaphysis of these bones. Fat droplets that enter the bloodstream are transported to the lungs and clog their vessels, which leads to breathing problems or a complete stop. Fat embolism can develop after severe and serious fractures of the forearm bones ( arising predominantly in their middle part), in which they are fragmented into many bone fragments.

Is surgery necessary for a forearm fracture?

For a forearm fracture, surgery is not always necessary. For simple and uncomplicated fractures, it is usually not prescribed, since in them there is no displacement of bone fragments ( or they move slightly), nerves and blood vessels are not affected. In these cases, only immobilization is used ( immobilization) of the affected limb using a plaster splint so that these bone fragments fuse together correctly.

If there is a slight displacement of bone fragments, which occurs with simple closed fractures of the forearm, before immobilizing the limb, the traumatologist resorts to their manual reposition ( reduction). Surgical interventions, as a rule, are needed in more severe clinical situations, when there is a strong displacement of bone fragments, fragmentation of a section of bone ( radial or ulnar) etc. In such situations, the doctor is simply forced to reposition the fragments intraoperatively ( through surgery).

The operation can be used in the following clinical situations:

• unsuccessful reposition ( reduction) with a closed fracture;
• open fracture of the forearm bones;
• closed comminuted fracture of the forearm;
• multiple closed fracture of the forearm ( a fracture in which breaks occur in several places in one or both bones of the forearm);
• the presence of damage to large vessels or nerves due to a fracture of the forearm;
• repeated displacement of bone fragments after successful reduction of a closed fracture;
• pathological fracture of the forearm bones;
• simultaneous fracture of the radius and ulna;
• a simple fracture of the forearm bones with displacement when the patient presented late to the traumatology department ( in these cases, improper fusion of bone fragments occurs, and the traumatologist can no longer set them by hand without the use of surgical measures).

How is rehabilitation after a forearm fracture?

After the cast is removed, many patients have to undergo so-called rehabilitation after a forearm fracture. It is necessary for the full and lasting restoration of impaired or lost functions of the forearm that arose after a fracture. Impaired functionality in such injuries is most often caused by damage to the nerves that regulate the contraction of the muscles of the forearm, and is also provoked by a disorder of microcirculation in the venous, lymphatic and arterial systems that feed these muscles.

Rehabilitation of patients with forearm fractures usually takes place on an outpatient basis ( at home). After removing the patient’s cast, the traumatologist sends him home, prescribing him to attend special physiotherapeutic procedures, trainings, massage, etc. It is worth noting that the choice of one or another rehabilitation method completely depends on the type, severity of the fracture, and the presence of complications. Therefore, the same method cannot always be used for restorative purposes for different forearm fractures.

The following main groups of rehabilitation measures that may be required for patients with a forearm fracture are distinguished:

• physiotherapy;
• physiotherapeutic methods;
• massage.

Physiotherapy
Physical therapy is prescribed for most forearm fractures, regardless of their type. Physical therapy is carried out through a variety of movements ( active, passive, active-passive, etc.) in the injured limb, which the patient performs under the supervision of a methodologist ( instructor). Therapeutic exercise is necessary for the gradual development of mobility in the elbow and wrist joints, strengthening muscles, restoring their tone, returning the full range of motion in the forearm, improving blood supply, and normalizing nervous regulation.

Physiotherapeutic methods
After forearm fractures, physiotherapeutic procedures are often used. They can be electrophoresis, ultra-high frequency therapy ( UHF therapy), ultra-high frequency therapy ( Microwave therapy), inductothermy, pulse therapy, etc. These procedures have anti-inflammatory, myostimulating ( stimulate muscles), healing, vasodilating, trophic ( increased metabolism in tissues) action on the fracture site.

Massage
Forearm massage is necessary to improve microcirculation at the fracture site, dilate small vessels, restore muscle tone, and increase metabolic processes in tissues. All this helps to quickly eliminate congestion at the site of injury, remove inflammatory substances from tissues, speed up the processes of restoration of muscle movements in the forearm, improve blood supply and nervous regulation of damaged bones, muscles and other tissues.

How to provide first aid for an open fracture of the forearm?

If you have an open fracture of the forearm, you should immediately call an ambulance ( if this is not possible, first you need to provide first aid, and then go to the traumatology department). Before the ambulance arrives, the victim must be given first aid, the essence of which is as follows. In the presence of severe arterial bleeding ( the blood is bright red and spurts from the wound) the victim needs to stop the bleeding. This is done by applying a tourniquet to the lower surface of the shoulder ( where does the brachial artery pass), thus the tourniquet should be located above the fracture site. Before applying a tourniquet, the skin should be wrapped with a rag or bandage. This will relieve the tight pressure from the tourniquet and prevent bruising.

Successful installation of a tourniquet should be indicated by the absence of a pulse in the radial artery below the fracture site and a significant reduction in bleeding from the wound. Also, after applying the tourniquet, you must write on paper the time of its installation. This paper should then be given to the emergency physician ( or a traumatologist), so that he knows the approximate time of shortage of blood supply to the injured limb. If the ambulance does not arrive at the place of call within one hour, the place where the tourniquet is compressed should be loosened for 5 to 10 minutes. This is necessary in order not to cause premature necrosis ( necrosis) tissues of the hand located distally ( below) installed harness.

Next, you need to put ( without touching the wound) several sterile swabs ( made from bandage). They can be soaked in antiseptic solutions ( alcohol, iodine, brilliant green, etc.). After applying tampons, they should be easily secured to the fracture site with a bandage. It is worth noting that placing tampons on a wound is a means of stopping severe venous bleeding ( blood is dark red). With such bleeding, there is no need to apply a tourniquet to the shoulder.

The next step involves installing a tire ( any oblong object - stick, board) under the injured forearm. The splint is installed for immobilization ( immobilization) forearm and for the prevention of unwanted complications. The length of the splint should be greater than the length of the entire forearm. It also needs to cover the elbow joint and wrist joint along with the hand. Before placing a splint under the arm, it should be wrapped with a bandage to prevent discomfort for the victim, as well as to prevent unwanted injuries in the form of splinters, scratches, etc.

It should be noted that the splint should be placed on the side opposite to the fracture site. To strengthen the splint to the forearm, the same bandage is needed. It is extremely important to attach the splint with a bandage along the entire forearm - from the elbow to the wrist joint, avoiding the open fracture site ( that is, the bandage used when installing the splint should not be applied to the site of an open fracture). This is necessary in order not to cause additional pain associated with compression or displacement ( may occur when wrapping a bandage) bone fragments.

After attaching the splint, the forearm should be bent at the elbow and brought towards the chest ( the tire at this moment should be below the forearm) together with the shoulder and hand. After this, the injured arm can be suspended by a scarf to facilitate transportation of the victim.

The human hand is a unique tool that ensures successful knowledge of the surrounding world. She is virtually constantly in motion, providing tactile awareness of the surrounding space.

For this reason, trauma that sometimes occurs to the upper extremities significantly impairs the quality of life. Especially such a dangerous injury as a displaced arm fracture.

Constant movement of the arms is ensured by a complex bone structure connected by joints and tendons:

• In total, there are 206 arm bones in the adult human skeleton.
• In an infant, this number is much higher. Babies have 350 bones, some of which grow together as they grow older.

Rehabilitation after a fracture

A set of rehabilitation measures is recommended for patients undergoing treatment for a broken arm. The following procedures are recommended to restore hand mobility. This is facilitated by a special set of exercises. They can only be performed if there is dull pain. If the pain intensifies, you need to stop exercising.

Exercise therapy complex for recovery and development of the arm:

• Take a small ball transfer it from the healthy hand to the hand of the sore hand, squeezing.
• Perform rotational movements in the joint which is located in the fracture zone.
• Raise a gymnastic stick above your head with straight arms, fix the position and slowly lower it.
• Cross your arms in front of the face at eye level.
• Perform torso turns with palm clapping in front of the body and behind the back.

A set of exercises for recovery

Using self-massage

Self-massage helps speed up recovery. To carry it out, take the cream and make soft stroking movements, kneading the area of ​​the arm affected by the fracture until the skin becomes slightly red.

Principles of nutrition for a broken arm

Foods rich in calcium and potassium help speed up recovery processes:

• Cottage cheese and dairy products are included in the diet.
• The restoration of bone tissue, joints and ligaments is helped by the inclusion in the diet of dishes that contain.
• Including jellied meat and jelly. It is also important to include foods rich in vitamins in your diet: vegetables and fruits, herbs.

Calcium rich foods

Comfortable sleeping positions

When an arm is broken, a person independently chooses to sleep the position in which he is comfortable and in which there are no pain reactions:

• When the sore area is located in the area of ​​the wrist or hand, you can sleep in any comfortable position.
• If your forearm or shoulder is injured, you need to lie on the healthy half of your body.
• If necessary, place a cushion under your back to prevent a spontaneous rollover onto your affected arm.

Features of treatment of a broken arm in a child

Children can often underestimate the extent of what is happening. If the baby’s skin on the arm is inflamed, swelling is noted, palpation reveals a painful area and temperature, immediate contact with a specialist is required.

An important condition for successful treatment of a fracture in a child is monitoring the lack of physical activity. It is advisable not to let the child go outside in the first days to protect the affected area from re-damage.

Consequences of a fracture and possible complications

The highest quality treatment does not guarantee the absence of consequences and complications of a broken arm. Significant harm to health can be caused by untimely access to a medical facility.

The most common consequences include:

• Loss or decreased mobility due to improper fusion. In this case, both the bone itself and the joints located next to it may hurt.
• Purulent-septic complications in open form.
• In situations where a fracture has caused the bones to separate from the soft tissues, the section of bone is completely removed. The tendons have to be sutured and the resulting area of ​​skin excised.
• When soft tissue changes, in some cases a contracture is formed. They reduce the level of mobility of the limb. Even after a successful operation, the prospect of fat embolism remains.

Disability due to a broken arm

If you contact the ITU after a broken arm, the possibility of assigning disability is small:

• For upper limb injuries disability is assigned in 25% of cases from the number of applications.
• Most of the ITU decisions on the assignment of disability, about 50% are due to injuries of the hand or metacarpal bones.
• In any case, disability is assigned in the event of recognition of confirmed permanent or temporary disability. A displaced fracture often leads to this result.