Broken arm bone
Content:
- What is a broken arm?
- Hand fracture symptoms
- Types of hand fractures
- Consequences of a broken arm
- How to develop an arm after a fracture?
What is a broken arm?
A broken arm is an injury to one or more bones in a limb. This concept combines fractures of the humerus or forearm, fractures localized in the elbow joint. This also includes related hand and finger injuries. The correct fusion of bones and the normalization of hand functions are extremely important for a person, because the upper limb allows you to work, rest, develop, in general - live fully.
Trauma to the upper extremities is common, most of all people seeking medical help with fractures of the metacarpal bones of the hand, with fractures of the radius, as well as with an injured neck of the shoulder. The most common cause is a fall on a limb. Also, a fracture may be the result of a strong blow or the result of increased physical exertion on the arm, the bones of which have been weakened by various diseases (bone tumor, osteoporosis, osteomyelitis, bone cyst, hyperparathyroid osteodystrophy) or have undergone characteristic age-related changes. Depending on the cause of the damage, fractures are divided into traumatic and pathological. If the bone was broken, but not completely broken, then we should talk not about a fracture, but about a crack, if an insignificant area broke off from it, then we should talk about a marginal fracture.
Hand fracture symptoms
Knowing the main symptoms of a fracture, you can differentiate it from just a strong painful soft tissue injury.
The following can be distinguished as obvious, non-doubtful signs that a person has a broken arm:
- Abnormal position of the upper limb. The arm is unnaturally bent, has a corresponding appearance.
- Mobility can be observed in the place where the wrist, elbow and shoulder joints are absent.
- When probing, a crunch characteristic of a fracture occurs, called crepitus. Compared to similar sounds, it resembles the cod that salt makes when it is fried. Sometimes crepitations can be heard only with the help of a phonendoscope, and sometimes without specialized devices.
- Bone fragments may be visible and there may be an open wound that bleeds profusely. In this case, we are talking about an open injury.
There are also relative symptoms that make it possible to suspect the presence of a fracture, but an accurate diagnosis can only be established by conducting a full examination:
- Feeling of pain, which can be localized both at the site of injury, and move to neighboring areas. In particular, when the ulna is broken, pain can radiate to both the shoulder and forearm. Its character is intense even when the limb is in complete rest, if you try to give the hand a load or move it, then the person will experience a lumbago, and the aches itself will intensify.
- Swelling of the site of injury and the presence of bruising. Regardless of the site of localization, swelling with a fracture always occurs. The size of the swelling can vary, it will be larger the closer the injury is to the hand or to the elbow joint.
- The symptom of a cold extremity is a very dangerous sign, indicating that there has been a violation of blood circulation due to the rupture of the large main arteries. Although this does not happen often. Another reason for a cold hand can be thrombosis, which develops against the background of rupture of the intima of the artery and carries a mortal threat. More often, a similar condition is observed in people of mature age.
- The presence of a hematoma. If pulsation is noticeable at the site of the bruise, then this indicates profuse hemorrhage, which is located in the subcutaneous tissue.
- The arm was deformed and became shorter than the intact limb. This symptom is characteristic of displaced injuries. Deformation becomes especially noticeable when the forearm bone is damaged.
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Depending on the location of the injury, there will be limited mobility in the joint closer to which the fracture is localized.
- If nerves are damaged, paralysis is observed. Fingers will be immobilized and insensitive.
Types of hand fractures
There are several types of injury, they are classified depending on the location of the injury, severity, characteristics.
There are several approaches to determining which type of fracture is:
- From the type of damage: open, when the skin and soft tissues are damaged, and the bone is visible (they are additionally divided into primary and secondary open) and closed, which are complete (absolute bone fracture) and incomplete (bone fracture or tearing of its tubercle).
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From the location of the fracture line: diaphyseal (the line is on the body of the bone), metaphyseal or periarticular (the line is between the end and the body of the bone), epiphyseal or extraarticular (the line is at the end of the bone).
- From which direction the fracture line is directed and from its nature: longitudinal (the line runs parallel to the bone), stellate, B and T - shaped, helical (the line runs in a spiral), transverse (the line runs perpendicular), oblique (the line is located at an angle to the bone), crushed (with the presence of many small fragments), comminuted (more than three fragments).
- From the number of damaged bones: multiple and isolated.
- Whether there is an offset. Displacement fractures are divided into primary (which are formed immediately at the time of injury due to the force applied to the limb) and secondary (formed as a result of the impact of muscles attached to the broken bones). The offset can be rotational, angular, in width or along the length of the limb.
- From the possibility of movement of fragments: stable (the fragments remain in one place) and unstable (secondary displacement of the formed fragments occurs).
- From the presence of complications. They are divided into complicated (with bleeding, fatty embolism, infection, blood poisoning, osteomelitis) and uncomplicated.
A separate subtype of fracture is a combination of trauma with bone dislocation. Most often they are complicated by severe damage to blood vessels and nerves. One of the most dangerous and serious types of injury is the Galeazzi fracture, when several different types of injuries are collected in one area. A fracture of the radial bone occurs, with a displacement of the fragment downward and eversion of the head.
Closed arm fracture
A closed injury is said to be when the bone did not break through the soft tissues and skin, but remained inside, held by the muscles. Such a fracture may or may not be accompanied by displacement. The cause of the occurrence is most often a fall on an outstretched arm.
Symptoms typical for a closed injury: acute pain, loss of limb functionality, deformity of the hand at the site of the injury. Edema and discoloration of the skin may appear, the very moment of injury is accompanied by a characteristic crunch.
First aid for a person with a closed hand injury is to immobilize the affected limb. This is done so that the bone does not move even more during movement, and fragments do not form. If fragments were formed at the time of injury, it is important to fix them in the place where they were originally located so that secondary displacement does not occur. In order to immobilize the hand, a tire of any even and rigid objects is applied to it.
Then the structure is securely fixed. It is not always possible for a person without medical education to provide a state of rest for the elbow joint with the help of a splint, so it is better to use a piece of cloth of a suitable size and hang your hand on a scarf. You should not try to align your hand yourself, try to straighten the bone, etc., in this way you can cause unnecessary harm to a person and cause additional suffering. It is enough to give the victim an anesthetic and go with him to the doctor, either independently, or wait for the ambulance to arrive.
Another important point in providing first aid during a closed injury is that all jewelry must be removed from the hand: bracelets and rings. This is done in order to protect the soft tissues of the fingers from death due to edema.
After the victim is delivered to the hospital, the necessary diagnostics and determination of the type of fracture will be carried out. If there is no displacement of the bone, then a plaster will be applied to the victim, but if it happened, then preliminary reduction will be required, and only then fixation of the limb using the same plaster. Shrapnel injuries will require surgical intervention and the installation of a certain type of metal structure.
Open arm fracture
With an open type of injury, damage and rupture of the soft tissues of the arm, muscles and skin occurs. The bone or a certain fragment of it that has been damaged will be visible.
Diagnosis of this type of injury is not difficult, since all the symptoms are obvious: bleeding, bone protrusion, severe pain, inability to move the limb, swelling.
Since open injuries are always accompanied by bleeding, it must be stopped. Do this yourself with a tourniquet only if it is arterial in nature. This can be determined by the following signs: the blood has a bright scarlet color, the bleeding itself is pulsating and very abundant. If these indicators are not found, then it is enough to restrict the imposition of a bandage from bandages. After performing these manipulations, you can give a person an anesthetic drug, but only one that does not raise doubts about its action. It can be ketoral, nimesulide, analgin, etc. Then you need to wait for the arrival of an ambulance.
Treatment of an open injury is operative, with the installation of rods, screws, wires or plates. Only after this is the application of plaster shown. The terms of rehabilitation increase in comparison with the recovery of a limb after a closed injury.
Consequences of a broken arm
Even with the timely provision of qualified assistance, no person is immune from the unpleasant consequences that may arise as a result of a fracture:
- If the bones have grown together incorrectly, then this is fraught with a violation of the functionality of the limbs, as well as its deformation. The hand itself will give the victim a lot of anxiety, both the bone itself and the joints located next to it will begin to ache. If an incorrect fusion of the diaphyseal fracture occurs, then surgical intervention will be required, which consists in opening the bone and repositioning it. Most often, the prognosis for improper fusion of the bones of the hand and their correction is favorable, and the limb after surgery restores its previous functions. This is especially true for patients who strictly followed all the doctor's prescriptions at the time of rehabilitation.
- Infection of the wound, with an open fracture and the development of septic complications. When soft tissues are exposed, there is always the potential for pathogens to enter. Therefore, only a sterile dressing is required, treatment with an antiseptic solution, it is important to conduct an examination under sterile conditions. It is necessary to clean the surface from foreign inclusions.
- Damaged skin requires excision, non-viable muscles must be removed, as bacteria begin to multiply in them. Tendons, like nerves, should be tried to be sewn together. All bones that are completely detached from the soft tissue must be removed, unless their fragments are too large or belong to a part of the joint. Disinfection is extremely important, as the patient's life depends on it and even a broken arm can be fatal.
- Contracture may form. It is caused by the fact that changes in soft tissues occur, which causes limitation of joint mobility. The reason is the complete absence of reposition, the assumption of inaccuracy when comparing the fragments.
- Fat embolism is another possible consequence of a hand injury. It can occur even after a successfully completed operation. Despite the fact that doctors are always wary of this type of complication, nevertheless, fatty embolism can often be diagnosed late. The reason is that it is disguised as a traumatic shock and often occurs against its background. If there is a suspicion of the possible occurrence of this complication, then manipulations on the reposition of fragments, as well as from osteosynthesis, must be abandoned for a while.
How long does a hand hurt after a fracture?
The pain after injury is pulsating and gradually begins to decrease. When the plaster cast is applied, the limb will hurt for several more days, but not so intensely.
In general, the soreness persists for the first two weeks, therefore, the application of cold topically is indicated, such a compress should be kept for no more than 15 minutes. Can be repeated every hour. If a person is not able to endure pain, then the appointment of NSAIDs is shown to him.
In general, the timing of fusion depends on the location of the injury and its severity. So, broken fingers are restored in about a month, the hand or forearm in two, the radius in 1.5 months. As the fusion proceeds, the painful sensations will also decrease.
Pain can also occur after the cast is removed. But with normal healing and bone healing, all unpleasant sensations should stop bothering a person after a week.
Swelling after a broken arm
Puffiness is a fairly common phenomenon after receiving this kind of injury. This trouble is temporary, but until the swelling has subsided, regular observation by a doctor is necessary. To reduce the severity of edema, it is recommended to apply ointments or gels, which will help to restore blood circulation in the damaged area.
Sometimes the puffiness does not subside for a long time, then special procedures are required to eliminate it. This can be phonophoresis, electropharesis, muscle electrical stimulation, or ultraviolet radiation. Professional massage and therapeutic exercises help to cope with swellings. Do not ignore folk remedies, for example, applying a wormwood compress or smearing the edematous area with blue clay.
If the swelling does not subside after two weeks, you should definitely go to an appointment with a doctor and ask a professional about the possible causes of this phenomenon.
On the subject: How to remove swelling at home?
After the fracture, the hand goes numb, what should I do?
Numbness of a limb after an injury occurs often. A large number of people turn to traumatologists with a similar problem. First, you need to determine the area in which there is temporary or permanent numbness, whether it is accompanied by pain in the joints. If such sensations arise after a short time after injury, then you should not bother - this is a completely normal process.
It is necessary to start experiencing when the loss of sensitivity is observed after removing the plaster, for several days and does not go away. Then it is necessary to undergo additional studies that will show there is damage to nerve endings or vascular disease. Only a doctor will be able to identify the true causes of limb numbness after a fracture and prescribe adequate treatment. But in advance, you should tune in to the fact that the disease may not completely go away, and the feeling of numbness will bother the person again, for example, when the atmospheric pressure changes.
In the absence of indications, you can try to get rid of the complication of the injury yourself with the help of salt baths or proper massage. Special exercises aimed at developing joints can also help, because limitation of mobility is often associated with the fact that the limb has been in a cast for a long time. The operations performed to fasten the damaged nerve endings and tendons will also affect. In this case, exercise therapy is a prerequisite for recovery. Sometimes a course of acupuncture can help.
Also, for the return of sensitivity, breaks in work, proper nutrition, sufficient intake of vitamin B 12 are important. It is worth spending more time in the fresh air, actively moving. Most often, patients manage to cope with this problem completely.
On the subject: 12 popular ways for home treatment
How to develop an arm after a fracture?
After such a serious injury as a fracture has been received, it is unlikely that it will be possible to forget about it forever. Most often, a limb requires competent rehabilitation, aimed at its restoration and development of functions. Often it is with the question of how to return the hand to work, patients turn to doctors.
When the long-awaited moment comes, and the plaster cast is removed from the limb, the patient is surprised to find that the hand has become as if “alien”. Such conditions are explained by the fact that she was immobilized for a long time, the muscles were weakened, and the blood supply was insufficient. Puffiness may occur.
In order to relieve swelling, you can try the following exercises:
- First you should try to squeeze your palm. This will determine the degree of loss of strength. You should not immediately try to use a limb, take its cups of tea or perform more complex actions. For a start, you can practice on ordinary plasticine. To do this, you need to try to warm it up with your fingers, rolling the torn off piece. If you manage to cope with the task, you can afford to take a break. Repeat after class. Such a simple exercise should be performed throughout the month, several times a day.
- The next exercise will help disperse the blood, making it circulate faster through the injured limb. To do this, while in a sitting position, stretch your arms in front of you. Turning the clenched palms to the right and left, you can feel how the hand gradually begins to function. But you should not put too much pressure on the broken limb or rotate it too actively. The exercise should be done slowly and without jerking.
- An ordinary tennis ball helps to relieve puffiness, which you just need to throw at the wall and try to catch. Again, do not get too actively involved in the task and overload the limb too much. Otherwise, you can only harm.
- Place three tennis balls in your palm and try to play them with your fingers. You should not stop the exercise, even if they fall out of your hand all the time. After all, its goal is to relieve puffiness, which means movement is necessary, otherwise the blood will not fully circulate through the vessels squeezed with plaster.
These simple exercises are recommended but not required. Those activities that the doctor advises will need to be performed in full and without omissions. For the development of a hand after an injury, there are specialized exercise therapy, as well as massage courses that are clearly aimed at rehabilitation. Specialized occupational therapy helps to develop a hand perfectly, which consists in knitting, embroidering, drawing, performing simple actions around the house or garden. Gradually, the person will be able to return to the full life that he had before the injury.
Exercise therapy after a broken arm
Physiotherapy is an effective way to regain lost mobility.
To do this, you should perform the following exercises:
- Raising the shoulders up and lowering them down.
- With support on the table: extension of the hand, lifting the forearm, rotation with the palm hanging down, squeezing the fingers into the lock.
- Circular rotation. To do this, you need to bend your arms at the elbows and turn them in different directions. Rotations in the shoulder joint are performed in a similar way, only the limbs in this case should not be bent.
- Raising your arms to the sides and up above your head, then raising your arms in front of you and up again.
- Exercise "fix the hair." The arm bent at the elbow must be rotated, touching the head clockwise and back.
- Claps in front of you and behind you.
- Rotation with a brush, which can initially be held with a healthy limb.
- Stretching the fingers. To do this, each of them must, as it were, sit on a twine.
- Exercise in the water. To do this, you need to fill the pelvis, place your hand there, trying to bend and unbend a limb in it. You can squeeze and unclench your palm there.
- Another effective exercise with a basin of water is to lift small objects, such as coins or buttons, from the bottom.
It should be noted that, depending on the stage of rehabilitation, the exercises must necessarily differ. They should be selected according to the principle - from simple to complex, gradually increasing the load:
- To begin with, you can simply move your fingers, bend your arm at the joint, and chat freely with it.
- After that, the main efforts should be concentrated on the wrists, to restore the functions of the fingers and hand.
- At the final stage, the load should be evenly distributed over the entire limb, with an emphasis on the interphalangeal joints.
Massage after a broken arm
Massage is one of the basic components of treatment aimed at restoring limb mobility. You can start it even before the plaster was removed. To do this, small holes are made in it and pointwise impact on the injured limb. This can be done with a special quartz drusen with a blunt tip.
Working with the muscles will promote blood flow to the arm, its nutrition and oxygenation of tissues. The swelling will disappear faster, the hematomas will dissolve better, the pain will decrease.
After I remove the plaster, the massage is carried out more intensively, but still carefully, with classic movements:
- To begin with, you need to carry out along the entire length of the limb with your fingers, transverse and longitudinal strokes.
- Then you should proceed to rubbing. In this case, it is already possible to produce some burden.
- This is followed by kneading with fingers, which promotes tissue regeneration.
- Vibration movements are the final stage of the massage. Presses alternate with strokes.
To carry out manipulations, you can use special massagers, applicators and rollers. For better glide, certain oils are always used. For a fracture, fir is best suited. To enhance the effect, you can mix it with creams and ointments that eliminate puffiness and have a warming effect.
How long does it take to develop an arm after a fracture?
The timing of rehabilitation measures varies, and depends on the nature of the injury, as well as on the speed of recovery. Some patients may need a couple of months to fully return to normal life, and some may need long-term treatment up to six months or even more.
In any case, after the plaster is removed, it is necessary to perform a mandatory program aimed at recovery for at least a month:
- The shoulder neck fully recovers after 3 months of treatment, plus a month of rehabilitation.
- The humerus body recovers after 4 months, plus 1.5 months of rehabilitation.
- The forearm bones are completely healed after 2 months, plus 4 weeks of recovery procedures.
- Radial bones will recover in 1.5 months, plus the same rehabilitation period.
- The bones of the hand grow together after about 2 months, plus 1.5 months of development.
- Fingers recover faster than any other bone, they need a month to grow together and a month to recover.
If there are joint contractures, then the process of recovery and development will be long and will be at least six months. When nerves have been injured or the fracture is complicated by an infection, the healing and recovery process can take several years.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
