Signs and treatment of an ulna fracture. Fracture of the ulna: causes, symptoms and basic treatment methods Fracture of the ulna: signs of first aid briefly

An elbow joint fracture is a complex injury that is diagnosed in 20% of fracture cases. It is known about the elbow joint that it consists of 3 bone fragments, namely the humerus, radius and ulna. Inside the joint there are articular joints that are connected to each other by ligaments and muscles.

The anatomy and physiology of the elbow joint is quite complex, so the injury that occurs when the elbow is fractured is considered dangerous. As a result of such an injury, many irreversible complications arise. As for how long it takes for a fracture of the elbow joint to heal, it must be said that it takes a very long time and, as a rule, a conservative treatment method is rarely used here, due to its ineffectiveness.

The elbow joint, in its anterior part, consists of the following bone fragments:

• Humerus.
• Ulna.
• Radial bone.

On the back of the joint are located:

• Brachial bone.
• Olecranon process.
• Elbow bone. Coronoid process.

Based on these anatomical features, injury can occur in any part of the joint. In this regard, symptoms, diagnosis and treatment will differ.

Classification

Fractures that are diagnosed in victims are divided into several types by experts. According to the place where the injury occurred, according to the nature of the damage. There are other classifications. More on this later.

Depending on the location, damage can be classified:

Fracture of the olecranon

One of the components of the elbow joint is the olecranon process. Damage to the appendix often occurs when a person falls on their elbow from a height. In this case, a fracture of the olecranon is identified with displacement in its upper part. As a rule, such an injury entails an extra-articular injury. The fracture takes a long time to heal, as a result of the fact that the triceps tendon is attached to the area itself; it, in turn, pulls the broken fragments towards the shoulder, which creates a diastasis between the fragments.

Fracture of the coronoid process

With a fracture of the coronoid process, the symptoms and nature of the damage are different. For example, isolated injuries of the coronoid process are a rare occurrence. Typically, a fracture results in a posterior dislocation or complex injury within the joint.

Due to the anatomical features, injuries to the coronoid process are extremely rare. Because this bone fragment is located as deep as possible under a thick layer of soft tissue. And as a rule, the fracture occurs at the base or at the very top of the process. Comminuted fractures of the coronoid process almost never occur.

Ulna shaft fracture

When the diaphysis is fractured, the injury is divided into 3 groups. The first group includes undisplaced fractures. To the second - . The third group of diaphysis fractures includes fractures with displacement of the proximal third, which is combined with subluxation or. The third type of fracture in medicine is called a Monteggia fracture.

Intra-articular fracture

The injury occurs inside the joint.

Extra-articular fracture

The damage occurs outside the joint.

Metaphyseal fractures

The injury occurs near the joint.

In addition to this classification, it is customary to distinguish:

• Closed fractures- the most common. When they occur, injuries to the skin do not occur; the damage itself can be identified by secondary signs, such as pain, swelling, and limited movements.

• Open– accompanied by damage to the skin.
• Splintered– when injured, there is a feeling of bone fragmentation. This type of fracture can be diagnosed using an image that will show the number of fragments and their location.
• With offset– palpation shows visible displacement of the bone.
• No offset when there is a crack - the easiest type of fracture. The healing process occurs faster than with other injuries.

Trauma code according to ICD 10

Fracture of the ulna, ICD10 code

Causes

A fracture of the olecranon, as mentioned above, occurs as a result of a fall from a height when the victim’s arm was slightly extended. Very often, for example, this happens precisely when the process is fractured with displacement.

When the coronoid process of the ulna is fractured, they speak of an indirect injury, which occurs as a result of a fall on the arm, in particular on the dorsum of the forearm, when its maximum flexion has occurred.

Fractures of the diaphysis occur due to the impact of a direct blow, which is also called a “bludgeon fracture.” Most often, this type of damage is diagnosed during an accident or fight.

In addition to the above-described causes of elbow injury, which are classified as a traumatic factor, there is also a pathology group in which fractures occur with minimal pressure on the bone. Most often, this happens when the patient has a calcium deficiency, or when he has diseases of the musculoskeletal system, for example, osteoporosis, arthrosis, osteoarthritis.

Symptoms

The symptoms of an elbow fracture are similar, but there are some differences. Since they depend on the location of the damage.

In case of a fracture of the olecranon process of the ulna, the signs of a fracture are characterized by acute pain and swelling of the joint itself. However, its limited action is noted. The elbow cannot be bent or straightened. Hemorrhage in the joint is also diagnosed. Pain may also be experienced when palpating the injury site.

When the coronoid process is fractured, the signs of damage are hardly noticeable and mildly expressed. There is often pain in the elbow and swelling at the injury site. Painful sensations can also occur when palpating the injured limb.

Clinical manifestations of a fracture

The symptoms of an elbow fracture are similar, but there are some differences. Because they depend on the location of the damage.

In case of a fracture of the olecranon process of the ulna, the signs of a fracture are characterized by acute pain and swelling of the joint itself. However, its limited action is noted. The elbow cannot be bent or straightened. Hemorrhage in the joint is also diagnosed. There may be pain when palpating the injury site.

In case of a fracture of the coronoid process, signs of injury are hardly noticeable and mildly expressed. There is often pain in the elbow and swelling at the injury site. Painful sensations may also occur when palpating the damaged area. hurts with passive movements. As a result of such symptoms, a conclusion is often made about intra-articular damage. And only with the help of x-rays can a correct diagnosis be made.

As a rule, the symptoms of an elbow fracture are not very different from each other; the difference can only be the degree of its severity.

First aid

A fracture of the elbow joint, if treated in a timely manner, heals faster and without any complications. If help is not provided in time, negative consequences may occur.

The first thing to do is call an ambulance. The victim is then given pain medication. They are trying to immobilize the limb for further transportation of the patient to the traumatology department. Complete immobilization consists of fixing the limb with a splint or wire loop. As a tire, you can use any available materials, for example, a piece of thick cardboard or plywood, or part of a board.

The splint must be applied in the area of ​​the elbow joint so as to immobilize the hand and shoulder joint. As a rule, fixation is carried out in a bent state at an angle. But this position can increase the pain. If the pain becomes stronger, the hand must be left in its original position and fixed.

Diagnostics

A fracture of the ulna, namely its olecranon process, is diagnosed using an x-ray. If the image revealed an intra-articular fracture of the elbow joint, additional research in the form of CT or MRI may be prescribed. X-ray examination is carried out in two projections. As a rule, this is enough.

With the help of CT, it is possible to detect to what extent the process has been damaged. After this, treatment tactics are determined. As for MRI, the study is necessary for complex fractures, as well as during surgery to compare the fragments.

Features of diagnostics of the coronoid process

Compared to other types of injuries, damage to the coronoid process may not be detected on anteroposterior and lateral films. Because to diagnose it, a forced position of the hand is necessary, which will remove the process from the zone of overlap of the shadow of the beam head.

To do this, the arm must be positioned so that the process and epicondyle of the humerus are in contact with the cassette. The forearm should be set in semi-pronation and in a flexion position at an angle of 160. The rays should be centered on the coronoid process. In this position, it is possible to diagnose a fragment of the coronoid process in almost 100% of cases. Since the process itself completely emerges from the shadow of the head of the radius.

Treatment

A fracture of the elbow joint without displacement, or with a slight (up to 5 mm) displacement, is compared using closed reduction without surgery. In all other cases, if displacement has occurred, treatment tactics are based on the location of the injury.

When treating a fracture of the elbow joint, particularly the coronoid process, reduction is rarely performed. Since all attempts to carry it out did not give the expected results. However, no significant shifts occur in this department. Treatment of a fracture of the coronoid process is carried out on an outpatient basis for 6–8 days, while the arm is fixed with a posterior plaster splint, with the forearm bent at an angle of 60–65 degrees. Then a complex of functional treatment is shown. As a rule, with such damage, working capacity returns within 5–6 days.

Interesting!

An article by one doctor told the story of how a 38-year-old woman came to him. She was diagnosed with a nonunion fracture of the coronoid process, and the injury was received 7 months ago and the pain was felt only when she extended her arm. During the survey, it was found that a fracture of this part of the bone was not detected at all. The doctor who examined her earlier diagnosed her with a bruise. At the same time, she was shown thermal procedures and therapeutic exercises immediately on the second day after the injury. Why did this happen and the diagnosis was not identified? This is due to the fact that the woman did not have severe pain, as a result of which she did not pay attention to it. Therefore, no one thought about additional research methods. Conclusion - it is always necessary to conduct a series of studies that will allow you to identify the injury immediately.

What happens if a fracture is not treated?

If the type of fracture in the victim is not diagnosed in time and timely therapy is not started, irreversible consequences will arise, the situation will be aggravated by contracture of the elbow joint after the fracture. Contracture of the elbow joint is a pathology in which pinching occurs when flexing and extending the arm. The reasons for this are different, but most often the condition is provoked by undiagnosed elbow fractures, inflammatory processes in the joint, various and degenerative tissue changes.

What is used to immobilize an elbow fracture?

To fix the damage, orthoses, bandages, plaster splints or bandages can be used. If the coronoid process is fractured, plaster cannot be applied. For this purpose, an orthosis is used.

If severe pain occurs, the use of painkillers is indicated.

Surgical treatment

Displaced fracture of the ulna, comminuted fracture, open fracture - conditions for which surgery is indicated. Typically, complex injuries of the elbow joint are subject to surgical treatment. If a person falls on his arm at a certain angle, a fracture of the styloid process of the ulna occurs. It is worth knowing that surgical intervention should be carried out in the first 24 hours after the fracture occurred.

During the operation, reposition is performed, then the bones are fixed using pins, bolts, and knitting needles. Sometimes they can perform osteosynthesis if necessary (sometimes they resort to performing osteosynthesis according to Weber, using knitting needles and tightening loops).

If the procedure is performed, bone fragments are removed, and an endoprosthesis is used instead of the epiphysis bone. If the fracture is open, with many displacements, and fragments have entered the joint, a periarticular plate is used. After the operation, the limb is also immobilized by placing a cast on the arm for 4–6 weeks.

How long to treat and wear a cast

An elbow fracture in many cases requires wearing a cast. But usually everyone is interested in how long you need to walk in a cast, and how long will the injury take to heal? The duration of wearing the cast, as well as the healing time, depends on a number of factors (age, illness, weight, lifestyle, etc.). Typically, the duration of wearing a cast is 1–2 weeks, 4–6 weeks. It all depends on the injury received and the nature of the assistance provided. The patient is on sick leave for the entire time he is in the cast. He is given a certificate of incapacity for work. In order for the bone fusion process to go faster, the doctor may prescribe.

Rehabilitation

An olecranon fracture is a complex injury, but if you approach its diagnosis, treatment and rehabilitation correctly, you will be able to completely restore the mobility of the limb. In case of a fracture of the coronoid process of the ulna, the recovery period should not exceed 6-7 days. Next, functional therapy begins. It is performed carefully and gradually.

Massage for this injury is strictly prohibited. This is worth paying attention to! Because there is a risk of myositis ossificans.

In the process of rehabilitation of the olecranon process, the following are indicated:

1. A set of exercises is recommended to be carried out in the first days after the injury has been sustained. At first, the exercises are done only with the fingers, since the muscles that are responsible for the movement of the fingers are located in the articular area from the epicondyles.
2. Next, under the supervision of a doctor, the arm is restored in the elbow joint after a fracture and surgery.

While the limb is in a cast, in the first stages of recovery, it will be difficult to straighten and bend the arm. But this must be done gradually, as soon as the doctor removes the plaster and allows rehabilitation after a fracture of the elbow joint.

It will be very difficult to immediately restore hand mobility, so you need to be patient. If these recommendations are neglected, arthrosis may develop.

Physiotherapy

For the purpose of rehabilitation, exercise therapy is performed after fractures of the elbow joint. But physical therapy is allowed only after consultation with a rehabilitation doctor, who will indicate the type of exercise and duration of treatment. Gymnastics and physical exercises after a fracture are usually performed at all stages of recovery. Electrophoresis, UHF, and magnetic resonance therapy can also be used.

Methods for elbow restoration after injury

The main goal of developing the elbow joint after a fracture is to restore its mobility and return to a normal lifestyle. Typically, after surgery, the recovery process takes longer. Therefore, you have to wear a plaster splint or orthosis for a long time (2-3 months). In this case, the arm muscles and tendons partially atrophy.

As for exercises to develop the elbow joint, they are necessary, but at the beginning of rehabilitation, pain and discomfort may occur at the site of the fracture.

If the ulna is fractured without displacement, the cast is removed more quickly. The rehabilitation process is not long.

Fracture restoration using exercise therapy is performed in 3 stages.

At the first stage

1. The patient is in a cast. In this case, the doctor recommends doing breathing exercises on the second day after the plaster was applied. It is also necessary to perform exercises on the part of the arm that is free and does not have a cast on it, that is, the area of ​​the shoulder and fingers.
2. Perform exercises that will help reduce swelling and normalize blood supply in the injured limb:

Place your hands behind your head on a pillow, sending impulses to the hand that is in a cast. Do not overexert your injured arm.

After removing the cast, you must slowly bend and straighten your elbow.

Second phase

1. The patient is sitting. The hand should be on the table. It’s great if the table is at the level of the armpit. This is followed by slow flexion and extension of the elbow.
2. The patient sits with his forearm resting on a high chair. You need to take a children's toy (ball, ball) in your hands. In this position, it is necessary to roll out the forearm area.
3. The patient is in a sitting position, but can also stand if it is more convenient. You need to take a small ball or stick in your hands. Using such objects, exercises are performed to develop the joint. In this case, the patient should not experience pain.
4. The patient is standing. The torso needs to be slightly tilted forward. In this case, you need to raise your arms slowly up, then lower them. Take your fingers into a “lock”, then raise them up and lower them behind your head, then return to the starting position.

Third stage

At the third stage, the above procedures are continued. Physiotherapy with paraffin applications is also included. The minimum number of procedures is 5 times. Exercises can be performed several times a day. If pain occurs, you need to consult a doctor and choose another treatment or reduce the load.

At the first stage, with any type of fracture of the elbow joint, massage cannot be done.

Massage

An elbow fracture is a complex injury. And the massage should be indicated by a specialist, since not all types of injury can be performed with massage. For example, if the coronoid process is fractured, massage is strictly prohibited. This can trigger the development of myositis ossificans. Therefore, it is better to consult your doctor about massage.

Complications

In case of a displaced fracture of the elbow joint, it is important to perform rehabilitation correctly, since improper physical activity leads to:

• to new injuries;
• to swelling in the area of ​​injury;
• to painful sensations in the elbow with radiation to the forearm;
• to reflex muscle contractions;
• to the growth of bone deformities of the elbow joint.

Fractures of the elbow joint lead to complications if assistance and treatment are carried out incorrectly. The rehabilitation process is very important, since if medical recommendations are violated, difficult-to-reversible consequences occur in the joint. In complicated cases, it is problematic to straighten the arm.

Prevention

In order to prevent a fracture of the olecranon without or with displacement, it is recommended to take care of your health and diagnose the problem in a timely manner. Remember, the entire rehabilitation process is important. You cannot choose a recovery course on your own. This can only be done by a doctor after studying the medical history. Next, you must follow all medical instructions. In such situations, it will be possible to avoid consequences and new injuries.

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.

- This is a violation of the integrity of the ulna as a result of traumatic impact. It can be combined with dislocation of the radius or be isolated. The pathology is manifested by severe pain, swelling, and impaired movement. With fracture-dislocations, shortening and deformation of the forearm occur, as well as a pronounced limitation of movements in the elbow joint. To confirm the diagnosis, X-rays are performed, and less commonly, CT scans are performed. Treatment can be conservative (reposition, immobilization with a plaster cast) or surgical (fixation with a pin, suture or plastic surgery of the annular ligament).

General information

Causes

Injuries usually occur at home and during sports activities. Some patients have a history of criminal incidents involving the use of sticks, batons, iron rods, etc.

• Isolated fractures of the ulna can occur in people of any gender and age; the cause is usually a direct blow to the forearm.
• Monteggia injuries (fractures of the upper third of the ulna combined with dislocation of the radial head) are more often observed in young and middle-aged men actively involved in sports; they are formed when falling on the arm or during a defensive movement when a person tries to parry a blow with a bent arm.
• In children, a Monteggia fracture is often formed as a result of a direct blow to the inner surface of the elbow joint.

Pathogenesis

An isolated fracture, as a rule, is located in the lower third and is transverse, so the fragments are well held and rarely displaced. Displacement along the axis and length is uncharacteristic, since the correct position of the fragments is maintained thanks to the intact radius. In some cases, there is an angular displacement, which necessarily requires elimination, since in the future it can negatively affect the function of the forearm.

A Monteggia injury is a high-energy injury. With such fractures, the fragments of the ulna are displaced, and the forearm is shortened, as a result of which the head of the radius is dislocated in the proximal radioulnar joint. Such injuries require mandatory reposition; otherwise, in the long term, a deformity of the forearm is formed, and dysfunction of the elbow joint is noted.

Classification

There are isolated fractures of the ulna without displacement and with displacement of fragments. Monteggia fractures are always accompanied by displacement; depending on the nature of the damage, orthopedic traumatologists distinguish four types of injuries:

• 1 – the head of the ray is dislocated anteriorly, bone fragments form an angle open anteriorly.
• 2 – the head of the radius is dislocated posteriorly, the fragments form an angle open posteriorly.
• 3 – the head is dislocated laterally, the ulna is damaged in the proximal part.
• 4 – the head dislocates anteriorly, causing a fracture of the proximal parts of both bones of the forearm.

Symptoms

Isolated fracture of the ulna

With an isolated injury, the patient complains of sharp local pain. The area of ​​damage is swollen and sometimes deformed. Hemorrhages are possible. Movements are limited due to pain, the function of the forearm is usually moderately impaired, active extension and flexion of the elbow joint, supination and pronation of the hand are carried out to a small extent, and rotational disorders are most pronounced.

Palpation of the damaged area is sharply painful; when palpating the rib of the bone in the case of a displaced fracture, a “ledge” is determined. Pathological mobility is not always detected during a careful examination; intensive manipulations to detect this sign are not recommended in order to avoid secondary displacement. Axial loading is painful.

Monteggia fracture

The elbow joint and forearm are swollen, deformed, and bruising is possible. The swelling is growing rapidly. A comparative examination reveals some shortening of the forearm on the side of the injury. With posterior dislocations, it is sometimes possible to palpate the displacement of the radial head. In the area of ​​the ulna fracture, a “step” or “ledge” is felt, which has arisen due to the displacement of the fragments.

There are no active movements; when passive movements are attempted, spring resistance is detected. The points of greatest pain are determined in the projection of the head of the beam and in the area of ​​​​violation of the integrity of the bone. When pressure is applied along the axis of the limb, pain occurs in the projection of the fracture. Crepitation is possible.

Complications

Complications are not typical for isolated injuries. Rarely, in the presence of unresolved displacement, a mild deformation of the forearm and a slight limitation of the functions of the limb are noted. With Monteggia fractures, concomitant vascular and neurological disorders are often observed, especially damage to the radial nerve, accompanied by a disorder of movement and sensitivity in the innervation zone.

Sometimes, with Monteggia injuries, compartment syndrome develops, caused by an increase in subfascial pressure as a result of severe swelling of the limb. Signs of this syndrome are increasing persistent pain, pain when pulling the fingers and increased tension in the forearm. After fusion of the bone, in the presence of the listed complications, dysfunctions of the forearm are possible, causing disability.

Diagnostics

Diagnosis of ulna fractures is carried out by a traumatologist. In the process of diagnostic search, medical history data, examination results and instrumental studies are used. The examination program includes the following procedures:

• Objective examination. Swelling is detected, hematomas and deformation of the limb are possible. Pathognomonic signs of a fracture are bone crunching and the presence of a “step” in the area of ​​damage. Dislocation of the radial head is indicated by characteristic deformation and springy resistance during passive movements.
• Radiography. It is the main instrumental method. To clarify the diagnosis for isolated fractures, x-rays of the forearm are prescribed in two projections. For Monteggia fractures, radiography of the forearm is performed, including the elbow and wrist joints, using two standard and oblique projections.
• Other imaging techniques. They are of auxiliary value for injuries of the ulna. Sometimes bone CT is prescribed to detail damaged structures, and MRI is prescribed to study the condition of soft tissues.

If a Monteggia fracture is suspected, attention is paid to the presence of neurovascular disorders and the pulse in the radial and ulnar arteries is assessed. If signs of damage to a nerve or vessel are detected, consultations with a neurologist or neurosurgeon and vascular surgeon are prescribed.

Treatment of a fractured ulna

Treatment of an isolated fracture

In the absence of displacement, treatment on an outpatient basis is possible. If bone fragments are displaced, hospitalization in the trauma department is indicated.

• Conservative treatment. For non-displaced injuries, a cast is applied for 6-10 weeks. If there is displacement, reposition is performed, a control photograph is taken after 10 days, and the plaster is kept for 10-12 weeks.
• Surgical interventions. Operations are performed when reposition is unsuccessful and it is impossible to keep the fragments in the correct position. Osteosynthesis of the diaphysis of the ulna is performed with a plate or pin. Immobilization also lasts 10-12 weeks.

In the postoperative period, antibiotic therapy is prescribed, UHF, analgesics, antibiotics, exercise therapy and massage are used. The sutures are removed after 8-10 days, then the patient is discharged for outpatient treatment.

Treatment of Monteggia fracture

The patient is hospitalized in a trauma hospital and closed reduction is performed.

• For extensor injuries, transarticular fixation using a thin pin is sometimes performed to prevent re-dislocation.
• For flexion fractures, fixation of the head with a pin is usually not required.

A plaster cast is applied, a control x-ray is taken, the limb is elevated to reduce swelling (the arm is placed on a pillow or suspended from a special stand), and physiotherapeutic procedures are prescribed. The needle is removed after 2-3 weeks. After 4 weeks, the plaster is replaced, changing the position of the limb. Immobilization is stopped after 8-12 weeks.

Surgical treatment is more often required for the extension type of fracture. Osteosynthesis of the ulnar diaphysis with a pin and suture of the annular ligament are performed. If the ligament cannot be sutured, plastic surgery is performed using an autograft cut from the patient's fascia. The beam head is adjusted and fixed with a knitting needle.

For neck fractures, resection of the radial head is performed; in such cases, a suture of the annular ligament is not required. To speed up fusion, auto- or homografts (small plates of cancellous bone) are applied to fragments of the ulna in some cases. The wound is stitched up. After the operation, physiotherapy, massage, and physical therapy are prescribed. Immobilization is carried out for 3 months.

In children, the surgical tactics are the same as in adults, the only difference is that they try to avoid head resection for any type of injury, since this can negatively affect the growth of the radius and the function of the forearm.

Forecast

For isolated fractures, the prognosis is usually favorable. Monteggia's injury belongs to the category of complex fractures that are difficult to treat and are often complicated by impaired limb function. In the early period, adults often experience nonunion or delayed fusion of the ulna due to a lack of soft tissue on the ulnar side of the forearm.

The outcome may be angular curvature or displacement of the head of the radial bone. Sometimes synostoses (fusions) form between the radius and ulna bones, resulting in limited rotational movements. Subluxations and dislocations of the head of the ulna in the area of ​​the distal radioulnar joint are also possible.

Prevention

Prevention involves taking measures to reduce the level of injuries. It is necessary to observe safety precautions when performing various work at home and at work, playing sports, and equip playgrounds using non-hazardous materials. Measures to reduce the number of criminal incidents (fights) play a certain role.

A non-displaced elbow fracture is a disruption of the structure under the influence of an external traumatic force. Injuries can happen at any age. The most common cause of injury in children is falls. Teenagers and middle-aged people suffer fractures as a result of sports injuries and traffic accidents.

In older people, injuries are caused by age-related problems with coordination of movements and the development of osteoporosis, in which bones become brittle.

Etiology of disorders

The ulna, together with the radius, forms the elbow joint in the upper part, and the wrist joint in the lower part. The limb and joints are equipped with large vessels and nerve fibers, so if a person’s arm breaks, adequate first aid is necessary to help prevent negative consequences and complications.

An open or closed fracture is often a consequence of injury to the upper limb, with the ulna of the left hand being affected much more often than the right. A fracture of the head of the radial bone of the elbow joint is diagnosed more often than other injuries; the violation is accompanied by damage to the medial collateral ligaments and other soft tissues located in the upper carpal joint.

Athletes suffer from this disorder when falling on an extended and extended upper limb. Injuries to the upper third of the ulna are often diagnosed in older people, which is associated with physiological changes and thinning of bone tissue.

In children, damage is also common and is mainly a consequence of excessive mobility, active games, during which one ends up landing unsuccessfully on the hand and getting a fracture. In this case, the styloid process often suffers, and the injury is of a compression or avulsion nature.

Classification

Since the elbow joint consists of 6 anatomical units, in addition to the neurovascular bundles, the types of possible fractures are quite diverse. Mainly they include:

• A fracture of the head of the radial bone is the most common. This happens because it lacks muscle protection and is more susceptible to injury;
• Fracture of the neck of the radius;
• Transcondylar;
• Fracture of the coronoid process of the ulna (usually combined with a dislocation or other injury to the forearm).

In turn, they are divided into different types.

1. Depending on the location of the injury:
   1. intra-articular – characterized by rupture of ligaments, disruption of the integrity of the joint, displacement of bones and their fragments may occur;
   2. periarticular - occur without displacement of bones and their fragments.
2. By the number of bones affected:
3. According to the nature of damage to the skin:
   1. closed;
   2. open.

All these factors are taken into account when assessing the severity of a person’s condition. Particular attention is paid to intra-articular fractures, since they are more unfavorable in treatment and rehabilitation.

Deformation and destruction in the forearm area is considered a consequence of a fracture of the radius or ulna. In severe cases, the victim breaks both bones at the same time. If the damage produces many fragments (3 or more), the damage is classified as fragmentation. If there are 1-2 broken areas, the fracture is classified as a simple fracture. He, in turn, happens:

• transverse;
• oblique;
• helical.

Considering the location of the injury to the forearm area, there are:

• violation of the upper or proximal segments of the bone;
• fracture of the diaphysis of the ulna, when a lesion in the middle third is diagnosed;
• destruction of the lower or distal end.

Depending on the change in the location of the fragments, fractures are distinguished:

• no offset;
• with offset.

The elbow joint has a rather complex structure. The presented part of the upper limbs is formed by the radius and ulna bones, which connect to the humeral tissue. Inside the main elbow joint there are several small ones.

Large nerves and blood vessels, which are responsible for the mobility of the entire limb, pass through this area.

Therefore, fractures of the bones of the elbow joint, in addition to difficulty in motor functions and the development of serious pain, are fraught with a whole host of complications.

What therapy is used for injuries of this type? How to treat elbow fractures? What is required for rehabilitation? We will try to answer the questions presented.

Causes of injuries

Elbow fracture. Signs, treatment and rehabilitation - Joint disease

The elbow joint is a complex mechanism formed by the radius, ulna and humerus bones, and contains many vessels and nerves in its structure. With the help of this joint, the human hand has greater mobility and allows movements of quite different amplitudes.

Injuries to this joint, including fractures, are a common occurrence that requires serious treatment, including surgical intervention, sometimes even repeated.

An elbow fracture is a fracture of one or more bones or processes that enter the elbow joint.

Types of Elbow Fractures

All elbow fractures can be divided into categories.

• Intra-articular fractures - there is a rupture of the triceps tendon, and bone fragments are displaced upward
• Periarticular fractures - tendon rupture and displacement are not observed and
• Closed fractures - without compromising the integrity of soft tissues and skin.
• Open fractures - the integrity of the skin is compromised.
• Comminuted fractures - separation of one or two fragments from the end of the bone
• Shattered fractures - there are a large number of small fragments.
• Incomplete fracture - a crack forms in the bone.
• Along the fracture line, transverse, longitudinal and oblique fractures can be distinguished.
• Often a fracture is combined with a dislocation and is called a fracture-dislocation.

The most common of the above types of fracture is intra-articular - a fracture of the olecranon process, which does not have muscle protection.

Symptoms and signs

There is pain when palpating the process. If a displaced fracture occurs, you can feel a void between the fragments. When trying to bend the arm in the damaged area, pain is felt, which intensifies at the moment of straightening. With no offset there is a little more freedom of movement.​

The most common locations of fractures

If the fractures of the articular part of the humerus are of a crushing nature, then the surgeon can replace the elbow joint with a prosthesis. This type of fracture of the elbow joint with comminution is more common in elderly patients.

Implants are made of metal and plastic and are attached with special bone cement. A fracture of the elbow joint after surgical treatment may be complicated by damage to the ulnar nerve.

This happens relatively rarely and nerve function is often restored almost completely. ​

​X-ray examination will clarify the exact location and type of fracture. Based on these data, the doctor will determine treatment tactics.​

Symptoms of a fracture

​There are several methods for fixing the bone. The choice of the most suitable one remains with the specialist. The success of treatment of a Monteggia injury depends on strong and maximally stable fixation of the ulna and correct reduction of the radial head. The experience and professionalism of the surgeon plays an important role here.​

The following symptoms are observed with this injury:

​After a week, a repeat X-ray is performed in order to finally exclude possible displacement of the fragments. For a non-displaced fracture, a cast is applied for 6-10 weeks. Next, the patient wears a scarf for some time.

A fracture of the ulna needs timely and proper treatment. The ulna has a complex structure, and its damage can be combined with dislocation or displacement. Therefore, the sooner the victim contacts a specialist, the greater his chances of fully restoring the motor function of his hand.​

Characteristics of fractures

​Titanium plate with screws for fixation (operation);​

• ​ To determine the fracture, an x-ray of the elbow joint is performed in two projections. This research is sufficient in most cases. For a more detailed study of the nature of the fracture, computed tomography (CT) is performed. With its help, you can determine how much the process is destroyed and decide on treatment tactics. Whether to perform the operation and using what metal structure. All these nuances are very important for better fixation and the best treatment outcome.​
• ​Internships:​

​Improperly or poorly healed fractures can cause impaired motor function. If the therapeutic rehabilitation complex does not help restore functions, then surgical treatment is also used. Through a longitudinal incision, all fragments are returned to the correct position and fastened. If the process does not fit well into place, then the tendon is fixed.

Closed fractures

​X-ray examination is carried out to determine the extent of the damage. Moreover, they do it in two projections. The first is the area of ​​the forearm in its upper part, and the second is the place of attachment of the muscles of the humerus. This is done in order to find out whether the annular ligament has ruptured due to a displaced fracture.​

Hand injuries, especially those occurring inside the joint, are dangerous, and approximately 20% of them occur to the elbow.

The elbow joint is one of the most complex in the human skeleton, since it combines three bones at once: the humerus, the ulna and the radius.

In addition, it consists of a large number of small articular joints. All this is united into a single elbow by connective tissues (muscles, ligaments).

The mobility of the limb is carried out due to the dynamics of the joint, as well as the blood vessels and nerve endings passing through the elbow. A fracture of the elbow joint is a serious injury, as it is often complicated by numerous consequences.

In terms of severity, only the injured knee can compete with it, since they are similar in structure. Treatment after a fracture will take a long time, and the recovery period is even longer.

Sometimes it is almost impossible to completely restore hand mobility.

Causes of damage

There are many risk factors for an elbow fracture. Among them are the most common ones, as a result of which damage occurs:

• Bad fall. It is common for a person to protect himself with his hands when falling, placing them in front of him. A fracture of the ulna is no exception. Having fallen on an outstretched or half-bent arm at the elbow, a person receives the main blow precisely on the elbow joint. In other words, by putting your hands forward, a person takes most of the damage on them.
• Chronic diseases. Bone fragility develops as a result of a number of chronic diseases, which makes it almost impossible to prevent a fracture of the elbow joint. Such diseases include osteoporosis, arthritis and many others that purposefully or indirectly destroy the bone structure. Physical stress or force of impact on the affected bone easily destroys it.
• Physical blows. A blow to the elbow can occur in a fight, a traffic accident, or simply by accidentally colliding with a door frame. Depending on how much force was applied and where the blow was directed, the severity of the injury is classified.

Injuries occur much less frequently as a result of playing sports, since athletes pay special attention to equipment, and the elbow is usually protected with an elastic bandage or shield.

Elbow fracture classification

A fracture of the arm in the elbow joint is divided like other fractures. The classification of an elbow fracture is determined as follows:

• closed or open;
• intra-articular or periarticular;
• with displacement and without displacement (usually only one bone breaks);
• multiple, fragmented, etc.

A fracture of the ulna is often accompanied by dislocation of the entire joint or stretching of connective tissues and is complicated by many diseases, for example, arthrosis.

As mentioned, the elbow is made up of three main bones and a large amount of muscle and connective tissue. In addition, the complexity of the elbow joint allows for a special classification based on the location of damage.

The olecranon process is the weak point of the elbow. It is not covered, like the rest of the elbow, by soft and muscle tissue.

A direct fracture of the olecranon is a fairly rare occurrence, but in the event of an unsuccessful fall, bone particles can break off from it.

Such damage is greatly complicated by the displacement of fragments that damage blood vessels and muscle tissue.

Injury to the bone head or neck of the radius occurs as a result of a fall on an outstretched arm. This type of violation is more common.

Violation of the coronoid process often occurs in combination with damage to the forearm and shoulder or is accompanied by a dislocation.

The most common fracture is the radius; it may be accompanied by articular dislocation and damage to the humeral condyle.

Symptoms of a fracture

Diagnosing the main signs is quite simple - they are clearly expressed. A serious reason to seek medical help will be the presence of at least one of the symptoms listed below.

After an injury occurs, the victim experiences the following symptoms:

• the elbow joint swells greatly, the arm increases in size. The swelling is so extensive that it can be seen with the naked eye and without palpation - manual examination of the victim;
• the victim is unable to move his arm, the elbow joint after injury is not able to move at all - the complex structure affects it;
• An extensive hematoma quickly forms at the site of injury. Blood flowing into soft tissues after damage to blood vessels tends to thicken over time and lead to unpleasant consequences. Such blood clots can only be removed through surgery;
• severe pain syndrome - severe, unbearable pain;
• Crunching and visible deformation will be another cause for concern.

Displaced fractures of the ulna are characterized by external signs: irregularities, pronounced arrangement of bones and inaccuracies instead of the usual structure of the arm.

In more detail, the symptoms of injury can be considered in individual cases:

1. An olecranon injury is a very common hand injury, especially in childhood. The symptoms are not much different from the main ones - the pain is felt on the inside of the joint, radiating to the shoulder and forearm. Swelling and bruising spread along the outside of the joint. In addition, an olecranon fracture is assessed by whether it is possible to bend the arm at the elbow. In this case, it is possible to perform rotational movements with the shoulders. There is a characteristic crunch of bone fragments, as well as external deformation of the hand.
2. A fracture of the head and neck of the radius is characterized by widespread pain at the front of the joint, radiating to the forearm. Hematomas and edema are not very pronounced, crunching and deformation are absent. A clear difference between this injury and others is the limitation in rotational movements.
3. Injury to the coronoid process of the elbow joint is described by severe aching pain that intensifies with palpation. Movement of the joint itself to bend and extend the arm is practically impossible. Minor edema is expressed by slight swelling of the tissue over the joint, with no external deformation.

Thus, an external violation of the arm and crunching of bone fragments appears only if a fracture of the entire elbow joint has occurred with displacement.

Urgent Care

Providing first aid is simply necessary. In this case, the tactics of first aid should be selected according to the severity of the injury.

However, it is not possible to reliably establish the complexity of the injury, for example, with a closed fracture.

However, everyone should know the basics of first aid in order to help themselves or others in time.

The basics of pre-medical care fit into the following several measures, which significantly simplify the course of the treatment period:

• Applying a homemade splint to immobilize the arm. It is necessary to firmly fix the hand on a solid object from the middle of the forearm to the fingertips. To do this, it needs to be tied to an improvised splint (for example, a board) or tied to the victim’s body if it is not possible to build a homemade splint.

• To generally reduce pain, local anesthetics and anti-inflammatory drugs are used. Intramuscular administration of the drug will be more effective, but this is not always possible.
• If possible, apply cold to the injury. This will help reduce swelling of the injury so that diagnosis can be made without complications. Ice will slightly reduce overall pain. Even an ordinary bottle of cold water or a frozen semi-finished product can play the role of ice.

Diagnostics and therapeutic therapy

A traumatologist diagnoses an injury based on several x-ray images. The elbow is photographed in several projections - this gives a more complete picture of the injury, making it possible to establish possible consequences.

An elbow fracture is characterized by swelling that increases over time. In the first week, the swelling increases. If the fracture is closed, a tight plaster cast is applied to the arm.

Painkillers and anti-inflammatory complex drugs are used to relieve pain.

The operation is allowed for open displaced fractures. Moreover, such operations must be carried out immediately, since if they are delayed, the functions of the hands will be partially lost. In rare cases, fixation with knitting needles is used.

An internal fracture with fragments and displacement is treated with bone grafting. Additionally, fixing plates are installed. Due to them, complete, but at the same time natural fixation of the hand in one position is achieved. This promotes rapid bone healing.

Rehabilitation

Rehabilitation actions begin during the treatment period - after 14 days it is recommended to strain the arm muscles under a cast. After which physiotherapy, consisting of magnetic therapy, is prescribed. The impact is carried out directly through the plaster cast.

Only a traumatologist can give recommendations on how to develop the elbow joint. After the bandage is removed, additional physiotherapeutic actions are added - electrophoresis, mud and sea salt baths. After a fracture, the hand needs to be massaged.

The elbow joint after a fracture needs serious and targeted development to fully restore all functions. Approaches to the exercises are performed for 10 repetitions, the number of which increases gradually. They must be performed three times a day.

In addition, it is recommended to diversify your daily meals with foods that contain magnesium and calcium. This will contribute to the restoration and fusion of bones. During preventive actions, you need to take vitamins aimed at replenishing missing substances in the body.

It is possible to recover from a fracture of the elbow joint, but it will take quite some time. That is why such injuries can be characterized by both rapid healing and slow development of motor function.

Any injury, including a fracture of the elbow joint, can also provoke a considerable number of chronic diseases in the future. Having a broken arm at the elbow is not a death sentence, so you shouldn’t give up.

Fractures of the elbow joint account for about 1/5 of all intra-articular fractures. Due to the complex anatomical structure of the elbow, there is a high risk of complications.

Its structure consists of the connection of: the bones of the elbow and radius (forearm) and the bones of the shoulder. And the joint itself is divided into 3 small ones:

• superior radioulnar;
• humeroulnar;
• brachioradial.

In addition, the passage of a large number of vascular and nerve bundles is concentrated in the joint. Therefore, it is very important to receive timely and correct treatment.

Diagnostics

During an external examination, the doctor may detect pathological mobility of bone structures, including parts of the radius. In this case, radiographic studies are necessary to determine the nature and severity of the injury. The traumatologist orders x-rays in two projections - this is an informative diagnostic method that allows you to accurately see the location of the injury.

For greater detail, computed tomography is used. It reveals not only the presence of a fracture, but also additional cracks, small bone fragments and other important details that determine treatment tactics.

If in case of damage to the middle third of the bone, radiographic examination is sufficient, then intra-articular injuries require a more careful study. Fractures of the coronoid process of the ulna are often accompanied by dislocations and subluxations, injuries of the humerus and radius. Therefore, additional studies are carried out: MRI, ultrasound, etc.

The diagnosis is made by an orthopedist or traumatologist based on clinical and instrumental examinations.

1. Anamnesis collection. The doctor assesses the circumstances of the injury and listens to complaints.
2. Visual inspection. When examining a patient with a fracture without displacement of the fragments, swelling of the arm, hematomas, and limited motor function are detected. On palpation, the patient complains of pain in the area of ​​the fracture.
3. Radiography. The picture is taken in two projections. On an x-ray, the fracture appears as a dark stripe with jagged edges. Using a diagnostic procedure, you can clarify the location of the injury and study the fracture line.
4. CT. A layer-by-layer scan of the affected bone is performed, which makes the picture more detailed than with an x-ray examination. A more accurate, but also more expensive diagnostic method, its price is quite high, and the procedure is not performed in all medical institutions.

Articular fractures may be accompanied by nerve damage, so consultation with a neurologist is necessary.

Before prescribing treatment for a fracture, it is important for the doctor to make an accurate diagnosis and only then decide which treatment regimen is suitable for the individual case. First, the doctor conducts an initial examination, after which a more detailed examination is necessary.

For this, the person is sent for an X-ray examination. If a violation of cartilage, ligaments and tendons is suspected, an MRI or ultrasound is additionally prescribed.

Treatment

The choice of treatment tactics directly depends not only on the type of fracture, but also on the age of the patient. Let's say that if this is a fracture of the radial process without displacement or with displacement, but minimal (no more than 3 mm), then most likely the treatment will be conservative.

The plaster is applied with the arm positioned at an angle, palm up. It is extremely important to completely avoid putting stress on this arm during treatment.

The operation is performed if a displaced fracture, intra-articular fracture, or condyle fracture occurs. It is carried out in stages:

1. Restoration of the location of fragments preceding the injury;
2. Their fastening with any surgical devices;
3. Stitching.

In the case of elbow fractures, when the bone is so crushed that it is not possible to compare it, they resort to implantation of a graft. For these purposes, bone tissue from a donor or the patient itself is used. The arthroplasty method is also widely used.

Bandages are also used to treat fractures and more. It can also be used during the rehabilitation period. Its main qualities are: reliable fixation of the damaged joint, as well as relieving the load from it.

Throughout almost the entire treatment period, anti-inflammatory non-steroidal drugs, painkillers, and antibiotics are prescribed. In cases of open fractures, an anti-tetanus injection is given immediately.

To restore bone structures, a board is appointed. Traumatologists resort to closed reposition of fragments in most cases.

The method of reduction is determined by the specifics of the injury. Reposition is carried out after anesthesia.

In the absence of displacement, specific treatment is not required. A regular plaster cast is sufficient.

With such damage, therapy for broken bones is minimal - the injury is treated independently using the method of immobilization.

With the development of the inflammatory process in traumatology and orthopedics, manipulations with medications are carried out - the introduction of antibacterial and anti-inflammatory drugs, the use of painkillers and immunoglobulins. A fracture takes a long time to heal if multiple bone structures, muscles, nerves, and blood vessels are damaged.

Based on the medical history, the doctor selects the optimal treatment method and sets the period of immobilization. How long to wear a cast for an uncomplicated fracture of the diaphysis? No more than 80 days.

Treatment of a displaced arm fracture will be more difficult, and the healing time of the bone reaches 112 days. It takes a month for broken bone tissue of the epiphysis to heal without displacement.

Patients are interested in how long it takes for a displaced lower epiphysis injury to heal - the bones heal in one and a half to two months.

Surgical treatment

Surgical reduction is used if a person breaks his arm in several places. Surgical intervention is advisable for simultaneous articular pathologies, multiple fragments, and soft tissue rupture.

For fractures of the radius and ulna, in which the fragments are displaced in a chaotic manner, osteosynthesis is indicated. During the manipulation, the fragments are connected using plates or knitting needles.

After surgery to reduce a displaced fracture of the ulna, the limb is cast - surgical intervention minimizes the risk of possible deviations.

For a subperiosteal fracture with soft tissue rupture, surgical treatment is extremely rarely required. The exception is when the fusion occurs incorrectly. If a fracture of the styloid process of the ulna is accompanied by articular disorders and multiple fragments, then surgical treatment is also resorted to.

Fractures of the ulna without displacement of fragments are treated with conservative methods. Under local anesthesia, the affected areas of the bone are aligned and a cast is applied. The patient is prescribed drug therapy.

A week later, a repeat x-ray of the limb is taken to monitor the condition of the bone structures. Next comes a rehabilitation course, including physiotherapy and exercise therapy. You can learn more about the methods of treating a closed fracture from the video in this article.

Urgent measures

If you suspect a fracture of the forearm bone, it is necessary to provide competent and timely assistance to the victim.

The instructions for providing first aid provide the following algorithm of actions:

• fix the limb using special splints or improvised means - flat boards, thick cardboard, rolled newspapers;
• to prevent the development of severe swelling, you can apply cold to the damaged area - ice, frozen foods, a container of cold water;
• in case of severe pain, give the victim an analgesic in an age-appropriate dosage;
• call doctors or take the victim to the emergency room yourself.

It is contraindicated to palpate the injured limb on your own. Inept manipulations can cause undesirable consequences.

Basic treatment

For undisplaced fractures, a plaster cast is sufficient. In case of damage to the elbow, the plaster is applied so that it covers the hand and shoulder joint. The hand is placed on a scarf garter or a special brace in a physiological position. It takes 4-6 weeks for the bone to heal.

The following medications are prescribed at the same time:

• analgesics to relieve pain;
• calcium preparations for bone tissue restoration;
• means to improve blood circulation.

In the fourth week, a control photo is taken.

A rehabilitation course is prescribed immediately after the acute symptoms of injury have been eliminated. It is needed to eliminate symptoms, accelerate bone healing, and restore impaired hand functions.

The course includes:

• physical therapy - carried out by performing active and passive movements with the injured arm;
• massage - performed to improve microcirculation in the fracture area, increase muscle tone, and prevent joint contracture;
• physiotherapy - UHF, magnetic therapy, electrophoresis, inductothermy have an anti-inflammatory, analgesic effect, and accelerate metabolism in tissues.

Rehabilitation is carried out on an outpatient basis and lasts at least a month.

​Scientific and practical interests: foot surgery and hand surgery.​

​Moscow, st. Berzarina 17 bldg. 2, Oktyabrskoye Pole metro station

Treatment occurs in exactly the same way if there is displacement of the fragments, but only slightly. The hand is fixed in the position in which the fragments take their places. Complete restoration of bone tissue requires 3 to 4 weeks.​

​Almost always the fracture occurs inside the joint. If there is no damage to the tendon in the area of ​​the triceps muscle, then the broken parts are displaced nearby and this is hardly noticeable. If a tendon ruptures, the muscle contracts and pulls the fragments with it.​

But more often surgery is necessary. For a simple fracture of the proximal end of the ulna, treatment is reduced to tightening the bone using a wire loop, after repositioning the bone with or without Kirschner wires.​

​displacement of the head of the radius.​

​shortening of the forearm on the injured side;​

​Depending on the mechanism of injury, there are 4 types of Monteggia injury:​

​sharp local pain;​

​1. Exercises begin to be performed in the first days after an injury in the fingers, since the muscles responsible for the functioning of the fingers begin from the area of ​​the elbow joint (from the epicondyles).​

A fracture of the olecranon process, which has a pronounced displacement of fragments, requires mandatory surgical intervention by a trauma surgeon. Otherwise, the forearm will not fully extend; this is a serious violation of the function of the upper limb.

The success of the operation depends on the accurate comparison of bone fragments and their fixation in the correct anatomical position. And further success depends on the correct development of the elbow joint.

​ A fracture of the olecranon process occurs mainly when falling on the elbow from one’s own height. There are cases when this fracture is characterized by a displacement variant.

Most often it occurs at the level of the apex of the process, but sometimes it causes extra-articular damage. It is to this area that the tendon of the triceps brachii muscle (triceps) is attached, which “pulls” the broken elements proximally (towards the shoulder), thereby creating a diastasis between the fragments, which is a serious obstacle to fracture healing.

​Moscow, st. Koktebelskaya 2, bldg. 1, metro station Dmitry Donskoy Boulevard

If the fragments are severely displaced, surgery is required. It is used if there is a distance of 2 mm or more between the fragments or they are displaced to the side.

Surgical intervention is also required for fractures with multiple fragments. After determining the type of injury, the most suitable treatment method is selected, in which it will be possible to begin movement in the injured area as early as possible.

To treat a fracture, osteosynthesis is used, that is, the bones are fastened with two knitting needles and titanium wire. The operation can be performed as soon as the patient is admitted to the department.

​Fractures occur with simultaneous dislocation of the head, called Malgenya injury.​

Anatomy of an olecranon fracture

​If an intra-articular fracture of the elbow joint has occurred and fragments have formed, then it is most difficult to reposition the ulna. In this case, they resort to bone grafting. In case of comminuted fractures, tightening with a wire loop cannot be performed, otherwise the articular surfaces will be shortened, then special dynamic compression plates are used.​

Symptoms of an olecranon fracture

​To prevent serious complications and increase the chance of a successful recovery with restoration of all functions of the hand, it is important to begin treatment of the injury as early as possible.​

​with a posterior dislocation, the displacement of the head of the radial bone is felt;

​I - dislocation of the head of the radial bone forward.​

• ​swelling in the area of ​​injury;​
• ​2. Early development after surgery is performed under the supervision of a doctor.​
• ​When visiting a doctor, the patient complains of pain and dysfunction of the elbow joint.​

Diagnosis of olecranon fractures with and without displacement

​Moscow, Bolshoy Vlasyevsky lane 9, Smolenskaya metro station​

​After anesthesia, an incision is made over the damaged area. All blood clots and very small bone particles are removed through it.

The fragments are adjusted relative to each other in the correct position using a single-tooth hook. Using a drill, two knitting needles are inserted.

At a distance of at least 3 cm from the fracture, holes are drilled for pulling the wire holding the fragments together. The ends of the wire are twisted with pliers.

No more than 2 cm of the length of the needles is left above the olecranon, the rest is bitten off. The ends are bent towards the bone.

Treatment of olecranon fracture

​12 folk methods for home treatment​

If displacement is not diagnosed after an injury, surgery is not performed. The affected areas are aligned under local anesthesia, and then a plaster cast is applied.

After 5-7 days, additional radiography is performed, which will show the condition of the bone structures and how the area that is not yet fused is being restored. For a fracture without displacement, the plaster should be worn for 2.5-3 weeks, after which the bandage is removed.

Resection of the head of the radial bone and removal of damaged soft tissues is prescribed for destructive injuries with displacement, the formation of many fragments and damage to the muscular and ligamentous apparatus. The doctor, under local anesthesia, sets the damaged areas, and to ensure that the fragments heal correctly, a staple, screw or plate is applied.

After all manipulations, the arm is immobilized using a plaster cast, and 5-7 days after surgery the patient is advised to perform light exercises aimed at developing the muscular corset of the affected limb.

Treatment should begin with immobilization. The upper limb is brought into a bent and elevated position. This is important to do as first aid, especially for a displaced injury. Otherwise, the fragments can damage the vessels and nerves near the joint. But if fixing in this position causes pain, you should not force your hand into this position.

In a medical institution, radiography is performed in two projections. If the injury is intra-articular, a computed tomography scan is also performed. The limb is then fixed using a plaster splint. If no displacement is detected, apply a plaster cast for a month.

An injury with displacement and the presence of fragments requires their reposition. Closed injury and displacement of fragments by less than 5 cm allows this to be done percutaneously. In other situations, surgical treatment is performed.

Conservative treatment

It is carried out in the absence of displacements. This is done by wearing a plaster cast. Physiotherapy and exercise therapy may also be prescribed.

The goal of conservative treatment is to ensure limb immobility, prevent swelling and relieve inflammation.

A non-displaced radial neck fracture requires wearing a cast for three weeks. Injury to the coronoid process is treated with a plaster cast for a month. Then rehabilitation is required, which takes about two weeks.

If the epicondyle is fractured and there is no displacement, a posterior plaster splint or circular bandage is applied to the upper limb. The duration of wearing it is three weeks.

Displacement of the fragments requires surgery, after which a cast is also applied for a period of six weeks. Rehabilitation in this case lasts from two weeks to one and a half months.

It is carried out in case of injury to the elbow joint with displacement, as well as in the treatment of an old fracture. The operation is necessary to compare the fragments. If this is not done, there may be serious consequences, in particular, the forearm will not fully extend. An open injury requires intervention within 24 hours.

Surgical treatment consists of comparing the fragments and fixing them with knitting needles or bolts. In some cases, it becomes necessary to eliminate fragments or a damaged head.

In the latter case, an endoprosthesis is installed instead of the head. The operation also involves suturing muscle tissue, torn tendons or ligaments.

In case of violation of the integrity of the ulna, plastic surgery is required, in which fixing plates are used.

Rehabilitation period

In the postoperative period, for rigid fixation, it is recommended to wear fixators - an orthosis or splint. The orthoses contain thin metal plates. The components of splints are plastic or iron plates. The use of fixators is necessary to hold the limb in the same position. This is important to create complete rest for the injured hand.

However, you need to remember that wearing a cast leads to muscle atrophy. For prevention, you need to start doing exercises already on the second day after the injury, when the pain in the arm becomes less pronounced. The consequences of improper rehabilitation are contracture in the articular area of ​​the elbow.

On the second day after injury to the articular area, you should perform gymnastics for the fingers, hand, wrist joint and shoulder. To prevent swelling, the limb should be carefully lifted above the head and placed behind the head.

First aid

Medical attention should not be neglected if there is a strong blow to the hand. Outwardly, there may seem to be no cause for concern, but hidden injuries can cause further health problems. In a child, the fracture heals quickly, so it is important to reposition and fix the bone structures in a timely manner.

How to provide first aid for a fracture? To begin with, you should exclude accidental impact on the hand to prevent displacement. The following manipulations are carried out at home:

• give a painkiller;
• cool the injured limb;
• immobilize the injured arm.

It is necessary to consult a doctor as soon as possible if there is severe swelling, hematoma and acute pain. A traumatologist will tell you what to do if you have a fracture of the ulna. Until medical care is provided in a hospital setting, the patient’s forearm is fixed. Immobilization for an isolated fracture of the ulnar shaft is a prerequisite for delivery to the emergency room.

Before applying a bandage, the limb can be numbed with topical anesthetics. Immobilization is carried out using a splint. This can be a stick, a board, or any hard and straight object. The dressing is not made tightly, but soft tissue is placed between the splint and the surface of the body. In case of open damage, it is necessary to carry out antiseptic treatment.

If there is a suspicion of destruction of the bone tissue of the upper extremities, it is important to provide adequate first aid and immediately transport the victim to the trauma department. If a child or adult has an open fracture, it is important to disinfect the site of the injury using peroxide and brilliant green. After this, it is necessary to stop the bleeding by applying a rubber tourniquet above the injured area.

Next, the limb is immobilized using a special splint or available hard and smooth materials (branches, sticks, knitting needles). If a person has severe pain, it is recommended to give an intramuscular injection of a pain reliever. At this stage, first aid ends. The victim must be taken to the hospital; it is advisable that the person be in a sitting position during transportation.

If fractures or dislocations of the limbs are suspected, it is strictly contraindicated to try to palpate or straighten the affected area on your own. This provokes the development of severe complications.

Complications and consequences

Any violations in the integrity of the structure of bone tissue or even the skin does not pass without a trace. The most harmless thing that can result from a fracture of the elbow joint is a bruise. But usually everything is much worse. Often a persistent contracture can develop, that is, the arm at the elbow does not fully extend or does not bend.

To avoid this, you should strictly follow the sets of exercises prescribed by your doctor. It should be remembered that if during exercise therapy your shoulder hurts and this does not allow you to perform any movements, you need to tell your doctor about it. Very often salt baths help to cope with this; their use helps:

• Warm and numb the injured area;
• Improve its metabolism;
• Remove swelling;
• Accelerate the regeneration of bone and cartilage tissue.

A very scary complication is non-fusion or improper fusion of the bone. This entails surgical intervention, and sometimes even more than one. A broken arm is very dangerous to health and can even result in disability.

To avoid consequences, you must not only follow the prescribed treatment, but also remember that rehabilitation also includes proper nutrition. You should eat foods with plenty of collagen. It is found in meat, fish, seaweed, etc.

The most important way to avoid complications is, of course, to avoid fractures. To do this, you need to be more careful and follow safety rules at work and at home.

An isolated fracture of the diaphysis (middle part) of the ulna is rarely accompanied by complications. A comminuted rupture with displacement is fraught with malunion. In this case, the fragments of the ulna become overgrown with hard tissue. Callus after a fracture negatively affects the functioning of the limb. Atypical fusion may require repositioning.

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megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

No matter what folk remedies I tried, nothing helped, it only got worse...