How much plaster should be on the hand. How to relieve swelling after a broken arm: traditional methods. Electrical stimulation of bone and muscle tissue

Injury to the hand in the form of a fracture in the wrist area is especially common among women in the winter. Only plaster can restore the integrity of the bone, allowing you to immobilize the hand in a certain position; it also ensures proper fusion of the bone, especially if we are talking about a fracture with a displacement in the wrist.

Why does the radius bone in the wrist break?

To break your wrist, you need to fall on your outstretched arms or put your hand up and plop down on it with your whole body. A complicated fracture is characterized by displacement of part of the bone to the back of the hand, the fragments, in turn, move towards the palm.

If the fracture is not displaced, it is almost impossible to determine it by eye. Symptoms of a fracture do not appear as clearly as with displacement:

• the patient complains of aching or dull pain;
• the affected wrist swells;
• blueness of the skin appears.

You cannot touch your wrist; any touch causes severe pain. It is impossible to bend and straighten the joint - this also provokes pain. First of all, you need to observe whether your fingers move. If not, then the problem is much more serious than it seems at first glance; most likely, the integrity of the tendons is compromised. The presence of a fracture is determined by x-ray; if the doctor insists on a bruise, still ask to be sent for an x-ray to make sure there is 100% no serious injury.

If you fall and the pain persists, it is best to seek help from an emergency room as soon as possible. A fresh injury is more treatable, especially when it comes to the displacement of a bone in the wrist, because it is important not only to put the bone back in its original place in time, but also to fix the sore spot with a plaster.

How to treat a broken wrist

Another method other than applying and wearing a cast to fuse the radius bone on the wrist has not yet been invented. If eliminating an ordinary fracture is not difficult (you need to lay your arm straight and carefully apply a plaster on top), then an experienced traumatologist will have to work with the displacement - the bone is first set, this must be done under anesthesia.

To prevent the patient from screaming in pain, the injured area is injected with a solution of novocaine, causing the area to begin to seem to swell, and after 5-7 minutes the doctor begins to return the bone to its original place.

It is important that the traumatologist is experienced - if after removing the plaster it is discovered that the bone has not healed properly, it is broken again and set again. In general, the process can be repeated endlessly, in a sense, lucky patients with a slender physique, in whom the skeletal system is visible visually - then even a beginner can cope with bone displacement.

If the fracture is not displaced, a plaster splint is applied starting from the upper one third of the forearm to the very base of the patient’s fingers.

How long does it take to restore the integrity of the wrist in a cast?

If we are talking about a non-displaced fracture, you need to wear a cast for 2-3 weeks, maximum 1 month. If a child is injured, a couple of weeks of wearing a plaster cast is enough to return the arm to full combat readiness.

In this regard, experts, answering questions about how to fix a wrist fracture and how long to wear a cast, point to the influence of a number of important factors:

• the nature of the injuries received;
• patient's age;
• where the fracture is located, which bone is damaged.

What you need to be aware of is the possible occurrence of swelling of the arm. When an arm with a cast is lowered upward, this happens often, so doctors recommend supporting the limb with a specially constructed bandage. It can be made from ordinary dressing materials:

1. Wide or medium bandage from 8 to 20 cm wide.
2. A scarf folded in half, a scarf - such a device does not tear and supports the sore arm well.
3. In pharmacies you can find a special supportive tight bandage.

A bandage or scarf is attached around the neck, then the height is adjusted to the level at which it is convenient to hold the injured arm. But if the fracture is displaced, this device is unlikely to help in the first stages of restoring the integrity of the wrist. A fracture, returning the bone to its place, analgesic injections - all this is stress for the hand, so it is not surprising if, after “sealing” in plaster, the limb swells greatly in the first day.

When should you sound the alarm? If cyanosis of the fingers and severe swelling appear, you need to urgently return to the traumatology department, cut the plaster and carefully push its walls apart, and then fix the bandage again with bandages, but in an expanded position. Otherwise, there is a high risk of squeezing blood vessels and nerves, which can cause tissue to begin to die, and sensitivity and mobility will be significantly reduced.

Dangerous consequences of wearing a plaster cast

What are the most dangerous side effects that await a patient when a limb is compressed with a plaster?

1. Volkmann's contracture.
2. Lack of sensitivity.
3. Complete necrosis of a limb followed by amputation.

What other complications occur while wearing a cast, besides denting the limb:

1. Bedsores. To avoid the appearance of bedsores, the doctor must extremely carefully and gently bandage the injured arm in a cast, especially for patients who are unconscious at the time of medical care. Ideally, the plaster cast should be uniform, without obvious lumpiness. The traumatologist needs to ensure that there are no cotton swabs or plaster crumbs left on the inside of the bandage - they can put a lot of pressure on the wrist.

Signs of bedsores are very characteristic:

• numbness in one area of ​​the arm in a cast;
• the appearance of brown spots on the surface of the gypsum;
• feeling of tightness and constriction;
• putrid smell.

In this case, it is not enough to simply cut the plaster; it is necessary to carefully examine the limb and, if there are wounds, treat them with Levomekol and Vishnevsky ointments.

1. Formation of abrasions and blisters on the skin. The plaster material must fit tightly to the hand; if this rule is not followed, bubbles will form inside. Inside they are filled with serous fluid, and it happens that a hemorrhagic admixture is formed. If it seems to you that there is a wet spot under the plaster, then we are talking about a bubble. The only way to get rid of it is by opening it. Soft bandages are applied to protect the wound from plaster.
2. Allergy to gypsum material is very rare and manifests itself with characteristic symptoms:

• itchy skin;
• redness;
• dermatitis.

The way out of this situation is to treat your wrist with a knitted tubular bandage before applying a plaster cast.

Prognosis in the treatment of fractures

Experienced doctors, having studied the patient’s medical record, can predict the final result after the fracture:

1. Fractures in patients under 16 years of age heal faster.
2. To avoid complications, complete rest is necessary.
3. The course of the disease is complicated if the patient suffers from chronic illnesses. Banal hypovitaminosis can also cause poor healing of cracks in the skeletal system.
4. For fast and proper bone healing, it is recommended to take calcium-based medications.

Rehabilitation of the wrist after removal of the cast

After removing the plaster cast, the hand may be in a different state, it all depends on the type of injury:

1. If the fracture is closed and not displaced, it is enough to handle your hand carefully over the next 2 weeks - do not lift heavy objects, do not do heavy physical exertion, do not unscrew the tap, replace outdoor games with passive ones, put off sports for another month.
2. If the wrist has been injured with dislocation of the radius, concomitant therapy with pain medications is often required. Plaster for a bone broken with displacement is applied 2 times - the first curved one is not removed for a couple of weeks, the second one is applied in the straight position of the limb and another 2-3 weeks are counted.

For many patients, the moment the cast is removed comes as a shock. The fact is that the injured hand is deprived of mobility, while it is sensitive and swollen to everything. To restore the wrist, it is necessary from the very first day of release from the plaster cast to attend exercise machines to develop and restore the functions of the hand. The gym offers its services at the clinic. Your task is to train muscles that have been inactive for 1 month.

You can train at home using a tennis ball, sponge or rubber wrist expander. Physical therapy should begin with warming up the hand - gently move your wrist, describing a circle, until the first pain appears. Give your hand a little rest before squeezing elastic objects. The exercise is carried out until the limb gets tired.

It happens that the fingers are already developed, but the wrist still does not want to bend at an angle. It is necessary to restore the painful area slowly, tilting the brush a little at a time and always alternating with stroking and warming up.

Treatment of fractures of the bones of the upper limb is carried out by using fixed bandages. Plaster casting is widely used in orthopedic and traumatological practice and successfully competes and is combined with other modern treatment methods.

Gypsum is a mineral that is common in nature. For medical use, gypsum is crushed into a powder and then fired to remove the water from the molecule. As a result of this processing, a fine white powder without a specific odor is obtained. If gypsum is combined with water, it turns into a paste-like mass, and after 5-10 minutes it acquires the density of stone. Due to its physical and chemical properties, gypsum is widely used in medicine..

Thoracobrachial bandage

In hospital, for fractures of the humerus, a thoracobrochial bandage is most often used. It is applied with the patient sitting or standing. If the bandage is applied after surgical fixation of the fragments, the patient is in a supine position.

Before applying a bandage, the victim is given general and local anesthesia.

To immobilize the shoulder in a supine position, it is necessary to prepare an orthopedic table or a special stand for the patient’s head and a wooden rail. The patient's injured arm is carefully bent at the shoulder joint to an angle of 45 degrees and turned slightly outward to an angle of 30-45 degrees. For fractures in the upper third of the shoulder, the angle of abduction of the shoulder from the body is approximately 90 degrees. The victim's forearm is bent at the elbow joint to a right angle and the hand is placed in a position of slight dorsiflexion at an angle of 160 degrees and abduction towards the elbow at an angle of 160-170 degrees.

To prepare the dressing, the doctor must:

1. Wide plaster bandages (18-24 cm) in the amount of 10 pieces;
2. Medium bandages (8-12 cm) in the amount of 5 pieces;
3. Plaster four-layer splint (12-14 cm wide);
4. Two wooden sticks.

The bandage can be applied to the patient with the help of three assistants. One person holds the patient's arm in the correct position, two people cast it, and one person soaks the bandages.

It is advisable to make the bandage with a cotton wool lining. You can make a continuous lining of cotton wool along the entire length of the plaster cast, or you can place it only under certain areas of the human body: on the forearms, as well as on the shoulder, elbow and wrist joints.

First, the doctor must prepare a plaster corset. To do this, you need to roll out a plaster bandage over a cotton-gauze pad to the pubic symphysis. The first two rounds of the bandage are done circularly, and then in a spiral. A necessary condition for applying a bandage is that one round covers half of the previous one.. The plaster casts should rise to the patient’s axillary region, gradually creating a corset over the entire torso. A piece of bandage is thrown over each shoulder girdle, then its ends are plastered to the corset. After the first layer has been applied, it is necessary to immediately apply the second, after which the doctor models the bandage. It is necessary to apply another 3-4 layers and again simulate the bandage.

When the corset is made on the patient’s torso, it is necessary to trim the edges using scissors and knives. This is done so that the bandage does not interfere with walking and sitting. The patient should move his healthy arm and tell the doctor whether the bandage is preventing him from moving. In the upper part of the plaster corset, the doctor makes a deep incision extending to the manubrium of the sternum.

After this, the plaster splint intended for the injured arm is soaked and smoothed. The longuet must be placed so that it lies in the middle of the axillary line on the corset. It goes from the scapula of the healthy side to the sore shoulder along the posterolateral surface, then along the back surface of the forearm, the back of the hand to the heads of the metacarpal bones.

To model the area of ​​the elbow joint, the splint is partially trimmed on both sides. The next splint is placed directly on the previous one, from the scapula of the affected side along the anterior surface of the shoulder joint, shoulder and forearm to the heads of the metacarpal bones. The doctor must partially cut it on both sides in the area of ​​the elbow joint. These splints must be reinforced with 2 wide and 2 medium bandages.

Additionally, the shoulder joint area is strengthened with plaster splints. Then the edges of the bandage are carefully trimmed so that it does not prevent the patient from sitting down and does not limit the range of active movements of the healthy arm. To ensure more reliable abduction, a wooden stick reinforced with a plaster bandage is placed between the iliac crest and the elbow joint. When applying the bandage, it is modeled in the area of ​​the collarbone, between the shoulder blades, and in the elbow joint.

The most common mistakes when using a plaster cast:

1. The doctor applied a plaster cast that was too short, which does not provide fixation of bone fragments;
2. Poor modeling of the plaster cast was performed;
3. The patient complains to the doctor that the bandage is very tight;
4. The doctor changed the bandage prematurely;
5. The victim did not undergo X-ray control after applying the bandage.

Complications when using plaster casts

1. Compression of the upper limb;
2. Bedsores;
3. Scuffs and bubbles;
4. Allergic reaction to plaster.

Upper limb compression

The main reason for compression of the arm by a plaster cast is an increase in the volume of the upper limb due to swelling of the soft tissues.

Swelling, as a rule, accompanies all injuries and is a consequence of local inflammatory reactions. The likelihood of compression of the upper limb in a victim increases if the broken bone was immobilized with a circular plaster cast in the acute period.

In order to monitor the state of blood circulation in the injured hand when applying a cast, the fingers should be open, mobile, pink and warm to the touch.

If the plaster compresses the blood vessels and nerves, the patient experiences pain in the area of ​​the bone fracture or throughout the entire upper limb, the fingers become swollen and cyanotic, and their sensitivity and mobility are impaired.

If these signs of compression of the victim's arm appear, the doctor should immediately remove the plaster cast. If the patient's upper limb is fixed in a circular plaster cast, it must be carefully cut with scissors and forceps, moving the edges in different directions.

When immobilizing an injured arm with a splint, the doctor must cut the soft bandages with special forceps or separate the edges of the splint with his hands. After such manipulations, signs of circulatory and innervation disorders in the hand quickly disappear.

If you do not cut the bandage in time, this can lead to irreversible consequences:

1. Volkmann's contracture;
2. Loss of hand function;
3. Necrosis of the upper limb and its subsequent amputation.

Bedsores

If a limited area of ​​the upper limb of a victim is subjected to constant pressure with a plaster cast, then local blood circulation is disrupted and a bedsore occurs.

Why do bedsores occur from plaster casts?

1. Prolonged compression of the hand can lead to necrosis and suppuration of the skin and soft tissues;
2. All bone and tendon protrusions on the hand should be well bandaged;
3. The doctor must be extremely careful when applying plaster casts to unconscious victims or those with impaired skin sensitivity;
4. When applying a bandage, the doctor should avoid squeezing it with his fingers during the hardening process;
5. The cause of local pressure on the tissue of the injured arm may be various irregularities on the inner surface of the plaster cast;
6. Local circulatory disorders in the arm may result from plaster crumbs getting under the bandage, and in some cases pressure on the tissue may be exerted by a matted wad of cotton pad.

Signs

1. The patient experiences pain in the arm and a feeling of discomfort;
2. The patient complains of numbness in the hand in a limited area;
3. Over time, the above symptoms intensify and a brown spot may appear on the surface of the bandage;
4. Some patients experience a putrid odor from the dressing.

What a doctor should do when bedsores form:

1. If, during application of the bandage, the patient complains of burning pain in the arm or discomfort, it is necessary to remove the plaster and examine the skin;
2. If the victim has had a circular bandage applied, then a small “window” can be cut out in the area that causes discomfort and pain in the person;
3. If, some time after application, the plaster cast begins to emit a purulent odor or becomes saturated with discharge, the doctor should remove it and carefully examine the skin of the hand;
4. If a wound develops on the skin of the injured limb, it is treated by applying ointments (Levomikol or Vishnevsky) and applying a sterile bandage;
5. If the patient has a splint applied, it is necessary to bend it and look at the condition of the skin of the upper limb.

Scuffs and bubbles

The plaster cast should fit tightly to the upper limb throughout its entire length. If this condition is not observed, then the bandage will move in small areas and bubbles will form in this place. They usually contain serous fluid inside, sometimes a hemorrhagic admixture appears in it.

If the doctor does not detect blisters on the skin of the injured arm in time, they are opened and the contents are poured under the plaster cast. Patients often complain to the traumatologist about a feeling of weeping under the bandage.

Doctor's actions

If a patient complains about the mobility of the upper limb under a plaster cast, the traumatologist must perform an inspection of the skin. After this, he additionally strengthens the splint bandage with soft bandages, and if the patient has a circular bandage on his arm, it should be replaced.

Allergic reaction to plaster

Allergy to plaster is very rare in victims.

Signs:

1. Itching of the skin under the plaster cast;
2. Redness of the skin;
3. Eczema-like dermatitis on the skin under the bandage.

Before applying the plaster, the doctor should ask the patient about the presence of an allergic reaction to plaster or chalk; if any, the patient is given a plaster over a knitted tubular bandage.

Prevention of complications when using plaster casts

1. Careful adherence to plaster application techniques;
2. Constant monitoring by medical personnel;
3. Attentive attitude of the doctor to the patient’s complaints;
4. Compliance with the rules of plaster cast care.

Care for patients with a plaster cast:

1. After applying a plaster cast, it should not be broken, so the patient is carefully transferred to a hard surface;
2. The upper limb is given an elevated position. If the patient is in bed, a small pillow should be placed under the arm (so that the bandage does not break and tissue swelling does not develop);
3. The doctor must provide the patient with conditions for the bandage to dry gradually;
4. If the patient shows the first signs of compression of blood vessels and nerves, as well as bedsores, the bandage must be cut along the midline on the dorsum of the forearm.

Problems that arise after plaster removal

Many patients are interested in the question: “ How long to wear a cast for a broken arm?»

The healing of the bones of the upper limb after a fracture very often depends on the type and complexity of the fracture. In some victims, a bone fracture may be quite complex and accompanied by rupture of ligaments and muscles, requiring surgical intervention. The simplest arm fracture without displacement of bone fragments usually heals within a month.

However, not all patients can use their hand well immediately after removing the cast; as a rule, this will require some time and a rehabilitation program, because the most important thing in the recovery period is active development so that the patient’s injured hand does not remain motionless.

The rehabilitation period after a broken arm can take a long time, it all depends on the desire and efforts of the person.

After removing the cast, the arm can fully restore its physiological functions in 1-6 months. In children, the process of bone fusion proceeds much faster than in adults. In elderly patients and postmenopausal women, the process of callus formation is slower, and they usually require a longer time for rehabilitation. Before removing the plaster, the traumatologist must take an x-ray of the patient to make sure that a good bone callus has formed and the bone has grown together.

After removing the plaster, some patients come to the traumatologist with complaints: “My hand is swollen after removing the plaster” or “My hand hurts after removing the plaster.”

After prolonged immobilization of the patient's arm with a plaster cast, the functionality of the joints of the upper limb is significantly reduced and, as a result, swelling of the soft tissues and limited mobility of the arm occurs.

Swelling of the upper limb after removing a plaster cast is a fairly common phenomenon in traumatology, which requires not only medical supervision, but also treatment.

Treatment of edema

1. Physiotherapy . The patient should perform regular slow flexion and extension in all joints of the injured arm;
2. Physiotherapy. After a fracture, the use of UHF, paraffin applications, and hydrotherapy is indicated;
3. Magnetotherapy. The use of a magnetic field after fractures has a good effect on the circulatory and lymphatic systems, which leads to a decrease in the severity of swelling of the hand;
4. Electrophoresis. Using this technique, drugs are delivered directly to the tissues of the injured hand;
5. Massage. After a fracture, the patient is recommended to undergo a massage course to completely relieve swelling of the soft tissues of the arm.

Drugs that are used to reduce swelling of soft tissues after a fracture:

1. Heparin ointment;
2. "Lioton - 1000";

Some patients have very severe arm pain after the cast is removed, this is due to the fact that it is not yet fully developed. If the pain syndrome is severe, the traumatologist prescribes the patient a short course of non-steroidal anti-inflammatory drugs or non-narcotic analgesics.

After removing the cast, a person must load his arm and perform therapeutic exercises; women and men can take on any work and not be afraid that a fracture will occur again.

It is very important to pay special attention to the hand during the rehabilitation period after a broken arm.. In some patients, after removing the cast, the hand swells and hurts. You can develop it by performing a certain set of exercises, massage and physiotherapy. In the first week after removing the cast, you can use non-steroidal ointments to relieve swelling of the hand.

Regular exercise in the pool helps develop joints and restore the physiological function of the hand.

During the rehabilitation period, the patient should receive adequate nutrition, which includes daily consumption of meat, dairy and fermented milk products, cheese, cottage cheese, and a large amount of fruits and vegetables.

To reduce arm pain and swelling of the hand after removing the cast, it is recommended to wear an orthopedic brace.

Patients begin sports training only after permission from the attending traumatologist, but not earlier than three months after the injury.

Fracture of the radius, with or without displacement, accounts for 20% of all fractures of the human skeletal system. It differs in location, direction of displacement of fragments, and complications. From the article you will learn features of displaced and non-displaced fractures, how long you will have to walk with a cast, the timing of bone healing and instructions for recovery and rehabilitation.

Types of radius fractures and their signs

Damage to the radial bone of the forearm can be intra-articular, violating the integrity and functionality of the wrist joint, and extra-articular, when the fracture line does not extend to the articular surface.

With a closed injury, there are no visible damage to the skin; with an open fracture, the integrity of the skin is compromised, which is often accompanied by complications such as rupture of blood lines and nerve trunks.

Fracture without displacement of bone fragments

Every second case of fracture radius occursno offset. This is due to the fact that the muscle groups on the forearm are poorly developed and do not have a mechanical effect on the bone at the time of its damage. An x-ray reveals a crack. An incomplete fracture can be localized both in the head and body.

In most cases, non-displaced injury is diagnosed in children and adolescents as a result of active games or sports. The symptomatic picture is blurry. There is no visible deformation of the limb, the swelling is not pronounced, the pain resembles a bruise.

Fracture with displacement of fragments

Displacement of bone fragments occurs under the influence of external force or internal force ─ the pressure of skeletal muscles on the beam. A characteristic sign is a clearly defined deformity of the upper limb.

The fault line is often transverse or oblique. The displacement occurs in the longitudinal or transverse plane; in 50% of cases, the bone simultaneously shifts horizontally and vertically.

In case of automobile or occupational injuries, impacted (compression) fractures are more often recorded. They are accompanied by massive damage to muscle tissue and deep layers of skin. The x-ray shows small fragments (bone fragments).

Typical radius injury

Fractures of the radius in a typical location are the most common forearm injury. When falling on the hand under the influence of body gravity, the radius bone cannot withstand and breaks in the area of ​​the lower third, 3-5 cm above the wrist joint. Depending on the location of the palm during the fall (turned outward or inward), two types of injury are distinguished.

Wheel Fracture or flexion ─ occurs with a direct fall on an open palm, while the bone fragment moves to the back of the forearm. According to statistics, 2/3 of such injuries in a typical location are of this type.

Smith's fracture or extension ─ the fall occurs on the palm turned inward, the fragments are displaced to the inside of the wrist.

Important! At the same time, nearby anatomical formations are damaged, the integrity of the radioulnar and radiocarpal ligaments is disrupted, and a dislocation or fracture of the lunate, scaphoid bones, and styloid process occurs.

Distinctive signs of a radial fracture in a typical location:

bayonet-shaped deformity of the lower arm;

sharp and severe pain;

quickly formed edema and swelling;

extended wrist joint;

any severe restrictions on the movements of the forearm and hand.

The injury is characterized by seasonality. A fracture in a typical location is more often diagnosed in women after 45 years of age in winter (during icy conditions). The strength of bone tissue decreases after menopause; it becomes loose, vulnerable, and sensitive to mechanical stress.

Plaster application for a radius fracture

Before applying a cast, an x-ray of the limb is prescribed in two projections, which allows qualitatively assess the degree of injury. According to indications, a closed reposition of bone fragments is performed, then they are fixed with bandages, and a control photograph is taken.

Purposes of plaster:

immobilization of the hand for proper fusion of bone fragments;

acceleration of recovery;

relief of the patient's general condition.

Standard the bandage is applied from the elbow to the fingertips, provided there are no complications.

Open fractures with several fragments or crushing are accompanied by damage to soft tissues and blood vessels. In this case, surgical treatment ─ open reposition is indicated. A trauma surgeon performs primary treatment of the wound (excises soft tissue with a scalpel, turning a lacerated wound into an incised wound for quick healing). Sews blood vessels and nerves. The wound heals within a few days. Only after this is a plaster cast applied.

Important! Negative sensations under a plaster cast, if they occur, you should immediately contact a traumatologist:

numbness of the hand, fingers;

feeling of fullness under the cast;

pain, fever, chills.

These are signs of bone displacement, internal bleeding, and acute infection.

If there was a compression fracture or the bone was significantly crushed, the reunited fragments are difficult to hold in an immobilization bandage; fixation is carried out through the skin with two knitting needles (the radius, head and neck of the ulna are captured). Then a cast is applied, cut from the wrist to the middle of the shoulder.

Modern technologies - plastic gypsum

Plastic plaster solves problems such as heaviness, severe limitation of movements, and constant itching of the skin.

Polymer immobilization bandage 4-5 times lighter than traditional plaster. It does not allow moisture to pass through, and you can take a shower or bath with it. Hypoallergenic material provides physiological air exchange, the skin under the bandage breathes. Plastic deforms and loses its qualities only under the influence of direct sunlight.

Artificial plaster follows the individual anatomical shape of the hand, it can be modeled for each individual case, and the patient does not experience discomfort when wearing it. The fixator does not disrupt physiological blood circulation and lymphatic drainage, so the hand does not swell. Creates favorable conditions for the restoration of the median nerve.

How long do you wear a plaster cast?

The duration of wearing an immobilization plaster cast depends on the following factors:

severity of the fracture;

patient's age;

the speed of metabolic processes in the body.

It takes at least 21 days to form. During this period, the hand must be securely fixed.

For a non-displaced fracture or crack bone fusion time is no more than 3 weeks. How long to wear a cast is determined individually, on average from 2 to 4 weeks.

For cracks in the neck and head of the bone, the splint is worn for 14-21 days. Damage to the bone body, depending on the number of fragments when the wrist joint is involved, requires immobilization for 1.5-2.5 months.

If 2 whole fragments were repositioned, without crushing the bones, with disruption of the articular surfaces, a cast is applied for a period of 4-5 weeks. If closed manual reduction was difficult, then immobilization can last up to 2 months.

When using knitting needles, the plaster is not removed for 2-2.5 months. If the bone comparison was carried out using the open method or after repeated reposition, the bandage is worn for 6-8 weeks.

The importance of a bandage for a radial fracture

The main purpose of the bandage is prevention of re-displacement bone fragments. The device also relieves skeletal muscle tension, relaxes the hand, and reduces stress on the joints. By immobilizing the limb, pain is reduced.

Modern bandages are made from environmentally friendly, natural materials. When worn, they do not cause irritation, allergies, or itching, and are suitable for all skin types.

Important! An incorrectly selected retainer causes harm and aggravates the healing process. The bandage can compress the joint and blood vessels, disrupting blood circulation, leading to complications ─ bone deformation during fusion, disruption of the innervation of the limb.

The bandage is worn throughout the entire treatment (plaster immobilization), as well as during the rehabilitation period, until the limb is fully functional.

Criteria for error-free use of the fixative:

the arm and joints are completely relaxed;

no painful sensations;

the limb does not swell, the fingers do not turn blue or go numb;

partial mobility of the phalanges is preserved;

a person is comfortable in a sitting position, standing, while walking.

Principles of rehabilitation for a fracture of the radius

After the bone is anatomically restored, it is necessary to resume the functionality of the entire limb. During your stay at rest, muscles and joints lose mobility. To achieve your previous physical shape requires time, diligence, patience and constant physical therapy work.

Important! In most cases, rehabilitation after a fracture takes the same amount of time as the person was wearing a cast. The exceptions are complex injuries with tendon ruptures, joint damage, and multiple fragments of bone tissue.

Comprehensive restoration includes the following activities:

physical therapy, use of special exercise equipment (mechanotherapy);

water procedures ─ warm salt baths, gymnastics in water (hydrokinesitherapy);

paraffin applications;

physiotherapy ─ UHF, magnet, electrophoresis, laser;

• a diet rich in calcium, taking vitamins to regenerate and strengthen bone tissue.

Exercise therapy is the main method of restoring hand function

It is necessary to develop the arm while it is in a cast. All finger movements are done with caution. If discomfort or pain occurs, immediately stop gymnastics.

The first exercises are done at the end of the first week after applying the immobilization bandage. Gymnastics begin from the shoulder girdle and gradually move down to the wrist. Fingers should be developed especially carefully.

After the cast is removed, the patient experiences stiffness of movement, mild pain, and a feeling of fear of damaging the bone again. Limited mobility is due to the fact that the ligaments have temporarily lost their elasticity. Despite this, the movements are made more actively, involving all muscle groups of the arm, including the deep ones.

Exercises for the arm while wearing a cast

Before working out your arm for the first week after an injury, you need to assess the person’s well-being. There should be no sharp pain or high body temperature. All exercises are aimed at ensuring that the patient can simply take care of himself independently ─ hold a cup, spoon, toothbrush, change clothes, cut with a knife. When kneading the arm, sharp, circular, forceful loads are contraindicated in order to avoid repeated displacement of bone fragments.

The first set of exercises for a hand in a cast is performed in a sitting position. It is important to develop each phalanx of the fingers to avoid the formation of contractures (limitation of passive movements). At first, you can help with your healthy hand. The following types of physical activity are effective:

place your forearm on the table with your palm up, carefully clench and unclench your fingers (6-10 times), repeat the same exercise with your palm down;

if the fracture is without complications and the elbow is free from plaster, make flexion movements in the joint ─ the hand lies on a hard surface and slowly rises to the face with the back and inner side of the palm alternately (5-7 times);

squeezing and unclenching a soft rubber ball or “anti-stress” toy with your fingers (10 times).

Gymnastics lasting 5 minutes is carried out 2-3 times a day. As you improve, this time is increased to 15 minutes. Criteria for successful rehabilitation at week 3: ability to dress independently with a cast on a limb, cut soft foods with a knife, and hold a filled cup.

Forearm restoration after plaster removal

Before starting the main exercises, do a light warm-up. Develop the wrist joint in a circular motion, clench your fingers into a fist, and lightly massage the hand.

Basic exercise therapy after a fracture includes the following groups of exercises:

spreading and closing fingers;

pressing the end phalanges onto a hard surface;

alternately raising fingers from the table with maximum amplitude;

rotational movements of the brush.

Effective use of available tools. It is useful to lift and hold a glass of water, knead plasticine with your fingers, toss and catch a tennis ball. To stretch the tendons and ligaments, gently rest your wrists on the table with your palms and the inside and outside of your hand.

The gymnastic complex must include movements that involve all joints and parts of the hand. At the same time, the shoulders and arms are raised and released, followed by extension to the sides. Rotate the forearm at the elbow joint clockwise and counterclockwise.

In order to restore the primary functionality of the limb, you need to use it more often in everyday life - combing your hair, dressing, preparing food.

Special forearm supination/pronation simulators help you develop your arm safely. During rehabilitation exercises, all movements are carried out anatomically and physiologically correctly (the amplitude is adjusted up to 90°C). Fast clinical results are ensured by optimizing the load in each individual case.

What contraindicated during the rehabilitation period until full restoration of working capacity:

carry a bag or package weighing more than 0.5 kg;

lift dumbbells;

practice with heavy medicine balls (volleyball, basketball);

transfer the center of gravity of the body to your hands (lean);

turn the key, open tight door locks.

With regular performance of the entire set of exercises, the functionality of the limb is restored in 1.5-3 months.

Gymnastics in warm water

Warm salt baths reduce muscle tone, relax the nervous system, relieve pain, dilate blood vessels, ensuring blood flow. For exercises, you need a container that can fit your forearm without restrictions (wide pelvis, baby bath). The optimal water temperature is 36-37°C.

Contraindications:

infection of soft tissue at the fracture site;

skin rashes, ulcers;

increased body temperature;

hypertension during exacerbation.

It is best to work out your hands in warm water in the evening, 2 hours before bedtime. Dissolve 100 g of sea salt and immerse the forearm, wrist, elbow joint, up to half the shoulder.

In the water, make bending movements with your fingers, palm, and rotate your brush in different directions. Raise and lower closed fingers, turn the palm up and down. Each type of exercise is done 6-8 times.

Therapeutic training in water is mandatory for the first 2 weeks after the removal of the cast, after which the procedure is advisory in nature.

Physiotherapeutic measures after a radial fracture

The goals of physiotherapy are rehabilitation of the musculoskeletal system, elimination of the negative consequences of surrounding soft tissues.

Massage

Light massage movements are allowed while wearing a cast. Direct impact on the muscles is carried out in open areas on both sides of the bandage ─ stroking, rubbing, low-intensity pressure. Tapping on the plaster is allowed. Acupressure is performed using a magnetic acupuncture apparatus.

This procedure increases blood flow, oxygen access to tissues, promotes rapid regeneration, and improves metabolic processes. This activates the outflow of lymph, quickly eliminates swelling, and reduces the time required to wear an immobilization bandage.

After removing the cast, the hand is massaged more actively. Classic movements:

transverse and longitudinal stroking over the entire surface of the forearm;

kneading;

percussion (tapping);

circular rotational movements working deep muscles.

Additionally, special hand trainers, rollers, rollers, and needle applicators are used. Full massages are indicated no earlier than a month after the removal of the cast, when muscle mass is restored.

Paraffin therapy

Paraffin treatment is a thermal effect on damaged tissue. Paraffin is a natural substance with high heat capacity. The method is indicated for rehabilitation after complex multiple fractures of the radius.

Deep heating relieves muscle spasms, improves microcirculation and lymphatic drainage. Prevents the formation of contractures and ankylosis (immobility of the joint). The therapeutic course is 15 procedures (every other day).

Electrical stimulation of bone and muscle tissue

Electrical stimulation is based on the use of pulsed currents to restore different types of body tissue.

The procedure accelerates the formation of callus, enhances bone calcification and the process of cartilage formation. The electric field acts at the cellular level, promotes the synthesis of chondrocytes, osteoblasts, and lymphocytes. According to WHO statistics, the technique reduces the rehabilitation period by 30%.

Shock wave therapy

UVT is a technique for restoring the musculoskeletal function of the arm using acoustic waves. Treatment is indicated for poorly healing fractures, complications due to improper reduction or immobilization, pseudarthrosis (formation of a false joint in an unusual location).

Shock wave therapy stimulates the formation of new blood vessels and bone tissue. After only 3 procedures, callus formation can be observed on x-rays. The presence of metal pins or plates is not a contraindication.

A plaster cast is designed to fix bone fragments in a certain position. How long to wear a cast for a displaced arm fracture? The rate at which broken bones heal depends on many factors. The regeneration process is influenced by the patient’s age, the severity of the injury and the individual characteristics of the body.

Symptoms

1. Mechanical damage affects the tissue of the periosteum, which contains a large number of nerve endings. The patient feels sharp pain after a fracture.
2. A fracture of the radius without displacement is accompanied by swelling of the injured limb.
3. Blood from damaged vessels quickly spreads to neighboring tissues. This leads to the formation of a hematoma.
4. The arm becomes much shorter.

Classification

Depending on the location of the injury, there are:

1. Trauma to the radial shaft is quite rare. The body of the bone is highly durable. But even such a dense part of the bone cannot withstand a strong blow. The patient's arm becomes deformed, pain and swelling occur.
2. A fracture of the radius in a typical location can occur due to the development of osteoporosis. The injury affects the coordination of finger movements.

First aid

Fracture diagnostic methods

What determines the duration of wearing a splint?

Before removing the bandage, doctors send the patient for radiological monitoring. Thanks to the examination, doctors can assess the condition of the callus. It is necessary to ensure correct fusion of bone fragments. Otherwise, repeat surgery may be required.

Wearing a plaster splint fixes the bones in the desired position. This method ensures the correct fusion of the bone fragments of the hand.

Complications when wearing plaster casts

1. The gypsum survives not only blood vessels, but also nerve endings. Compression is accompanied by pain and swelling in the area of ​​the fracture. A sign of compression is loss of sensation in the fingers. The victim's coordination of movements is impaired.
2. Some patients experience allergies after applying a plaster cast. Dermatitis occurs on the skin under the cast and itching begins. Unpleasant sensations deprive a person of peace. Before immobilization, the doctor must find out if the person is allergic to chalk and plaster. To avoid redness of the skin, a knitted bandage is used. It is wrapped around the victim's hand. Only after this they begin to apply a bandage.
3. Prolonged squeezing of the hand can lead to suppuration of the skin. Therefore, the specialist must be extremely careful so that plaster chips do not get under the bandage. All skin and tendon protrusions should be carefully bandaged. If a purulent odor appears, the wound is examined. A thin layer of Vishnevsky or Levomikol ointment should be applied to the injured area. These agents accelerate the healing process of damaged tissue.
4. The plaster cast should fit snugly around the injured limb. Otherwise, it will move while being worn. A person develops blisters in which serous fluid accumulates. After opening, the contents of the bubbles fall under the plaster cast. This can lead to various complications.

The treatment of such injury is discussed in as much detail as possible in the article "". The manual reduction operation is performed under radiological control. Thanks to this method, it is possible to ensure the correct healing of broken bones. To relieve pain, the victim is prescribed painkillers. An open fracture of the radius with displacement is accompanied by damage to the skin. Suppuration of the wound complicates the treatment process. The soil may contain tetanus pathogens. To prevent infection by dangerous bacteria, the patient needs to take immunoglobulins. They contain antibodies to various diseases.

In what cases is surgery necessary?

1. The patient was diagnosed with an open fracture.
2. Damage to the diaphysis of the radius has occurred.
3. A fracture of the radius is accompanied by damage to the nerve endings
4. Without the help of a surgeon, it is impossible to help patients with significant destruction of bone tissue. The Ilizarov apparatus is used to treat complex fractures.
5. Surgical treatment methods are used to eliminate the consequences of open fractures. After initial treatment with an antiseptic solution, the surgeon removes the contaminated tissue. A displaced fracture of the radius can cause the formation of pus. The next step is the treatment of bone fragments. This manipulation is necessary to prevent wound suppuration.

How long does the recovery period last after surgery?

1. The wound became infected, which led to suppuration.
2. If signs of osteomyelitis are detected.
3. Hormonal disorders have occurred.
4. The patient suffers from diabetes, the wounds of such people take a long time to heal.
5. Malignant tumors have been discovered, extensive metastases destroy bone tissue.

What should the patient know?

The body needs calcium and phosphorus, which are used as building materials. Be sure to include fermented milk products, vegetable oils and eggs in your diet.

A doctor's speech about a cast for a fracture of the radius. VIDEO

The human upper limb has a specific structure that distinguishes us from other mammals. It is this that allows people to work, serve themselves, perform daily manipulations with objects, live and develop fully. For this reason, any hand injuries bring a lot of inconvenience and trouble, this is especially true for fractures. The greatest danger to life is an open fracture of the arm, but if treated and healed incorrectly, a closed fracture will also cause the victim a lot of trouble and discomfort.

You can get a fracture not only when you fall on a limb or get hit, but also after putting a significant load on your arm, which has become weak due to various diseases.

Classification

A fracture of the limbs of the upper shoulder girdle implies an injury that violates the integrity of 1 or a number of bones of the arm with further separation of their parts. The classification of such hand injuries is carried out according to several criteria:

• In appearance: open - damage to the skin in the area of ​​injury with possible displacement of a bone fragment outward; a closed fracture of the arm is diagnosed when the skin in the injured area is intact;
• According to the number of broken bones - single and multiple;
• According to the location of the injury: diaphyseal with a fracture line on the bone itself; metaphyseal with a fracture line between the base and the end of the bone; injury to the epiphyseal cartilage or the so-called intra-articular fracture with rupture of ligaments and displacement of bone fragments;
• According to the type of fault line: longitudinal with damage to the bone parallel to its axis; screw with a break similar to a spiral; T or V-shaped; transverse and oblique with bone injury perpendicular or at an angle to its axis;
• or without it. The displacement can be primary when it occurs during an injury, or may appear secondary under the influence of muscle bundles attached to the bone. The bone can move in length, width, angle or rotation;
• With displacement of fragments (unstable arm fractures) and without it (stable fractures);
• With or without complications. Fractures can cause various types of blood loss, infection, fat embolism, and even blood poisoning.

In addition, a fracture of the arm differs according to the type of injured bone:

• The humerus can fracture in the upper, middle or lower zone;
• The clavicle may be fractured midway through the diaphysis due to a fall or direct blow;
• The scapula, which connects the collarbone to the humerus, breaks very rarely, since it is located deep in the muscles and is relatively mobile;
• In the elbow joint, injuries occur due to weak tendons and ulnar ligaments when falling on the arm or elbow;
• Wrist fractures are one of the most common hand fractures and are possible even from severe physical exertion, not just from a blow.

Symptoms

Symptoms of an arm fracture may differ depending on the type of injury, but all fractures without exception are characterized by the following symptoms:

When a hand is broken, the symptoms are often ambiguous, therefore, for correct diagnosis and treatment, an X-ray examination is used, and sometimes a computed tomography scan with consultation with a neurologist if the functioning of the nerve endings is disrupted.

Providing first aid

If you do not know what to do if your arm is broken, then urgently call an ambulance and under no circumstances try to set the damaged bones yourself or look for additional ones. Even if you know how to identify a fracture and provide first aid, you should definitely call an ambulance in the following cases:

• Injury from a fall from a great height. In this case, only the doctor will tell you whether the victim can be transported and what types of injuries there are, other than a broken limb. There is a high risk of polytrauma and damage to internal organs;
• There is no pulse on the radius upon palpation, and the hand becomes cold and pale. These are symptoms of ruptured arterial vessels;
• Poor hand sensitivity, fingers do not move, or the hand hangs like a whip. This is a sign of nerve rupture;
• Open wound with bleeding;
• Severe pain that is not eliminated by painkillers, there is a high risk of painful shock;
• A child's arm is broken.

In any other case, you can provide first aid yourself, and then take the victim to a medical facility, where you will be given professional advice on how to treat a broken arm.

If you suspect that the victim has a broken arm, the first thing you should do is immobilize the injured area. To do this, a splint is made from improvised means, which is attached to the injured limb with bandages.

In case of an open injury, it is imperative to stop the bleeding; to do this, apply a pressure bandage or tourniquet and disinfect the wound with brilliant green or iodine. The location of the tourniquet or bandage depends on the type of bleeding:

• Arterial (scarlet blood flows like a fountain) - tourniquet slightly above the wound;
• Venous (smoothly flowing brown blood) - applying a pressure bandage.

The pain of a broken arm should be relieved by any painkiller such as analgin, aspirin or ketorolac.

Treatment

Treatment of a fractured arm is divided into surgical and conservative. Its choice depends on the type of damage and the occurrence of possible complications. Treatment can be divided into 3 stages:

1. Preparation of bone fragments or reposition. In the absence of displacements and complications, it is performed in a closed form; in other cases, the attending physician usually prescribes open surgical bone grafting.
2. Fixation of a broken bone is carried out by conservative application of plaster and osteosynthetic surgical methods using pins, plates, knitting needles and an Ilizarov apparatus. Whether the structures can be removed and how long the cast should be worn is determined solely by the attending physician; this usually happens after the injury has completely healed.
3. Rehabilitation.

The doctor determines how long to wear a cast based on the type of injury and its location: for a shoulder fracture - 1.5-2 months, injury to the forearm - 1.5-2 months, radius - 1 month, wrist bone - 3 weeks-1 months, wear a cast for the same amount of time if you have a finger injury. If there is displacement, the cast may last several weeks longer. In some cases, to facilitate movement, the arm in a cast should be worn in a scarf. If an arm is broken, there is no need to bandage it, as, for example, with a rib fracture; conservative treatment is limited to applying a plaster cast.

Fractures heal faster if you additionally use drug treatment, for example, a special cream or ointment after bone fractures (fastum gel, ketoprofen, etc.) you also need drugs that increase calcium levels in the body and, in some cases, painkillers such as ketorol or nimesulide. You should definitely check with your doctor on how to relieve swelling in case of a broken arm.

Swelling

Swelling of the arm after a fracture is a completely natural and common phenomenon, but you should not think that it will go away on its own. Special gels and ointments that improve blood supply to the damaged area will help relieve swelling after a broken arm.

If the swelling does not go away for a long period, then physiotherapy is prescribed: phonophoresis, ultrasound or electrophoresis. Only a doctor can determine how to relieve swelling after a fracture in a specific situation, so do not self-medicate to avoid serious complications, especially if the swelling lasts more than 2 weeks.

Rehabilitation therapy after a broken arm

After the initial measures for a broken arm, treatment is replaced by another very important stage in restoring the full functioning of the limb - rehabilitation. It is a complex of physiotherapy, exercise therapy, gymnastics, various types of massages, and occupational therapy.

After 3-4 days, you can begin active movements of the joints that are not in plaster or with your fingers.

From the third day, the doctor may prescribe the following procedures:

• Interference currents will help relieve hand swelling and pain;
• UV irradiation of a healthy arm in a symmetrical area reflexively improves blood flow in the area of ​​injury;

2 weeks after the injury and as soon as the cast is removed, the doctor may prescribe procedures aimed at quickly restoring the function of the injured arm:

• Magnetic therapy improves blood circulation, removes swelling;
• Laser therapy removes the inflammatory process at the site of injury by improving microcirculation;
• UVS relieves swelling, relieves pain and inflammation, especially after surgery;
• Ultrasound is better at introducing medicines and ointments for arm fractures;
• Electrophoresis of novocaine solution anesthetizes.

All activities are carried out in a complex and are prescribed for each case and patient separately.

In order for the bones to grow together faster and all the functions of the limb to be restored after the removal of the plaster and tumor, you can take mud, pine and sea baths, do paraffin applications and go to the bathhouse. Such procedures strengthen muscles and improve blood circulation.

1.5-2 months after the injury, you can begin light massage procedures for the muscles of the broken segment, and after the bone heals, you can perform a more active massage.

FAQ

There are a number of questions that people most often ask about arm fractures and their treatment, here are the answers to some of them:

1. How long does it take for a broken arm to heal? – There are no specific data, since each case is individual in the type and course of the injury. But there are average figures: the neck of the shoulder is treated for 4 months; body of the humerus – 5 and a half months; forearm bones – 3 months; fingers – up to 2 months with rehabilitation.
2. How long does it take for an arm fracture with joint contracture to heal? – In this case, at least 6 months are required.
3. How long to wear a cast? – This must be done until the bone has completely fused, so only a doctor can determine the timing of wearing it using an x-ray examination.
4. Is it possible to reduce a fracture before the ambulance arrives? – It is strictly forbidden to reset bone fragments yourself in order to avoid additional displacement, crushing and entry of bacteria in the presence of an open wound.

A fracture is a very serious injury; if you dreamed that you or your children had some part of their body broken, then this will definitely lead to a general malaise of the body or illness of relatives. But if you see such an injury on a complete stranger, then this should be regarded as a warning about a serious quarrel.

According to modern dream books, you can find out why you dream of breaking an arm or leg, but all the answers boil down to one thing - a turning point in your life, health, work awaits you, this can be either a joyful or a painful event.