Forearm - part of the arm, including the radius, ulna. In fact, this is a continuation of the shoulder. The connecting joint is the elbow. The forearm is connected to the wrist by the wrist joint. According to the ICD, a fracture of the forearm is coded S52. Such an injury is a serious injury that obliges you to urgently consult a doctor. One of the important stages of assistance is immobilization in case of a fracture of the forearm. This must be done quickly, carefully, without worsening the patient's condition.
Fracture: causes
Fracture is provoked by injuries received by the bones, the causes of which are:
- bad falls;
- straight punches;
- arm twisting.
The risk of forearm fracture is higher if the patient has:
- older than average;
- low muscle mass;
- bone disease;
- sport activity.
High chance of forearm fracture in those who experience violence or are undernourished.
How to suspect?
For open/closed forearm fractures, patients complain about:
- pain;
- puffiness;
- deformation of the affected area.
The sick hand cannot move normallyrange.
If you have these symptoms, you should immediately consult a doctor. At the initial examination, the specialist interviews the patient, collecting information about both the symptoms and the previous events that provoked the fracture of the forearm. The doctor also examines the damaged area to make an accurate diagnosis.
Determining the fracture
To diagnose a closed/open fracture of the forearm, an X-ray is taken first. This allows you to get information about the internal structures of the human body, gives an idea of the state of the bones. The doctor can pinpoint the problem area.
Another efficient and accurate method of obtaining data is computed tomography. In testing, a computer and a powerful x-ray are used, which allows you to get an accurate picture of internal damage and the structure of bones, muscle tissue. Tomography allows you to get an idea of the condition of the tendons, cartilage. If the fracture of the forearm is complex, then tomography becomes an indispensable assistant to the doctor involved in bone restoration.
You can deal with the problem
Modern medicine allows you to treat a fracture of the bones of the forearm, however, success depends on what the injury is: where exactly it is located within the organ, how complex it is. Doctors usually hold activities aimed at:
- return of bones to their original state, which is often accompanied by anesthesia, surgery;
- keep the affected area immobile until the bonesgrow together.
Effective Methods
In order for the splint to be effective for a fracture of the forearm, it is applied by one of the following methods:
- plaster bandage applied before surgery, as well as in cases where an invasive method is not needed;
- metal plate (installed during surgery);
- screws (Invasive).
To relieve pain, anesthetic injections are given. After the operation, the patient's condition is regularly checked by tomography or x-rays to monitor the healing process. In the event of an unexpected displacement of the bones, you can immediately diagnose it and take appropriate measures.
What's next?
When first aid was provided for a fracture of the forearm, the operation was performed and the patient recovered, it is necessary to do special exercises. Their main task is to strengthen the muscles, restore the ability of the organ to move. The main task of the patient and doctors is to restore the ability to function to the shoulders, fingers. Physiotherapy is usually prescribed and sports and any heavy exertion are prohibited.
Typically, a forearm fracture heals in about 10 weeks, sometimes faster. If there was an open or displaced fracture of the forearm, then the duration of treatment and rehabilitation is longer. In some difficult cases, full recovery will not be achieved. However, in any case, the success of the measures is largely determined by how clearly the patient follows the instructions of the doctors. In violation of such highthe likelihood of complications.
How to prevent?
Of course, knowing how to treat a broken forearm is a useful and important skill, but knowing how to prevent such a situation is even more useful. Recommended as preventive measures:
- avoid dangerous situations that could provoke injury;
- control the content of vitamin D, calcium in food;
- do bone strengthening exercises regularly;
- train muscles;
- at work, in sports, observe safety rules.
Conservative and invasive
A fracture of the forearm can be treated either surgically or conservatively. The second option is possible if there is no displacement or if the patient's condition is such that the operation carries great risks to life. The conservative method involves a long stay in a plaster cast, which can provoke incorrect fusion. In many patients who have treated a fracture in this way, the affected limb functions much worse than before the fracture. There are also unstable fractures that make accurate repositioning difficult.
Surgery is recognized by many traumatologists as the best known treatment option in our time. There are minimally invasive methods that allow you to operate on the ulna, radius bones. The doctor during the event repositions the bones, fragments, arranging them physiologically correctly, and then fixing the position with special devices. Small invasion is achieved by the fact that onlysmall punctures, and all movements are controlled through x-rays. Soft tissues remain intact, recovery takes a relatively short time period, you can leave the hospital earlier. In addition, this operation reduces the risk of complications.
Fixers and consequences
A variety of fixators are used for fractures of the forearms. One of the most effective is intraosseous rods, indispensable for damage to the diaphysis. When using such clamps, you can achieve results with minimal muscle damage. The operation that accompanies the installation of the fixators leaves scars, but they are very small, almost invisible even to doctors.
Another popular type of fixators are plates that are attached to the bones with screws. Osteosynthesis is a kind of "gold standard" of medicine. The most modern plate models allow fixing bone fragments in the most correct position and holding them until the fracture heals.
This is important
In the case of an open fracture, surgery cannot be avoided. The intervention involves the use of special devices that fix the forearm from the outside. This allows you to stabilize the patient's condition, after which you can proceed to further activities.
When the wound heals, the apparatus is removed and the bones are fixed with plates or rods. This approach minimizes the likelihood of purulent complications.
Be careful
Operating the forearm area is not an easy task. This area is rich in nerves, blood vessels, damage to which can have an extremely negative impact on the patient's condition. With additional injuries, the likelihood of complications is high, which can lead to an irreversible loss of motor activity or sensation. The most likely violation of the functioning of the brush. To avoid complications, the surgeon must carefully plan and implement the intervention.
Healing Hazard
The diaphysis of an adult heals for a long time. After six weeks, an x-ray of the damaged area is taken to check for the presence of callus. After another four weeks, a test for the level of strength is carried out. Normally, the bone should gain up to 80% of the strength level before the fracture. Tissue remodeling and complete healing take years.
As the damaged area is spliced, the metal retainer can be removed. This event is not mandatory, but sometimes the presence of a metal element causes discomfort or even pain, which is an indication for removal. Plates, rods are removed from the human body after two years or later. A prerequisite is that signs of consolidation should be obvious on the x-ray.
Typical fracture
Usually typical is a Smith or Colles fracture. With this damage to the bone, the fragments do not move. After an X-ray examination, a plaster cast is applied to the patient to immobilize the affected part. The plaster cast starts at the fingertips and continues up to a third of the forearm. Immobilization of the hand lasts about a month. When the castremoved, physiotherapy is prescribed to develop the muscles of the wrist. Under normal circumstances, recovery takes one to two weeks.
A simple fracture complicated by displacement requires traction reduction as the bones are adjusted by pulling on the injured arm. The event requires anesthesia - local, conductor. The doctor's assistant pulls the hand, the other assistant pulls the limb in the opposite direction, holding the elbow. Gradually, the bone fragments are pulled in this way, creating a distance between them, and the doctor manually sets all the fragments into place, pressing so that they take the correct position.
What's next?
When the reposition is complete, a plaster bandage is made, keeping tension on the arm to avoid re-displacement. As the plaster dries, the tension gradually decreases.
If it was not possible to successfully move the fragments or it was revealed that the fracture is accompanied by a very large number of fragments, if displacements reappear or the joints are badly damaged, then an operation is urgently needed. Osteosynthesis is carried out, metal fixators are used, and then a plaster cast is applied. Usually, with such a fracture, you will have to spend a month or a half in a cast, and rehabilitation takes 2-4 weeks.
Fracture: Consequences
Fracture provokes consequences of varying severity. They depend on the location of the damage and its complexity. If the fracture is easy, then everything heals quickly and leaves no visible marks, does not provoke complications. And herethe displacement of fragments is a signal of increased danger of additional problems. If an open fracture with displacement is diagnosed, then the situation is classified as very complex.
The following consequences of fractures are usually observed:
- nerve dysfunction;
- osteomyelitis;
- embolism;
- fusion pathologies;
- bleeding.
The last complication occurs most often and is provoked by soft tissue damage. The main difficulty is that it is internal, and is visually reflected as a bruise or invisible to the eye in principle. The doctor must take into account that bone fragments can injure blood vessels, soft tissue.
Internal bleeding often accompanies closed, displaced fractures. With open fractures, damage to the vessels is more significant, since the fragments are strongly displaced, and external bleeding appears.
Disturbance of nervous activity
This consequence of a fracture is quite common and is classified as quite severe. It is provoked by the fact that during a fracture, bone fragments damage the structure of the nerve trunks located near the bones. More often, nerve damage is fixed if the fracture with displacement is open. At the moment when the bone is damaged, it mechanically touches the nearby nerve trunks, due to which they lose their normal performance.
Violation of nervous activity is manifested by loss of sensitivity, including pain and temperature. In addition, fingersor the whole hand loses mobility, the limb becomes numb, the functions of the joint are blocked.
