No matter how colorful our life is, sometimes there are situations that unsettle. These are some psychological problems, lack of money, just a bad mood or something else. But, of course, he alth problems can rightfully be considered the most unpleasant of this long list, regardless of whether it happened to us or to our loved ones. One of these most unpleasant situations is a dislocation of the arm at the elbow.
Joints
There are three types of bone joins:
- fixed suture (for example, in the skull),
- semi-movable cartilage (this way the vertebrae are connected,
- movable joint that allows a person to make a full range of various movements.
The joints connect the humerus and collarbone, which makes it possible to raise and lower the arm; the femur and pelvis (the so-called hip joint), thanks to which we walk and raise our legs. And this is only a part of the huge number of important joints that allow a person to do the things that he likes, whether it's dancing or sports, sewing or another hobby.
But one of the most important joints, thanks toto which we make hand movements is, of course, the elbow. With its help, a person is able to bend or unbend the arm at the elbow by one hundred and forty degrees! Therefore, with injuries of this joint, a person’s life ceases to be full until it is fully restored. A dislocation is a very unpleasant problem that constantly threatens him.
Structure and functions of the elbow joint
In order to figure out what to do with a dislocated elbow, you need to understand its structure. The joint connects three bones at once. Two of them are located in the forearm area: the radius (its narrow end goes to the elbow, and the wide end to the wrist) and the ulna (on the contrary, the narrow part goes to the wrist, and the wide part goes to the elbow, hence the name). And one in the shoulder area - the humerus.
Because the elbow joint is complex, it consists of three simpler ones, covered with a capsule on top. Each of them has its own function, and their combined work gives the elbow the opportunity to make all the movements that it is capable of. The first joint is the one that connects the humerus and ulna and, accordingly, is called the brachioradialis. The second - beam-ulnar, and the third - shoulder-ulnar. Between the bones are soft cartilage, and the joint capsule is filled with fluid, which does not allow friction to destroy tissue.
The elbow joint allows four types of movement. The first two are performed in the frontal plane - this is flexion and extension. The first is the direction of the brush to the shoulder, andthe second is abduction back, straightening of the arm. And the other two are in the vertical plane of the radius. Stretch your hand out in front of you with the back of your hand pointing down, and remember the phrase "SOUP is being carried." The movement in which the palm moves to this position is called supination. And if you turn your hand so that the back of your hand is pointing up, pronation will occur. Here you can use the phrase "Spilled soup" to remember. All these movements are carried out not only thanks to the joint, but also thanks to the muscles. For example, triceps (triceps extensor) and biceps (biceps flexor).
How a dislocation occurs
This type of injury can be divided into direct dislocation and subluxation. In both cases, there is a displacement of the articular surfaces in different directions, and as a result, further impossibility to function. A dislocation occurs with complete displacement, that is, when there is no contact between the articular surfaces of various bones. In the second case, on the contrary, their partial contact remains.
They also classify dislocation of the arm at the elbow (or subluxation) and in the direction of displacement of the bones. In addition, the displacement itself can occur both with the entire forearm as a whole, and with a separate bone.
Rarely does a person get only a dislocation. More often this injury is accompanied by a fracture, rupture of the tendons and joint bag, hematoma, muscle damage.
Reasons
Dislocation of the elbow joint is caused by improper application of force. The influence can be direct, that is, directly on the elbowjoint (direct injury) and indirect (indirect injury). For example, the first impact can be attributed to an accidental blow with a hammer to the elbow, and the second - a fall on the palm with the transfer of force through the forearm. Sometimes a dislocation occurs with a sharp movement of the arm.
But the latter case is very rare and most likely to occur in people with a predisposition to such an injury. For example, such prerequisites include weakness of the ligamentous apparatus of the elbow joint, flattening of the semilunar notch of the ulna. In addition, people who rarely play sports are much more likely to get a dislocation than trained people.
Dislocation in children
Dislocation of the elbow in a child is accompanied by the same symptoms as in an adult. Only in children there is one more circumstance in which he can get injured. This situation, which is familiar to many, is commonly called "nanny's elbow." When a child walking down the street with an adult stumbles and starts to fall, the parent or other accompanying person is likely to grab the elbow. Agree, in adults this happens … less often. But this is fraught with unpleasant consequences, so you can’t do it!
Symptoms
In general, it is unlikely that a person with a dislocation will get up (if he fell), waving his arm and, as an example, go to catch butterflies. Recognizing an injury is fairly easy. But even if you make a mistake and the symptoms of a dislocated elbow will be accompanied by another injury, it will not be superfluous to consult a doctor. Because all these signs will not speak of a completely he althy limb. Now to the symptoms of a dislocated elbow.
- Unnatural arm angle. For example, the palm is severely twisted, but there is clearly no injury to the wrist. However, here long explanations will be superfluous, it is noticeable. The shape of the elbow itself may also be unnatural. For example, the head of the joint protrudes or the upper end of the forearm has gone above where it should be.
- Swelling of the elbow and/or entire arm. Loss of motor ability of the hand (or several times worse pain during flexion, extension at the elbow, moving the fingers, raising the arm, supination and pronation). In the elbow joint (as in any other) there is a huge number of nerve endings, so the injury is unlikely to go unnoticed by the nervous system. She, noticing something was wrong, will quickly try to transmit a signal about the violation to the brain, and the person who is "lucky to earn" a dislocation of the elbow will find out about it in the form of pain, most likely severe.
- In addition to pain, loss of sensation and numbness in the area of injury are possible.
- Fever, chills will not be unusual.
First Aid
Let's imagine a situation that we have a person lying in front of us, who, by all indications, has a dislocated elbow. What to do? First of all, you should calm down, push your emotions aside and act according to the following rules (attention, the rules are recommendations, not complete instructions).
- First of all, you need to immobilize (immobilize) the limb. This can be done with a splint, stick, tying to the body. You need to fix it so that it does not moveshoulder joint, elbow and carpal; the arm should be bent ninety degrees. But if you are in a populated area, then it is better to leave the limb bent (also 90 degrees) and ask the patient not to move it (he is unlikely to want to swing it in all directions). The specialist who arrived in the ambulance immobilizes her according to all the rules.
- Apply cold. A wet cloth will do.
- Immediately call an ambulance. If there are other people besides you, ask them to call her while you are giving first aid. You can also take it to the emergency room yourself, but in this case it is better to immobilize the limb.
No way! In any case, you can not independently adjust the hand! This should only be done by a specialist and after careful research.
In addition, if the dislocation is accompanied by bleeding (for example, caused by an open fracture accompanying the dislocation), measures should also be taken to stop the bleeding. With arterial (scarlet blood, pulsating stream) - a tourniquet above the place of outpouring of blood and a bandage on the wound. With venous (dark blood, poorly poured out) - a tourniquet below the bleeding, also a bandage. Be sure to sign the time and date of applying the tourniquet in both cases and put it under the tourniquet itself! When bleeding, be sure to call an ambulance.
Injured
Here is an injured person being taken to the hospital and entering the traumatologist's office. First of all, the doctor does an external examination, if necessary, checks the sensitivityarms. After this, the sufferer is necessarily sent for x-rays (two pictures are taken - from the side and from the front) so that the doctor can determine the type of dislocation, whether it is accompanied by any other injuries and other information important for treatment. Sometimes, during radiography, a contrast agent is injected into the joint capsule, which allows more accurate conclusions about the condition of the elbow and the arm as a whole.
Below in the photo is a dislocation of the elbow (X-ray, side view) can be studied.
After the x-ray, the traumatologist decides what to do next. In the event that only a dislocation is observed, the joint will most likely be repositioned under local or general anesthesia (local - the introduction of an anesthetic, for example, novocaine, to eliminate pain in a certain area; general - putting a person to sleep for a certain time). After that, they are sent for a control x-ray, the limb (in case of successful reduction) is fixed with plaster at an angle of 90 degrees and secured with a bandage through the neck.
Also take a radiograph from a different angle. The front view can be seen in the photo below.
But in some cases surgery is required. Most often this happens if the dislocation is accompanied, for example, by an open fracture. In some operations, fixing elements are also used - titanium spokes, plates. After the operation, the hand is also immobilized. Next, you need to wear a cast on your arm for a while.(regardless of whether there was surgery or not). Usually this time is 2-4 weeks. During this period, the joint should be overgrown with new tissue in those places where the previous one was broken.
Recovery
Here is already behind all the torment - the plaster was removed. But no matter how… After a dislocation of the elbow, recovery is mandatory. The fact is that even after successful overgrowth of the injury, the limb cannot instantly regain all motor functions. Therefore, you need to help her in this. First of all, this, of course, is exercise therapy - physiotherapy exercises. In this case, a person performs all the necessary exercises for the elbow joint, gradually increasing the load. Naturally, all this is carried out under the supervision of a doctor.
Auxiliary procedures are massage and other physiotherapy (magnetic, laser therapy, ultrasound). The entire recovery period can be carried out while being on an outpatient or inpatient basis. During inpatient treatment, the patient lies in the hospital, where he undergoes a recovery period. And on an outpatient basis, he visits her regularly.
Consequences of a dislocated elbow
After an injury, other pathologies may develop. For example, osteoma is a benign tumor of bone tissue, inflammation of the ulnar nerve. In addition, it is not always possible to restore former mobility to joints that have suffered such an injury, especially if it happened in combination with others. It is also possible that the joint reacts to a sharp change in atmospheric pressure - aching pain, weakness.
Conclusion
Dislocation is a dangerous injury. It is better, of course, not to receive it at all, but you cannot protect yourself from everything. Therefore, it is always better to know how this happens and what to do, so as not to harm, and even better to help the person who received this injury.
