Dislocation of the hand is an injury associated with displacement of the articular part of one or more bones of the wrist joint. This condition is a serious injury, as the hand consists of many small bones. When even one of them is displaced, a person loses his motor ability, while experiencing severe pain.
Type of dislocation
Due to the large number of bones in human hands, this part of the human body is the most mobile and, as a result, the most susceptible to damage. For the correct treatment of a dislocation of the hand joint, it is necessary to understand what type of injury the victim received:
- Perilunar dislocation - the ulnar, capitate, navicular, radius and styloid process are displaced. At the same time, the lunate and radius bones remain in their places.
- Transnavicular-perilunar dislocation - the reverse side of the navicular bones is displaced. This injury usually results from a broken bone.
- True type of dislocation - all upper row bones are displacedregarding the radius bones. Often with this type of injury, a fracture occurs with the opening of the styloid processes. In this case, the injury is accompanied by severe pain syndrome. This type of damage takes longer to heal than any other.
- Transnavicular-translunate displacement - the navicular and lunate bones change their position in relation to the distal bones.
- Dislocation of the finger - refers to a hand injury and can occur with any of the five fingers on any hand.
- Peritrihedral-lunar type of dislocation - the lunate bone is displaced in relation to the capitate bones.
There are a number of dislocations of the hand, but they are mostly of a mixed type, combining several types of injuries.
Given the complexity of the structure of the wrist joint, you need to understand that only an experienced trauma surgeon can help the victim and, as a rule, only in a hospital setting, where there are appropriate diagnostic devices, tools for stretching and repositioning joints. Attempts to correct the dislocation on your own usually result in torn ligaments and fractures.
What leads to hand injury
Dislocation of the hand is the most common injury, as a person uses his hands in any life situation, for example, to protect his face in a fall. Stretching the arms in front of you in this case occurs reflexively, the person with his entire mass falls on them. Also, the joint can be dislocated when it is stretched while lifting weights or hanging on the hands.
Often dislocation of the hand occurs in children when an adult pulls hard on the childhand or raises it for her. You need to understand that the bones and ligaments in children are much weaker than in adults, and a slight effort is enough to injure the baby's hand.
Sports injuries are a separate category. Athletes, when performing exercises, subject their bones to overload, so their injuries are the most complex (include several types at once). Also, in athletes, dislocations are usually combined with fractures.
Dislocation of the hand joint can occur for a pathological reason. This is caused by destruction of the joint due to some systemic disease, such as gout, polio, osteomyelitis, tuberculosis, or arthritis.
Injury symptoms
Symptoms of a dislocated hand usually appear immediately after the incident, that is, falling or lifting heavy things. They can be:
- Combat syndrome. It occurs immediately after an injury or when you try to move your hand.
- Swelling of the soft tissues around the injured joint.
- Visual change of the joint. The arm may be bent at an unnatural angle, or an unusual protrusion or depression appears at the site of the joint.
- The victim cannot move the injured limb not only in the area of damage, but also along its entire length - from shoulder to hand.
- The skin in the area of the damaged joint changes its temperature - it becomes several degrees higher than the rest of the body.
- The sensitivity of the fingers is lost. This indicates damage to the nerve fibers in the area of the joint.
Diagnosisdislocations
Dislocation of the hand according to ICD 10 (International Classification of Diseases) has the code S63, is a separate disease and, accordingly, is diagnosed with a complex set of measures.
First of all, an external examination of the injured limb is carried out. Attention is drawn to the presence of edema, increased skin temperature, anatomical location of the bones. During the examination, the doctor tries to find out from the victim how exactly he was injured, in what situation, whether it was a compression blow or sprain. This gives an additional indication of the type of damage.
To clarify the diagnosis, an X-ray of the affected joint is performed. In the pictures, in addition to dislocation, cracks and fractures in the bones are found.
First aid
Not always immediately after an injury, a person has the opportunity to see a doctor. In order to reduce pain and not damage the hand even more, the victim must be given first aid.
Bandaging the wrist joint is a mistake. It is necessary to fix the whole hand. To do this, it is bent at the elbow and fixed to the torso with a wide piece of matter, for example, a scarf. Then you need to apply ice to the affected joint to relieve swelling from the soft tissues and restore blood circulation. In addition, this measure can reduce pain.
You can give the patient any painkiller in the dosage prescribed in the instructions for it. It could be Nurofen, Ketorol, Nise or Nimesil.
After completing all the first aid procedures, you should call a doctor or take the victim to the trauma center.
You can't set the joint yourself. Hand dislocation treatment is a very delicate process. It is easy to hurt your hand more if you do it wrong.
Reposition of the joint
Reduction of the joint is carried out only by professionals. There are several methods for this procedure. Which one is appropriate in each individual case, the doctor decides based on the type and severity of the injury.
For example, only one shoulder joint is reduced according to the methods of Janelidze, Kocher, Mukhinu-Motu, Hippocrates. And this despite the fact that in the shoulder there is only one joint and two bones, while in the radial joint of the hand there are 8 bones.
Before reduction, the patient takes an anesthetic to relax the muscles around the affected area. Sometimes it takes 10 to 30 minutes. Adjusting a joint with tight muscles can damage ligaments and break bones.
Dislocation treatment
Conservative treatment of dislocation involves the use of various medications used after the joint has been repositioned. They are aimed at relieving pain, swelling and restoring muscles and ligaments stretched during injury. They are prescribed by a doctor, indicating the dosage and regimen.
For pain, it is suggested to take "Ketorolac", "Ibuprofen" or "Diclofenac", as these drugs also relieve inflammation.
Therapeutic ointments of local action are widely used - "Hydrocortisone", "Prednisolone", "Diclofenac","Indomethacin", "Ketonal", "Ketoprofen". There are also products containing natural ingredients such as bee or snake venom. These are Viprosal, Kapsikam or Kapsitrin.
Ointments should be applied by gently rubbing them into the skin. This accelerates their absorption and has a healing effect on soft tissues, as it is a gentle massage.
Surgical treatment
If the dislocation was accompanied by ruptures of ligaments, blood vessels or nerve fibers, surgical treatment is performed. During the operation, all damaged soft tissues are sutured, but it is especially important to restore blood circulation and the ability to move the arm.
The method of the operation is selected depending on the type of dislocation and associated injuries. The operation is performed under general anesthesia.
Post-operative joint rehabilitation
Usually, after surgery or (if it was not performed) after repositioning the joint, the hand is fixed at the site of injury for a long time (from 1 to 4 weeks). During this time, the muscles of the hand lose their tone, and the nerve fibers lose their conductivity. Restorative therapy is used to restore the functions of the wrist. It includes a number of physiotherapy techniques, such as shock wave therapy, magnetic therapy, paraffin applications and so on.
Therapeutic massage is widely used, during which blood circulation in soft tissues and joint mobility are restored.
An important aspect of joint therapy is therapeutic exercises. You can start doing it while still in a cast or tight bandage. For thismanual expanders are used, which are a rubber ring, a ball or a spring with finger rests.
The sooner you can start gymnastics, the faster the function of the wrist will recover.
Gymnastics can be done independently in any free time. To do this, put your hand on some kind of emphasis with your palm up, take a dumbbell or a steel ball in your hand and slowly bend and unbend the joint.
You can gradually accustom the joints of the hand to the load, leaning your hands on the table and transferring body weight to your hands, each time increasing the load.
Treatment of the joint with folk remedies
There is a method of treating a dislocated joint with compresses made from medicinal herbs and roots. Such therapy is effective only in combination with drug treatment and only after the dislocation is reduced. Not a single compress will set the bones in the joints. This must be understood.
In general, this therapy relieves swelling and inflammation, but before using this method of treatment, you should consult a doctor.
The most commonly used bryony root or elecampane root. The plant must be ground into a fine powder, pour boiling water in a ratio of 1 tbsp. l. funds for 500 g of water and boil for about 15-20 minutes. After cooling the broth, you need to strain it, soak the bandage in it and bandage the joint.
An ointment is made on the basis of rubbed plant roots. To do this, you need to mix the resulting powder with vegetable oil to a state of homogeneous slurry and apply the resulting product ondamaged joint.
Conclusion
Very unpleasant and dangerous injury - dislocation of the hand. Everyone should know what to do in such a situation. The main thing to remember is that without timely medical care, an injury can develop into a serious pathology. Independent actions are not welcome. It is only necessary to provide first aid. All further manipulations should be carried out by an experienced specialist. Depending on the type of injury, the appropriate treatment is selected.
