If we examine the statistical information about fractures of the forearm, then the radius (from the Latin radius), with almost the same structure and anatomy, breaks much more often than the ulna. This is due to the psychological peculiarity of each person during the fall to put their hands forward, then the strongest blow will fall on that part of the surface where the bone comes out. Although it does not support the body like the lower limbs, its proper functioning affects the ability to move the arms.
It is the head of the radius that most often suffers.
Location of the radius
Radius in the forearm is located next to the ulna. That is why they are dependent and interconnected with each other. When the palm is turned back with a raised hand, then they are both parallel,however, when the palm is turned in the opposite direction, the bones cross. Partially, the beam rotates around the elbow, which ensures pronation (repetitive ability) and supination (rotational ability). In addition, the location of the radius bone can be determined by the thumb.
Anatomy of the radius
The radius includes the diaphysis (long body) and two ends - proximal and distal. The distal epiphysis is more powerful, it contains the surface of the wrist joint, as well as the styloid process, which connects to the hand. The structure of the proximal end of the radius is as follows: it includes the articular circumference (the beam connects to the humerus with its help) and the head. Under the head of the radius is the neck, then the tuberosity, to which the brachial biceps muscle is attached. Its development occurs due to the development of ossification points. There are three types of faces: back (with a rounded edge), front (also rounded) and lateral (the face goes to the elbow, with a pointed edge).
Definition and functions
The head of the radius is the uppermost part of the bone, it is one of the two bones of the forearm. The main function is to provide rotational movements in the forearm (palm down - palm up). Its form is determined entirely by its function.
Fracture
Fracture of the head of the radius refers to a violation of the bone structure, which is located in the area of the elbow joint. It's defeat insidejoint.
There are the following types of illness according to the specifics of trauma:
- fracture of the radial head without displacement;
- offset;
- comminuted;
- edge.
Fractures according to the degree of openness are divided into closed and open.
Treatment methods
Conservative treatment can be dispensed with depending on the extent to which the fragments are displaced (if the displacement is small) - six to eight weeks in a plaster cast.
Then you will need a rehabilitation course - special exercises to help develop the joint.
If fractures with a strong displacement of the radial head, then there are two methods of surgical treatment - removal or fixation of fragments of this head (osteosynthesis). Surgical therapy is carried out through a five-centimeter incision along the outer surface of the forearm. The doctor decides on the choice of a particular method, based on a large number of factors - the occupation of the person, the degree of displacement of fragments, etc.
In most cases, the removal of the head does not affect the functioning of the forearm much - a person almost does not feel inconvenience in everyday life.
With a significant displacement of fragments, a fracture of the head of the radius of the elbow joint can be fixed with small pins or screws (osteosynthesis).
When a fracture is too complex, with a lot of small fragments that almost cannot be connected, it is carried outremoval of the head of the radius. In some cases, a prosthesis is placed in its place, but according to recent information, it is not always necessary to replace it to restore the normal functioning of the forearm. Postoperative therapy consists in the use of calcium preparations, painkillers, and sometimes topical preparations to reduce swelling. After the operation, the protective mode - the hand is worn for about three weeks on a scarf bandage, sometimes a plaster splint is used.
How to design a limb
After three weeks, the patient needs to actively develop the hand. To do this, they can prescribe physical therapy, which increases the range of motion, physiotherapy courses (for example, magnetotherapy, phonophoresis with hydrocortisone and cryotherapy) to improve the condition of soft tissues.
Next, consider the subluxation of the head of the radius.
Dislocations and subluxations
Isolated dislocations and subluxations of the upper extremities are observed most often in childhood. The injury is sometimes so small that the parents do not pay attention to the subtle symptoms, and then the subluxation, including the head of the radius, develops into a chronic injury. You need to be very attentive to the complaints of the child, if any. So, in preschool children, dislocation of the head of the radius is one of the most common injuries that occur when falling. Isolated complete dislocation in medical practice is observed in children under the age of five years. Dislocations of the head of the radius are divided into acquired and congenital.
Congenital are rarer and most often easily restored if they were recognized earlier. Sometimes it is possible to cure a subluxation without the use of significant medical manipulations. If the disease is left unattended, we are talking about an old dislocation. Its danger is that it makes the joint area vulnerable, limits the motor functions of the joint.
For adult patients, dislocations of the head of the radius are more common, and in young children - subluxations. Most of the injuries in this case are pronation dislocations, which the baby receives when stretched. Anterior injuries in the area of the elbow joint are noted during falls on the hands. The specificity of a typical dislocation of the head of the radius of the elbow joint in patients from one to five years old is damage to the ligaments, while in girls such injuries occur twice as often.
Features of diagnosis and treatment
Reduction in some cases is carried out without preliminary diagnostics by an instrumental method. An x-ray is required for an unspecified type of injury or a possible fracture is suspected. Often congenital dislocations in obstetrics, if the inflammation progresses in the fetus or there is intoxication of the body, the help of a toxicologist is necessary. A newborn is diagnosed with subluxation of the head of the radius by palpation. Sometimes an ultrasound is prescribed. Injuries often require differential diagnosis. In children after three years of damage have similar symptoms. In this case, x-rays are required.
The damaged area is clearly visible on the picture, and the radiograph also shows chips and cracks in the bone structures. Treatment involves such manipulations: the use of painkillers - the pain experienced by the child after an injury is suppressed by non-narcotic analgesics. Ibuprofen preparations are often given, which are also characterized by anti-inflammatory effects. A closed reposition is performed - the shoulder joint is fixed before insertion.
Reposition is done in a sitting position, a he althy arm is extended along the body. At the same time, a smooth movement is carried out in the area of the elbow of the injured limb with the palm down to absolute supination. The head of the radius, after the inclusion, falls into place, a click is heard. Another way is immobilization, no specific treatment is required, it is enough to apply a kerchief bandage for three days. In case of a complicated injury, a plaster splint is used and worn for up to three weeks.
Treatment of dislocation of the head of the radius is chosen based on the medical history. Complex manipulations in early childhood are not needed. In infants, it is possible to set the joint right the first time. To avoid a new dislocation of the radial head in childhood, bandages and orthoses are used, the wearing period of which is determined individually.
Surgical therapy
If complications occur after injury and treatment, you should consult a doctor. With a dislocation of the head of the radius with an accompanying fracture of the elbow bone, healing is more difficult. Closed reposition is sometimes impossibledue to the presence of bone fragments and atypical displacement of the articulations of the joints. An operation is also required in case of rupture of the olecranon, violation of nerve fibers and blood vessels, improper fusion of an old injury. With a constant displacement of the head, you need to fix it with knitting needles. The same procedure is required for a complicated fracture in the elbow area. After surgical treatment, the recovery period is longer.
