Judging by the practice of doctors in the field of surgery and traumatology, a fracture of the radius of the hand is the most common type of fracture. This pathology accounts for about 45 percent of the main number of violations of the integrity of the bones. This number is explained not only by the anatomical feature, but also by the conditions of the injury. In most cases, when a person falls, he involuntarily puts his hand forward.
Anatomically, the radius is supported by a lot of ligaments, but is not strong. The fragility of this joint also increases due to age-related changes, so there are many pensioners among the total number of people with this diagnosis.
The paired radius forms together with the ulna two joints: the wrist and the ulna. It is located in the bones of the forearm. Most often in the practice of traumatologists there are fractures of the beam in a typical place. This is what experts call damage to the area closest to the joint.
Causes of fractures
The number of such injuries increases significantly in the winter season. Ice and melted snow cause people to fall. At the moment of landing, a person puts his hands forward, as a result of which the main blow falls on them.
Active sports can provoke such a fracture, for example, skiing, skating, cycling, rollerblading, etc.
Ambulance paramedics fix a large number of fractures of the radius in car accidents: people on impact try to find support by stretching their arms forward.
With age, bone tissue becomes thinner, as a result, older people are at risk for fractures of this joint.
Types of bone changes after injury
Fractures can be conditionally divided into several main categories, which also have their own subgroups.
- Fractures of the radius of the arm without displacement.
- Fractures of the radius with displacement.
The second type is subdivided depending on the direction of the fragment (a broken piece of bone).
- Colles fracture (flexion type). In this case, the fragment is moved closer to the back of the forearm. Such options are possible after resting with an open palm on the ground during landing.
- Smith fracture (extension type). In this case, the fragment moves closer to the side of the palm. Such options are possible after exposure to the reverse surface of the wrist.
Depending on the area that has been injured, the following fractures are distinguished.
- In the region of the head or neck of the bone. This is a traditional type of injury where a fall occurs on arms outstretched in front of you.
- In the area of the neck,the central section of the radius or ulna. Such a diagnosis is made mainly after a direct blow or fall.
- In the region of the styloid process (located at the junction of the neck and radius). Such injuries occur when falling on an outstretched arm in front of you. In this situation, the wrist is pushed first outward and then back. As a result, the bone is damaged and requires immobilization with a plaster splint for 5 weeks. When the styloid process is displaced, it is necessary to “reset” the bone fragments. This procedure is called repositioning. The purpose of its implementation is to fix the articular surface without flaws.
Damage classification
Due to the wide variety, injuries of this type are grouped into blocks.
The first block includes:
- open type - a fracture with damage to the skin (in some cases, fragments of a broken bone protrude in such places);
- closed type - without skin damage (in such cases, the damaged area is determined by x-ray and local symptoms: swelling and pain when touched).
The second block is added:
- fractures without displacement of fragments (in such cases, a fracture is formed on the bones, and injuries of this type are the most frequent and do not require additional interventions other than fixation);
- fractures of the radius of the arm with displacement (this pathology is a complicated injury and after reposition, the likelihood of re-displacement is high).
To the third blockrefer to:
- intra-articular fractures (as a result of such damage, the area of \u200b\u200bthe wrist and neck is covered);
- extra-articular fractures.
Signs of pathological injury
Sometimes a fracture of the radius of the hand has to be diagnosed based on indirect symptoms, since there are no clear signs.
Complaints may occur:
- sharp pain in the wrist;
- general malaise, nausea, weakness of the patient and even loss of consciousness;
- difficulty or complete loss of movement in the hand, fingers - due to severe pain;
- hematoma formation, swelling in the crook of the arm and in the hand: such symptoms are the result of hemorrhage inside the muscles;
- crunching when trying to move the wrist.
In difficult cases, a wrist injury can be identified by visual deformation of the bone. Such signs are accompanied by a fracture of the distal metaepiphysis. The deformation can be bayonet-shaped or fork-shaped.
Fracture should be suspected if more than one symptom is present. The main ones are pain and swelling. To identify an accurate diagnosis, a visit to a traumatologist or surgeon is necessary. In case of a fracture of the radius of the arm, treatment is prescribed immediately.
First aid for a fracture of the radius
The main action to be performed after injury is to create rest for the hand. This is done with a homemadesplint, which is applied from the elbow joint to the forearm. To reduce pain, you can fix the brush. Any flat solid object can be used as a tire: a piece of plywood, boards, cardboard, etc.
Before examining a doctor, the hand should be held at the level of the belt or raised up - this will reduce swelling and pain. Cold should be applied to the injured area through the fabric: ice, a bottle of water and other similar things.
Diagnosis
Accurate diagnosis of a fracture of the radius of the hand occurs after an X-ray examination. The picture can determine the presence of damage, its type and type. Also, after the examination, the doctor suggests the approximate time of wearing plaster immobilization.
In difficult situations, additional MRI or CT diagnostics are required. Such studies are carried out in order to determine the nature and extent of the associated injury.
Healing injuries
The duration of treatment for a fracture of the radius of the arm depends entirely on the method. Among them are:
- conservative;
- surgical intervention.
Conservative methods
This type of assistance consists in fixing the injured arm with a plaster splint. The conservative method is used for a fracture of the joint without displacement. Gypsum can be from standard materials or polymer. The second type of bandage is expensive, but it can be exposed to water.
After applying a plaster splint, it is necessary to visit the clinic several times a week forfurther inspection. The traumatologist will monitor the condition of the bandage and arm. After the edema subsides (approximately 7-12 days after the injury), a second X-ray examination is performed. This diagnosis prevents accidental displacement of the bone and makes it possible to more accurately determine the time of wearing the fixation.
Surgical methods
Treatment of a displaced fracture of the radius of the hand is performed surgically. Also, such an intervention requires multi-comminuted and complex intra-articular injuries. Traumatologists, under local or conduction anesthesia, scrupulously restore the bone, reposition the fragments.
In medicine, repositions are divided into 2 groups.
- Closed. This method is more considered conservative, because the reduction of fragments does not require surgery and is carried out manually by specialists under local anesthesia. Performing the necessary movements, traumatologists set the bone in the correct position. This manipulation requires high concentration and precision. The return of the radius to its anatomical position is a very important process, the incorrect implementation of which threatens with serious complications.
- Open. This manipulation is performed surgically under conduction anesthesia. Traumatologists make an incision over the damaged area to gain direct access to the fragments. The purpose of the process is to eliminate the displacement and fix the fragments in the correct position using a certain design. This action is called osteosynthesis. After this procedure, swelling and soreness of the damaged area decrease,the process of rehabilitation after a fracture of the radius of the hand.
Osteosynthesis Methods
Depending on the location of the injury, the time elapsed since the injury and the degree of displacement, doctors distinguish several methods of osteosynthesis.
- Using knitting needles.
- With overlay plate. This method is suitable for the wrist area.
- With the help of the Ilizarov apparatus (distraction apparatus). This method is used for multiple small fragments and severe bone fragmentation.
After rendering assistance and applying a plaster splint, some patients experience pain at the site of a fracture of the radius of the arm. The timing of fusion depends on the correct implementation of the doctor's recommendations, the severity of the damage and the individual characteristics of the organism. Often the first time the joint swells. Doctors recommend keeping the arm elevated and taking painkillers.
Rehabilitation measures
Treatment of a fracture of the radius of the arm and the timing of fusion after removal of the cast depend on the correct implementation of rehabilitation measures. It consists in the development of the elbow and wrist joint. If rehabilitation is carried out incorrectly, ignoring the advice of the attending physician, the hand may lose its full capacity.
Each specific injury requires a specific, individual series of exercises and activities. In most cases, with a fracture of the radius of the arm, physiotherapy is prescribed,therapeutic exercises and massage on the damaged area.
Complications and possible consequences
After a fall with support on the hands, you should pay attention to the symptoms that have appeared. If there is soreness, swelling of the impact site, bone crepitus and impaired movement, you should think about a fracture and consult a doctor for a diagnosis. In the absence of a timely response, complications can be achieved. And some of them lead to disability.
Complications of a radius fracture include the following.
- Rupture of nerves. These elements in the human body are responsible for sensitivity (heat, cold, sensation of objects) and movement.
- Tendon injury. They carry out flexion and extension movements, a grasping reflex.
- Muscle tear. After such damage, contractures and shortening of the length of the limb can form.
- With open fractures, infection of the wound is possible, which subsequently leads to osteomyelitis.
- Changing the appearance of the brush (in case of incorrect bone fusion).
To prevent any of these situations, you should consult a doctor in a timely manner to diagnose damage.
