A radius fracture occurs when a person falls on an outstretched arm. Fractures differ in the direction and type of movement of damaged bone fragments and disruption of the integrity of the skin. Fractures of the radius can be displaced or non-displaced. At the Yusupov Hospital, rehabilitation specialists restore impaired function of the upper limb after a fracture of the radius using modern rehabilitation methods.
A senior instructor-methodologist of physical therapy exercises the development of the wrist joint using a set of gymnastic exercises. Patients restore muscle strength while working on mechanical and computerized simulators. Muscle massage relieves spasm and helps restore movement in the joint. Restoration of impaired limb function occurs faster after physiotherapeutic procedures.
Complications of a broken arm
Complications of radial bone fractures are divided into 2 large groups: immediate and long-term complications of injury. Immediate complications of injury develop due to the effect of damage resulting from a bone fracture on the normal functioning of the limb. Long-term consequences of injury are complications that arise as a result of inadequate treatment or disruption of normal healing after injury.
Immediate complications include:
- ruptures and injuries of the nerves that provide sensitivity or mobility of the limb;
- injuries to the finger flexor tendons;
- tight swelling of Turner's hand;
- damage to large vessels;
- complete or partial muscle rupture;
- separation of muscles from places of attachment to bone;
- acute infectious complications (with open fractures).
Long-term consequences of injury include:
- ischemic contracture - impaired mobility of the joints of the affected limb due to an incorrectly applied plaster cast, which compresses the soft tissues, disrupting the blood supply;
- long-term infectious complications;
- violations of the bone structure due to improper restoration of bone fragments, incorrectly applied plaster cast;
- long-term consequences of hemarthrosis.
Complications of a fracture of the radius aggravate the course of the pathological process, slow down the formation of callus and the restoration of function of the upper limb. From the first days after the reposition of bone fragments, rehabilitation specialists at the Yusupov Hospital begin a complex of physical therapy and physiotherapeutic procedures aimed at preventing complications of a fracture of the radius.
Causes
Each bone has its own factors that lead to damage. Thus, a fracture of the hand in the wrist , namely the scaphoid bone, occurs when falling on an outstretched arm. Road traffic accidents often lead to damage. Another reason is hitting a hard object with your fist or during a fight. Damage occurs as a result of a blow to the palm. Bilateral injury occurs less frequently and is caused by a fall on both upper limbs at once. In parallel, with a fracture of the scaphoid, dislocation of the lunate may also occur.
Injuries to the lunate are rare, occurring mostly from a fall on an outstretched arm or from a direct blow. Injuries to the trapezium, triquetrum, trapezoid, pisiform, hamate and capitate bones are rare in the practice of a traumatologist and are the result of a direct blow.
Treatment of fractured radius and joints
Adequate first aid for a fracture of the radius allows you to avoid complications of injury and speed up recovery after a displaced fracture of the radius. The goal of first aid is to reduce pain, ensure rest of the affected limb, and prevent damage to the soft tissues that surround the fracture site. In case of a closed fracture, the limb is fixed using a splint. If the fracture is open, stop the bleeding and apply an aseptic bandage to the wound, then immobilize. If the radius is fractured with displacement, there is no need to try to restore the normal position of the bone fragments at the scene of the incident, so as not to damage the surrounding tissues, vessels and nerves.
In the emergency room, patients with a fracture of the radius are provided with first aid. The traumatologist assesses the condition of the victim in order to determine the scope of further treatment and prevent the development of complications. After confirming the fact of a fracture, the anatomical and functional integrity of the injured limb is restored and the arm is immobilized to prevent displacement of fragments of the broken bone.
The traumatologist compares the bone fragments and fixes them with a plaster or polymer bandage. For some types of radial bone fractures, doctors perform closed or open reduction followed by fixation with knitting needles and apply an external fixation device. After treatment, patients need to restore impaired function of the upper limb.
Classification
Fractures can be classified according to the direction of the line, the presence of confusion, or depending on the location. Damage is identified:
- transverse;
- splintered.
In the scaphoid bone the fracture line passes:
- in the proximal part;
- in the middle part;
- in the distal part.
Rehabilitation and recovery
Complete recovery after a fracture of the radius consists of restoring bone structure and limb function (mobility and sensitivity). Even with absolutely adequate treatment, prolonged immobility in the joints and muscles of the upper limb leads to the fact that it is difficult for the patient to make movements in the joints that were previously accessible to him. The process of recovery from injury takes a long time and requires patience and desire from the patient to work.
Rehabilitation specialists at the Yusupov Hospital begin to develop joints and muscles in case of a fracture of the radius as early as possible. The timing of the start of rehabilitation measures depends on the type of fracture and method of treatment. If the fracture is treated conservatively, then after 3-5 days, after the swelling subsides, they begin to work on the fingers.
First, passive movements are performed. Take the finger on the broken limb with your healthy hand and carefully begin to bend it in all joints. In this way, stretch all fingers except the thumb for 5-7 minutes 3 times a day. After a week of such training, they move on to active movements. The patient can begin to bend his fingers independently, without the help of a second hand. It is very important to distribute the load correctly. If pain or swelling appears again during the exercise, the exercise should be stopped.
Simultaneously with the beginning of passive movements in the fingers, active movements in the elbow and shoulder joints begin. The patient raises and lowers his arm, bends it at the elbow. Do these exercises for 3-5 minutes at least 2 times a day, gradually increasing the load. After 3-4 weeks, if active movements of the fingers do not cause pain, they begin to increase the load on these joints. You need to take a lump of plasticine and knead it in your fist. This exercise should be done as often as possible, throughout the week. After removing the cast, proceed to exercises with a wrist expander. You should exercise at least three times a day for 5-7 minutes.
A physical therapy instructor teaches a patient fine motor skills exercises. By the end of the fourth week, the patient may begin to draw or write with the affected hand. You can sort out rice or buckwheat grains one grain at a time. This will preserve not only the strength and mobility of the joints, but also the coordination of movements of the fingers. You can type texts on a computer keyboard as a coordination exercise. If the patient does exercises while he has a plaster splint installed, then after its removal, the rehabilitation period will be significantly reduced.
Exercises should involve all joints of the injured limb. It is important to regularly warm up your fingers. To relieve tension in the affected limb, some activities after removing the plaster cast should be done in water. The duration of the course of physical therapy is determined individually by rehabilitation specialists at the Yusupov Hospital. The average duration of a course of therapeutic exercises is 1.5 months.
Rehabilitation therapists teach patients exercises that can be performed at home. Water gymnastics involves performing simple physical therapy exercises in water. Classes can be carried out in the bathroom. Cosmetic sea or table salt should be added to warm water. It will simplify the process of doing the exercises.
The complex consists of the following exercises:
- flexion and extension movements of the palms in the water;
- circular movements of the hand;
- rotations in the elbow joint;
- clenching and unclenching the palm into a fist.
The duration of the procedure is from 10 to 15 minutes. It is recommended to do 2-3 approaches daily.
Patients can also perform the exercise therapy complex recommended by the instructor at home. You should take the starting position “sitting at the table”. You need to place your elbows on the table, and place a thin, flat mat under your hands. The hands must be bent and unbent, and made rotational movements. Place your hands on the table edgewise, and then tilt your hand so that the little finger first touches the surface of the table, and then all fingers successively. Rest your elbows on the table, clasp your palms and tilt them alternately towards your left and right wrist.
Symptoms
Each bone fracture has its own clinical symptoms, despite the fact that they are located in sufficient proximity. It is not always possible to make a correct diagnosis based on symptoms, but they can lead to an understanding of the essence of the issue. So, the scaphoid bone is characterized by:
- pain in the area of the “anatomical snuffbox”, it appears at the base of the first finger, between the tendons, if you lift it up;
- pain when tapping the first and second fingers;
- pain during dorsal extension of the hand;
- swelling and subcutaneous hemorrhages at the site of injury;
- signs of a broken hand in the wrist are complemented by pain when trying to clench into a fist;
- in a displaced fracture, the site of injury is deformed;
- fragments can crepitate, pathological mobility is observed;
- active and passive movements of the hand are limited.
Symptoms of damage to the lunate bone:
- pain at the site of injury;
- painful dorsiflexion of the hand;
- swelling and bruising in the projection of the bone;
- pain when putting pressure on the third and fourth fingers.
Symptoms of a fracture of the trapezium, triquetrum, trapezoid, pisiform, capitate and hamate bones:
- pain and swelling when palpating the damaged area;
- pain when putting pressure on the finger, the axis of which passes through the damaged bone.
Exercise therapy for quick recovery after injury
In the process of restoring the function of the upper limb after a fracture of the radius, thermal procedures play an important role. Physiotherapists at the Yusupov Hospital carry out warming in a variety of ways (paraffin or ozokerite applications). Massage is added to the complex of gymnastic exercises. The following procedures are used to treat a radius fracture:
- ultra-high frequency electromagnetic field (during the procedure, the tissues of the affected limb begin to heat up, the patient feels warmth, regeneration accelerates, pain weakens);
- low frequency electromagnetic field – reduces swelling, eases discomfort and pain;
- ultraviolet irradiation helps to increase the synthesis of vitamin D, which is necessary for the absorption of calcium from food in the digestive tract;
- Calcium electrophoresis on the area of injury helps accelerate the formation of callus and facilitates the restoration of damaged bone tissue.
You can undergo a recovery course after a fracture of the radius at an affordable price in a rehabilitation clinic. The contact center is open 24 hours a day, 7 days a week. Call the Yusupov Hospital and make an appointment.
Diagnostics
A detailed history of the injury and a thorough examination in any case will not allow us to accurately determine the fracture. An x-ray is required, and first of all, in the lateral and anteroposterior projections. However, this is often not enough, and therefore an additional three-quarter image is taken. This projection allows us to assess the condition of the scaphoid bone in profile.
It happens that a crack in the body of a bone is not visible even with a detailed study of the image using a magnifying glass. However, the patient still complains of local pain in the wrist. In such a situation, the x-ray must be repeated after three weeks. During this time, against the background of decalcification, the gap between the fragments will widen, which will make it clearly visible on the image.
For any suspicion of an inaccurate diagnosis, as well as for an intra-articular fracture, CT or MRI results will be needed.
Open reduction followed by fixation with screws or plates
There are cases when severe displacement has occurred and reposition cannot be carried out using conventional methods. Then an operation is performed during which the displacement is eliminated and the fragments are fixed with titanium plates or screws. This technique is considered more durable than fixation with knitting needles. The plates firmly and rigidly hold the fragments in the desired position, therefore, firstly, it is not always necessary to wear a cast or a fixing bandage, and secondly, the wrist joint can be developed almost immediately.