What can you do before the specialists arrive?
Before the ambulance arrives, you need to calm the child down and provide him with first aid:
- Immobilize your hand using available materials . For this, any flat, hard objects will be useful - a board, a ruler, thick cardboard. It is necessary to fix not only the site of the suspected fracture, but also the adjacent joints - the wrist and elbow.
- Children find it difficult to bear pain. Therefore, you need to give your child an anesthetic in a dosage appropriate to the child’s age. The instructions in the medicine package will help you calculate the dose.
- With open fractures, there is a high risk of infection . The wound must be treated with an antiseptic and covered with a sterile napkin.
- If massive bleeding is present, the bleeding must be stopped. A tourniquet is applied above the wound for arterial bleeding (scarlet blood comes out in pulsating bursts), and below the wound for venous bleeding (dark blood oozes out in a trickle).
With a displaced fracture, the child's forearm may have an unnatural shape. You should not try to straighten the limb yourself. Such actions will cause severe pain to the baby and will only worsen the situation.
Symptoms
It is not difficult to recognize a fracture in a child. In this state, the child is usually scared, agitated, screaming and crying.
Typical symptoms:
- severe pain is the main symptom of a fracture;
- swelling, redness, hematoma in the fracture area;
- hand or joint deformity;
- wound with protruding bone fragments due to an open fracture, bleeding;
- unusual position or free sagging of the arm;
- crepitus when palpating a limb;
- impaired motor function of the hand.
Fracture of the head radius is quite rare, more often in adolescents. This injury is usually combined with damage to the humerus and dislocation of the elbow joint. This type of fracture is characterized by joint deformation, hemarthrosis, swelling and limitation of movement. A particularly sharp limitation is observed when attempting to rotate the forearm.
You should pay attention to the temperature of the child's hand. If the limb is cold, then there is a high probability of damage to the blood vessels by fragments.
Anatomical features of radius
The radius consists of a body (diaphysis) and distal and proximal ends and, together with the ulna, form the forearm. The distal (lower) end of the bone is more massive; the head of the bone is located on it, which connects to the wrist joint.
The proximal (upper) end in the area of the elbow joint has a condyle. It should be noted that the bones of a child are significantly different from the bones of adults. Children's bones contain more organic matter, the bone shell is denser and better supplied with blood. Children have areas of bone tissue growth. All this determines the specifics of childhood trauma.
Structural features
Children often experience a greenstick fracture, which is when the bone appears as if it was broken and then bent. In this case, a slight displacement of the fragments is observed, since the fracture occurs only on one side, and the second side is protected by dense periosteum. But sometimes a fracture can bring serious consequences in the future.
Near the joints there is a growth area of connective tissue. And damage to this area can cause it to close prematurely and shorten or bend the injured arm.
"Green Branch"
Diagnostics
The diagnosis is carried out by a traumatologist. The examination reveals swelling of the arm, hematomas, deformation of the limb, damage to the skin and soft tissues due to an open fracture, pain, and impaired movement.
An experienced specialist can make a diagnosis based on clinical studies. But in the event of a fracture, the child is likely to make mistakes. Pronounced subcutaneous tissue makes palpation difficult.
In the event of a bone fracture, the mobility of the limb is maintained. Sometimes such fractures are diagnosed as bruises, and then the treatment will be incorrect and lead to dysfunction of the hand.
An X-ray examination is necessary to establish an accurate diagnosis. X-rays are taken in two projections, which can be used to establish the location and line of the fracture, the presence of fragments and displacement, and the nature of the fracture (photo).
In severe cases, an MRI or CT scan may be needed - the price of which is quite high. To exclude blood poisoning in open fractures or the presence of complications, the child may be referred for a laboratory blood test. Only after a final diagnosis has been established is appropriate treatment prescribed.
Method of treatment and recovery
For any injury to the musculoskeletal system, you must visit a doctor. Serious open fractures require immediate hospitalization to prevent infection in the wound.
You should not self-medicate and put off visiting a doctor. The sooner qualified medical care is provided, the faster the arm will restore functionality after a fracture of the radius. In displaced fractures, it is important to prevent increased bone displacement and damage to blood vessels and nerves.
First aid for a broken arm
While waiting for a doctor or before going to the traumatology department, it is necessary to immobilize the injured limb. Fixation will minimize further displacement and reduce pain.
When applying a temporary splint at home, use a straight board of a suitable size and a bandage. It is important not to tighten the arm too much so as not to disrupt blood circulation, but at the same time reliably fix the area of damage.
Important! In case of a displaced fracture, it is strictly forbidden to reset and align the bones yourself, as this can lead to an even more serious injury to the hand.
Cold is applied to prevent severe swelling and reduce pain. The victim is provided with a comfortable body position and rest.
In case of an open fracture, the wound is carefully cleaned if possible and treated with antiseptic drugs.
Medical treatment
The task of the traumatologist is to accurately determine the type and characteristics of the fracture and immediately carry out therapeutic measures. The doctor obtains important information about the nature of the injury from interviewing the patient and examining the injured limb. The final conclusions are made based on the x-ray image. If there are injuries to other organs and parts of the body, a more complete examination will be required.
The displaced parts of the bone are combined under anesthesia. The normal fusion of the bone and the functioning of the limb after recovery depend on the accuracy of the alignment. Once the bone pieces are aligned, they are secured with a bandage and plaster.
The length of time the cast is worn depends on the severity of the injury and the individual rate of bone healing in the patient. Premature removal may result in improper fusion. If the bones are displaced, you will have to wear a cast for at least 1-3 months. Before removing the plaster, a control photo must be taken to ensure a positive result of the treatment.
At first, the doctor may prescribe painkillers to alleviate the patient’s condition. If you have open wounds, you will need a course of antibacterial drugs.
Final restoration
Removing the cast is not the final stage of treatment. After a fracture of the radius, the arm gradually restores full mobility. To develop the muscles and joints of the hand, it is necessary to regularly perform physical therapy exercises.
Physiotherapeutic measures have a positive effect on recovery processes.
A fracture of the radius is a serious injury. Timely seeking medical help and following all doctor’s instructions reduce the risk of complications.
What will the treatment be like?
Treatment depends on the nature and severity of the fracture, the degree of displacement, and the number of fragments. It can be conservative or surgical. With any treatment method, drug therapy is carried out. Painkillers and anti-inflammatory drugs, immunomodulators, drugs containing calcium and chondroitin, and vitamins are prescribed.
Conservative treatment
Conservative therapy is carried out for minor displacements. In this case, closed reduction is performed. The procedure is quite painful, so local anesthesia is performed.
The doctor and parents should reassure the child and explain why this procedure is necessary. Immobilization is carried out several days after the process of swelling has completed. The duration of wearing a plaster cast is from 3 to 10 weeks. On the 10th and 20th day from the date of injury, X-ray control is carried out.
Surgery
Surgical intervention is performed in cases of an open fracture and the impossibility of closed bone reposition. The essence of the osteosynthesis operation for a displaced fracture is the correct comparison of fragments and fixation using metal screws or plates. A specialist will tell you more about this operation in the video in this article.
Causes of injury
This type of fracture occurs quite often in children. This is facilitated by active, outdoor games or sports.
A displaced fracture develops due to:
- falling from a height onto your hand;
- active games at home or outside;
- playing sports without following safety precautions;
- being hit on the hand with a heavy object;
- Road accident.
The most common type of injury is a fracture of the lower 1/3 radius, the so-called fracture in a typical location. Most often this is the result of a fall on a bent hand with an outstretched arm.
Most often, children get injured during outdoor games.