A spica bandage is a type of cross-shaped or figure-of-eight bandage. Its advantage is the ability to provide reliable fixation in areas of the body of complex shape, in the area of various joints - hip, shoulder, wrist and others. The application technique is simple, anyone can master it in order to be able to provide first aid to victims of various injuries.
Author of the article / Site experts Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category
Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.
Indications for use
The indications for the use of spica bandages are quite broad; they are divided into 2 groups:
- Fixation of protective aseptic material:
- for various wounds;
- for burns;
- for applying a compress to the joint.
- Immobilization of a joint or limb in case of injury:
- bruises;
- sprains;
- dislocations;
- fractures.
This type of fixation is also used for acute inflammation of the joints, exacerbation of chronic arthrosis, and arthritis with severe pain.
Why are injuries dangerous?
Of course, for every person the ability to walk, run, move firmly and confidently on their own feet is very valuable and important. If a person loses mobility, he cannot live a full life, perform usual household chores, or work in positions that require certain physical activity.
Content:
- Why are injuries dangerous?
- Characteristics of lower extremity injuries
- What to do in case of injuries
- Types of dressings used for lower extremities
Injuries to the legs and pelvic area are one of the reasons that can contribute to a person’s disability and loss of the ability to walk, move, and run. Injuries of the lower extremities are conditions that occur due to mechanical action, when the integrity of muscles, ligaments, joints, bones, and skin is disrupted when parts of the articular apparatus change their location and cannot interact normally.
Lesions of the lower extremities are generally divided into two groups - closed and open. The former pose the greatest danger to humans, since they cannot be seen and assessed during visual inspection - the damage is located under the skin that has preserved its integrity. It can be tissue ruptures, fractures, dislocations, and less commonly, crushing of muscles and ligaments.
Open wounds and trauma mean that the skin at the site of injury is also torn, cut or crushed, and any internal damage can be seen. This principle of division is especially relevant for those who find themselves in a situation where it is necessary to provide first aid to victims during accidents, natural disasters, accidents, since even the absence of obvious external signs of damage is not a guarantee that everything is fine with the person.
What are the types of lower extremity injuries? All of them are differentiated by the nature of the disorder they cause in the body.
The most common:
- bruises and bruises;
- dislocations;
- fractures;
- ruptures and sprains;
- tissue crushing;
- meniscus tear.
Types of fixation
A spica bandage is applied using a regular gauze or elastic bandage. The first type of fixation is suitable for dressing wounds - holding sterile material. An elastic bandage is convenient for immobilization for various joint injuries and diseases; it is quite reliable, puts less pressure on tissues and does not interfere with blood circulation. For wounds, this type of fixation is not recommended, because the elastic bandage makes it difficult for air to reach the wound, which can create increased humidity and suppuration.
The bandage is applicable on a wide variety of areas of the body: in the area of various joints, in the groin and buttock areas, forearm, thumb and other areas of the body that are inconvenient for conventional bandaging.
Symptoms and treatment
In order to identify an injury in time and begin treatment, you need to know the main symptoms:
- pain in the gluteal region, lower back, radiating to the groin: sometimes occurs immediately after the incident, but more often with repeated exercise (walking or squats);
- slight stiffness of movements - they are limited to a reflex spasm;
- discomfort when sitting and walking: feeling of numbness or tingling;
- difficulty abducting the hip to the side;
- a click or crunch is heard when rotating a bent limb - this is accompanied by pain.
If all these symptoms are combined, you should immediately contact a traumatologist to prescribe treatment.
The first step is to eliminate the damaging effects on the ligaments. For this purpose, orthoses are indicated, which are selected by the doctor. The period of their use directly depends on his recommendations (usually two weeks). This period is just enough for the joint to recover. In this case, you need to rest more on your back. An elastic bandage (spica bandage) can be applied to the upper thigh to reduce mobility.
If the sprain is mild (grade 1), then cold compresses can be applied on the first day after the injury to reduce swelling and pain. The next day, you can already use warm compresses, UHF and other methods of physiotherapy to improve blood circulation. To reduce pain and swelling, special ointments and non-steroidal anti-inflammatory drugs (NSAIDs) are also used, but it is worth considering that such drugs have many side effects. And after a week you can start gymnastics.
If first aid was provided on time, and rehabilitation was carried out under the supervision of a doctor, then thanks to conservative treatment, the ligaments will be able to fully function even with a second-degree sprain. But this will require a lot of time (about two months) and effort. The specialist may prescribe muscle relaxants, painkillers, calcium supplements, etc. In some cases, surgery is possible.
If we talk about symptoms in children, the signs are very similar to the symptoms of trauma in adults. But making a diagnosis can be difficult even for a professional, so additional examinations are needed: x-rays or MRIs. After a sprain, the child often complains of pain. They can be either minor or very strong. This largely depends on the extent of the damage. Sprains that do not cause pain or discomfort are considered especially dangerous. In this case, the baby’s condition will gradually worsen. After some time, the hip joint may become less mobile. A hematoma or swelling may appear at the site of injury, and the skin will become hot.
If there is acute pain, parents should urgently take the child to the doctor, because such an injury requires timely and proper treatment.
For mild sprains, the injured leg needs rest. It will be necessary to give up sports and physical education lessons. It is necessary to develop TBS gradually. A second or third degree sprain requires hospitalization. If there is a rupture, the child will be placed in a cast. Often the symptoms of a sprain are similar to a dislocation or fracture, so diagnosis should only be entrusted to professionals.
Preparation for the procedure
First of all, you need to give the patient a position that will be comfortable both for him and for the one who will bandage. If the bandage is applied to the area of the shoulder and shoulder joint, the patient is seated so that he relaxes, and when applied to the hip joint or lower limb, the patient must be laid down.
You need to prepare materials: wide (20 cm) gauze or elastic bandage, fastening pins, adhesive tape (plaster), sterile wound wipes, cotton-gauze roller.
Sprain of the hip joint
Excessive physical impact on the connective tissues of the hip joint is the main cause of sprains. A large load on the ligaments of the hip joint occurs during sudden jumps, flexion or extension. People who lead a sedentary lifestyle are most often susceptible to such injuries, because the ligaments lose their elasticity.
At risk are children, elderly patients, as well as people suffering from obesity, diabetes and hypertension. Deformed posture, as well as bad habits, can play a role.
The causes of hip sprains can also be considered:
- sports or domestic injuries;
- long walking on uneven surfaces;
- conducting training without preparation;
- improperly performed physical exercises;
- deformation of the thigh and lower leg;
- incorrect placement of the foot when moving.
It is much easier to prevent ligament damage than to treat its consequences later, so you need to beware of situations that can lead to injury. But, if you fail to protect yourself, then you need to act very quickly to prevent complications.
Shoulder bandaging technique
In most cases, a spica bandage is used in the area of the shoulder joint, where injuries and diseases are most common. There are 2 methods of overlay: ascending and descending.
Ascending spica bandage
The algorithm for applying an ascending bandage is as follows:
- The patient is seated facing the bandage, with his arms down. Around the shoulder, make 2 securing initial rounds in a clockwise direction.
- They move to the back, and through the opposite armpit they exit to the anterior surface of the chest.
- The bandage is led to the front surface of the shoulder, crosses the initial rounds, circles around the shoulder and again leads to the back, overlapping the previous round by ½-2/3 of the width.
- The bandage is again passed through the armpit to the chest, but this round is placed ½-2/3 higher.
- They go around the shoulder again at a level higher, go back, and everything is repeated, with each move of the bandage being located higher than the previous one. The last turn is wrapped around the shoulder and the bandage is secured with a pin.
The result is a fairly reliable fixation, and on the outside of the shoulder, the placement of crossed rounds resembles an inverted ear.
Descending spica bandage
It is applied according to the same principle as an ascending bandage. The difference is that the first 2 rounds are secured not on the shoulder, but around the chest, then they move high to the shoulder, go around it, and bring the bandage to the back, armpit and chest. Everything is repeated, only each subsequent round moves not up, but down. A “spike” also forms on the outer surface of the shoulder, only turned in the opposite direction – upward. The technology is presented in the video:
Why are bandages needed for chest injuries?
Wounds and injuries to the chest are conditions that necessarily require medical attention. But now the ambulance is called and is already rushing to help, and the victim with an extensive wound and bleeding loses strength, loses blood and may not wait for specialized care.
First of all, you should assess the condition of the victim and determine whether he has:
- closed;
- penetrating;
- non-penetrating trauma.
The first type of injury is the most difficult for those who will provide first aid, since there is no external wound, but the injuries themselves can pose a fatal danger to a person. Closed chest wounds:
- rib fractures;
- shake;
- pneumothorax;
- hemothorax;
- traumatic asphyxia.
All these conditions can cause the development of heart or respiratory failure, but a person without a medical education, as well as without special tools and medications, will not be able to take any global measures to help the victim. The first aid algorithm for closed chest wounds looks like this:
- call an ambulance;
- give the victim a semi-sitting position;
- carefully and without sudden movements, free him from constricting and interfering clothes;
- For an unconscious person, tilt your head back and slightly to the side;
- monitor consciousness and pulse until doctors arrive.
Non-penetrating wounds do not affect the integrity of the lungs and are therefore considered less dangerous. After calling doctors, it is necessary to assess the person’s condition, determine if he is bleeding, apply a pressure bandage and monitor his condition until the ambulance arrives.
Penetrating wounds greatly aggravate the patient's condition. He experiences shortness of breath, a feeling of lack of air, bloody foamy sputum, and a drop in blood pressure. The person must be in a semi-sitting state; he cannot talk, breathe deeply, drink, or eat. A bandage must be applied.
Why do you need to bandage a patient with chest injuries? Typically, applying a bandage has several purposes:
- immobilize the victim;
- stop the bleeding;
- prevent infection.
The difficulty of applying bandages to the chest is that the torso in this area has the shape of an inverted cone, in addition, it is constantly in rhythmic movement due to breathing, so the applied bandage can slip.
The most popular dressing material for the chest is sterile medical bandages 10, 12 or 14 centimeters wide. Additional fastenings and solid elements for tires can also be used.
Spica bandage for the hip joint
The use of a bandage in the hip joint area is used to close wounds after surgery, for injuries, for the treatment of coxarthrosis, bursitis. With its help, you can fix the dressing material in the groin area, the upper third of the thigh.
In this area, the bandage can be applied in 3 options, depending on the location of the intersection of the bandage rounds:
- front;
- lateral;
- rear
Front option
Applied with the bandage rounds crossing in front, it is used to fix the joint, groin area, and thigh. There are 2 options for the bandage: ascending, when the first fixation round is applied around the thigh, and each subsequent one is shifted upward, going around the lower back, and downward, when fixation begins from the lower back, and the next rounds are shifted down by 1/3-½ of the width.
Side option
It is used to cover the outer surface of the joint, hip, pelvis, for example, after operations and injuries. There are also 2 options – ascending and descending.
Rear option
Applying a bandage with crosses along the back surface is convenient for fixing the dressing in the buttock area and the upper third of the thigh. It can also be applied using an ascending or descending technique.
The spica bandage for the hip joint can also be unilateral or bilateral - on the right and left joint.
How to properly apply a spica bandage to the hip joint
Rules for applying bandages for chest injuries
The position of the victim at the time of dressing should be such as not to interfere with free access to the chest. Usually a person is left in a semi-sitting position, with his back or his side on the floor against a hard surface so that he can breathe normally. When positioning the wounded person, he should be seated so that the muscles in the affected area are as relaxed as possible. In case of fractures of the chest, spine or ribs, it is prohibited to change the position of the victim, except in exceptional cases, for example, if he needs to be pulled out of a burning car or from under a rubble.
During bandaging, the damaged part should be motionless; the person should not inhale very deeply and exhale sharply. The person providing assistance, while applying the bandage, is positioned so as to see both the injured chest and the victim’s face.
The first round (circular rim) of the bandage is a fixing one, and all subsequent turns overlap each previous turn by two-thirds.
If bleeding is excessive, it must be stopped using pressure bandages or finger pressure. Sterile material is applied to the wound under the bandage - gauze pads, cotton pads or a clean cloth. The finished bandage should tightly fix not only the chest itself, but also the material placed under it. The edges of the wound should first be treated with antiseptic agents.
In cases where there are foreign bodies, bone fragments, or splinters in the wound, it is forbidden to remove them yourself. Foreign objects protruding from the wound should be carefully wrapped around the perimeter with sterile napkins, secured with tape, covered with sterile material and bandaged.
Care of the bandage
The dressing needs to be changed regularly if it is holding the sterile material in place on the wound at the same time as dressing the wound. If a bandage is applied to intact skin due to a closed injury or joint disease, then it must be changed strictly after the time recommended by the doctor.
Avoid getting the dressing wet or dirty; in these cases, it should be replaced.
When bandaging for immobilization, care must be taken to ensure that the bandage does not loosen. To do this, it must be well fixed with closed pins or special adhesive tape. Too tight tours need to be loosened so that the blood circulation of the limb is not disturbed.
If the bandage is applied for a long period of time, it must be removed 2 times a week for hygienic treatment of the skin using detergent or antiseptic solutions. You also need constant monitoring of the patient’s sensations and the color of the skin on the diseased part of the body.
Characteristics of lower extremity injuries
A bruise, accompanied by swelling, bruising and pain, is considered the most gentle of all types of injuries to the lower extremities. It can occur after a fall or sharp blow. In this case, the integrity of the blood vessels in the skin is disrupted, a bruise appears, which changes its color over time. In addition, soft tissue bruises can accompany more dangerous injuries - fractures, ruptures.
Joint dislocation is a pathological condition in which parts of the joint, most often the articular head, leave their usual “location”, for example, the head extends beyond the acetabulum.
Such injuries occur due to the fact that a person makes a sudden and atypical movement that goes beyond the functional capabilities of the joint, as well as due to impacts and lifting heavy objects.
A bone fracture is the appearance of a crack or break in it, which may be accompanied by the distribution of bone fragments in the wound. Fractures can be closed or open - in the first case, the skin remains intact, and in the second, the skin is chopped or cut by protruding bone fragments or as a result of mechanical force. The person feels severe pain, the fracture site swells, and blood circulation is impaired. It becomes extremely difficult to move and step on the sore leg due to pain.
Tears and sprains of tissues, ligaments, and muscles occur due to sudden forced movements that exceed the ability of the joint to withstand loads. Athletes often encounter such injuries, but ordinary people are not immune from painful and dangerous injuries. It is especially facilitated by excessive overload, exercise in the gym without following the rules of exercise and safety precautions.
Tissue crushing occurs as a result of a strong blow - as a result, their normal structure and vitality, blood circulation and metabolic processes are disrupted. Such wounds are dangerous with a high probability of developing infection and inflammation; they take a long time and heal poorly.
The meniscus is a structural element of the articular apparatus, which serves to stabilize its component parts. The most common causes of a meniscus tear are sports activities. However, not only athletes can encounter it - older people with arthrosis also often experience rupture of this articular element. This condition is dangerous for humans, as it causes inflammation, fever, joint blockade, severe pain, and decreased mobility.
Possible errors and complications
There are 2 types of errors when applying a spica bandage: too tight or, conversely, weak bandaging.
When bandaging tightly, the initial or reinforcing rounds usually compress the soft tissues, resulting in the following complications:
- pain in the limb below the bandage;
- feeling of numbness in the skin of the limb;
- swelling of the tissues downwards from the bandage;
- bluish or pale coloration of the skin of the limb.
Bandaging that is too tight acts as a tourniquet with all the ensuing consequences: the development of contracture (stiffness), thrombosis, lymphostasis, trophic disorders up to gangrene. At the first feeling of discomfort, the bandage should be loosened.
On the other hand, insufficiently tight bandaging negates the function of the bandage: it does not fix the joint, does not hold the dressing on the wound, it can move or fall out, and the wound can become infected. Therefore, bandaging should be moderately tight.
Brief overview and characteristics of shoulder orthoses
Orthosis for the shoulder joint
In addition to bandages, a shoulder bandage or orthosis is used for fixation. Medical devices are designed to immobilize and reduce stress on the shoulder joints. Prescribed after sports and domestic injuries, with instability of the ligamentous apparatus, arthrosis and arthritis, in the postoperative period. The bandage is recommended to be worn to reduce dangerous injuries from excessive sports activities.
Kinds:
- Soft. The products are made of elastic, breathable material. They fix the shoulder joint well, but practically do not interfere with the movement of the healthy arm. Suitable for long-term wearing.
- Semi-rigid. Designs with metal or plastic inserts. Designed for strong joint fixation. Prescribed for pathologies of the musculoskeletal system in acute and chronic form, to reduce the recovery period after injury to joints and tendons.
- Tough. Metal rigid structures. Prescribed for complicated fractures, dislocations with tendon rupture.
A spica bandage is an integral part of first aid for a victim. It is used to safely transport a person to a medical facility. The effectiveness and duration of therapy depends on correct application.