Judging by the practice of doctors in the field of surgery and traumatology, a fracture of the radius of the arm is the most common type of fracture. This pathology makes up about 45 percent of the main number of bone integrity disorders. This amount is explained not only by the anatomical feature, but also by the conditions of the injury. In most cases, when falling, a person involuntarily puts his hand forward.
From the point of view of anatomy, the radius is supported by a large number of ligaments, but is not strong. The fragility of this joint also increases due to age-related changes, so among the total number of people with this diagnosis there are many pensioners.
The paired radius forms together with the ulnar two joints: the wrist and the ulnar. It is located in the bones of the forearm. The most common in the practice of traumatologists are beam fractures in a typical place. So 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 provoke people to fall. At the time of landing, a person puts his hands forward, as a result of which the main blow falls on them.
Active sports, such as skiing, ice skating, cycling, roller skating, etc., can provoke such a fracture.
Ambulance paramedics record a large number of radial fractures in car accidents: people try to find support when they strike, stretching their arms forward.
Bone tissue becomes thinner with age , as a result of this, elderly people belong to the “risk group” of fractures of this joint.
Types of bone changes after injury
Fractures can conditionally be divided into several main categories, which also have their own subgroups.
- Fractures of the radius of the arm without displacement.
- Radial fractures with displacement.
The second type is divided according to the direction of the fragment (broken piece of bone).
- Fracture of the Wheel (flexion type). In this case, the fragment moves closer to the back of the forearm. Such options are possible after stopping with an open palm in the ground during landing.
- Smith fracture (extensor type). In this case, the fragment moves closer to the side of the palm. Such options are possible after exposure to the back surface of the wrist.
The following fractures are distinguished depending on the site of the injury.
- In the area of the head or neck of the bone. This is a traditional type of injury when falling on arms extended in front of you.
- In the neck, central region of the radius or ulna. Such a diagnosis is made mainly after a direct hit or fall.
- In the area of the styloid process (located at the junction of the neck and radius). Such injuries occur when falling on an arm extended in front of you. In this situation, the wrist is pushed out first and then back. As a result, the bone is damaged and requires immobilization with a plaster cast for 5 weeks. When the styloid process is displaced, it is necessary to “reposition” the bone fragments. This procedure is called reposition. Its purpose 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 damage to the skin (in such cases, the damaged area is determined by x-ray and local symptoms: swelling and soreness when touched).
The second block includes:
- fractures without displacement of fragments (in such cases, fracture-like damage forms on the bone, and injuries of this kind are the most frequent and do not require additional interventions beyond fixation);
- fractures of the radial arm with displacement (this pathology is complicated damage and after reposition, the likelihood of repeated displacement is high).
The third block includes:
- intraarticular fractures (as a result of such damage, the area of the wrist and neck is covered);
- extraarticular fractures.
Signs of a pathological injury
Sometimes a fracture of the radius of the arm has to be diagnosed, based on indirect symptoms, since there are no clear signs.
Complaints may be observed:
- sharp pain in the wrist;
- general malaise, nausea, patient weakness, and even loss of consciousness;
- difficulty or complete loss of movement in the hand, fingers due to severe pain;
- the formation of a hematoma, edema on the bend of the arm and in the hand: such symptoms are the result of hemorrhage inside the muscles;
- the occurrence of a "crunch" during attempts to move the wrist.
In complex cases, the wrist joint injury can be determined by visual deformation of the bone. These signs are accompanied by a fracture of the distal metaepiphysis. The deformation may be bayonet or fork.
A fracture should be expected in the presence of several symptoms. The main ones are soreness 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 that must be performed after an injury is the creation of rest of the hand. This is done using a makeshift splint that is applied from the elbow to the forearm. To reduce pain, you can fix the brush. You can use any flat hard object as a tire: a piece of plywood, boards, cardboard, etc.
Before examining a doctor, the hand should be kept at the level of the belt or raised up - this will reduce swelling and pain. It is necessary to put cold on the injured place through the fabric: ice, a bottle of water and other similar things.
Diagnostics
An accurate diagnosis of a fracture of the radius of the arm occurs after an X-ray examination. From the picture, you can determine the presence of damage, its type and type. Also, after the examination, the doctor suggests the approximate time of wearing gypsum immobilization.
In difficult situations, an additional MRI or CT scan is required. Such studies are conducted to determine the nature and extent of the combined injury.
Damage treatment
The duration of treatment for a fracture of the radius of the arm completely depends on the method. Among them are:
- conservative;
- surgical intervention.
Conservative methods
This type of help consists in fixing a damaged arm with a plaster cast. The conservative method is used for joint fracture without displacement. Gypsum can be made of standard materials or polymer. The second type of dressing is expensive, but it can be exposed to water.
After applying a plaster cast, you need to visit the clinic several times a week for further examination. A traumatologist will monitor the condition of the bandage and arm. After the edema subsides (approximately 7-12 days after the injury), a repeated X-ray examination is performed. This diagnosis prevents accidental bone displacement and makes it possible to more accurately determine the wearing time of the fixation.
Surgical methods
Surgical treatment of a fracture of the radial arm bone with displacement is performed. Also, multi-fragmented and complex intraarticular injuries require such an intervention. Traumatologists under local or conduction anesthesia scrupulously repair the bone, and repair the fragments.
In medicine, reposition is divided into 2 groups.
- Closed. This method is more considered conservative, because the removal 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 accuracy. The return of the radius to the anatomical position is a very important process, the improper implementation of which threatens with serious complications.
- Open. Such manipulation is performed operatively 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 displacement and fix the fragments in the correct position using a specific design. This action is called osteosynthesis. After this procedure, edema and soreness of the damaged area are reduced, the rehabilitation process after a fracture of the radius of the arm is accelerated.
Methods of osteosynthesis
Depending on the place of damage that has passed since the time of the injury and the degree of displacement, doctors distinguish several methods of osteosynthesis.
- Using knitting needles.
- Using an overlay plate. This method is suitable for the area of the wrist joint.
- Using the Ilizarov apparatus (distraction apparatus). This method is used for multiple small fragments and serious fragmentation of bones.
After assisting and applying a cast of gypsum, some patients experience soreness at the site of 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 body. Often the first time the joint swells. Doctors recommend keeping your hand in an elevated position and taking painkillers.
Rehabilitation measures
Treatment of a fracture of the radius of the arm and the timing of fusion after removal of the gypsum depend on the correct implementation of rehabilitation measures. It consists in the development of the elbow and wrist joint. If the rehabilitation is carried out incorrectly, ignoring the advice of the attending physician, a complete loss of working capacity of the hand is possible.
Each specific damage requires a specific, individual series of exercises and exercises. In most cases, with a fracture of the radius of the arm, physiotherapy, medical exercises and massage on the damaged area are prescribed.
Complications and Possible Consequences
After falling with support on the hands, attention should be paid to the symptoms that have appeared. If there is pain, swelling of the site of the impact, crepitus of the bones and impaired movement - it is worth thinking about a fracture and consult a doctor to establish a diagnosis. In the absence of a timely reaction, complications can be achieved. Moreover, some of them lead to disability.
The 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 damage. They carry out flexion and extensor movements, grasping reflex.
- Muscle rupture. After such damage, contractures and shortening of the limb length can form.
- With open fractures, infection of the wound is possible, which subsequently leads to osteomyelitis.
- Changing the appearance of the brush (with improper bone fusion).
In order to prevent any of these situations, you should consult a doctor in a timely manner to diagnose damage.