Dislocation of the hand is an injury associated with a displacement of the articular part of one or more bones of the wrist joint. This condition is a serious injury, since the hand consists of many small bones. With the displacement of even one of them, a person loses his motor ability while experiencing a severe pain syndrome.
Type of dislocation
Due to the large number of bones in the hands of a person, this part of the human body is the most mobile and, as a result, is most susceptible to damage. For the correct treatment of dislocation of the wrist joint, it is necessary to understand what type of injury the victim received:
- Perilunar dislocation - ulnar, capitate, scaphoid, radius, and styloid process are displaced. In this case, the lunar and radius bones remain in place.
- Amyloid-perilunar dislocation - the reverse side of the scaphoid is displaced. Such an injury usually results from a bone fracture.
- The true type of dislocation - all the superior row bones are displaced relative to the radius bones. Often with this type of injury, a fracture occurs with the opening of the styloid processes. In this case, a severe pain syndrome accompanies the injury. This type of damage is treated longer than all others.
- Trans-crescent-transresolunar displacement - scaphoid and lunate bones change their position with respect to the distal bones.
- Dislocation of a finger - refers to a brush injury and can occur with each of the five fingers on any hand.
- Peritrihedral-lunar type of dislocation - the lunate bone is displaced in relation to the capitate bones.
There are a number of dislocations of the hand, but they are mostly of a mixed type, combining several types of injuries.
Given the complexity of the structure of the wrist joint, one must understand that only an experienced surgeon-traumatologist can help the injured person, and, as a rule, only in a hospital, where there are appropriate diagnostic tools, tools for stretching and repositioning joints. Attempts to independently correct the dislocation usually end in a rupture of ligaments and fractures.
What causes a brush injury
Dislocation of the hand is the most common injury, since a person uses his hands in any life situation, for example, to protect his face in the fall. Stretching hands in front of you in this case occurs reflexively, a person with all its mass falls on them. Also, the joint can be dislocated when stretched when lifting weights or hanging on the hands.
Often, a dislocation of the hand occurs in children, when an adult strongly pulls the child by the hand or lifts him by her. You need to understand that the bones and ligaments in children are much weaker than in adults and, in order to injure the baby’s handle, a little effort is enough.
Sports injuries are singled out in a separate category. When performing exercises, athletes subject their bones to overloads, so their injuries are the most complex (they include several types at once). Also, in athletes, dislocations are usually combined with fractures.
Dislocation of the wrist joint can occur for a pathological reason. This is caused by the destruction of the joint due to any systemic disease, for example, gout, polio, osteomyelitis, tuberculosis or arthritis.
Symptoms of Injury
Symptoms of a dislocation of the hand usually appear immediately after the incident, that is, a fall or a heavy lifting. They can be like this:
- Battle syndrome. It occurs immediately after an injury or when trying to move a hand.
- Soft tissue swelling around the damaged joint.
- Visual change in the joint. The arm may be bent at an unnatural angle, or an unusual protrusion, a cavity, appears on the joint site.
- The injured person cannot move the injured limb not only in the area of damage, but also along its entire length - from the shoulder to the hand.
- The skin in the area of the damaged joint changes its temperature - it becomes several degrees higher than the rest of the body.
- The sensitivity of the fingers is lost. This indicates damage to nerve fibers in the joint area.
Diagnosis of dislocations
Dislocation of the brush according to ICD 10 (international classifier of diseases) has the code S63, is a separate disease and, accordingly, is diagnosed with a complex set of measures.
First of all, an external examination of the affected limb is carried out. Attention is drawn to the presence of edema, fever, anatomical location of the bones. During the examination, the doctor tries to find out from the victim exactly how he was injured, in what situation, whether it was a compression stroke or a sprain. This gives an additional idea of the type of damage.
To clarify the diagnosis, an x-ray of the affected joint is performed. In addition to dislocation, cracks and fractures in the bones are found in the images.
First aid
Not always immediately after an injury a person has the opportunity to consult a doctor. In order to reduce pain and not even damage the arm, the victim must be given first aid.
Bandaging the wrist joint is a mistake. It is necessary to fix the whole arm. To do this, it bends at the elbow and is fixed to the torso using a wide piece of matter, for example, a scarf. Then you need to apply ice to the affected joint to remove edema from the soft tissues and restore blood circulation. In addition, this measure reduces pain.
You can give the patient any pain medication in the dosage prescribed in the instructions for him. It can be Nurofen, Ketorol, Nise, or Nimesil.
After completing all the first aid procedures, you should call a doctor or deliver the victim to an injury point.
You can not adjust the joint yourself. Treatment of dislocation of the hand is a very delicate process. You can easily damage your hand more if you act improperly.
Joint reduction
Reduction of the joint is carried out only by professionals. There are several procedures for this procedure. Which one is suitable in each individual case, the doctor decides based on the type and severity of the injury.
For example, only the shoulder joint is adjusted according to the methods of Janelidze, Kocher, Mukhin-Motu, Hippocrates. And this despite the fact that in the shoulder there is only one joint and two bones, while in the radial joint of the hand there are 8 bones.
Before the reduction, the patient takes an anesthetic to relax the muscles around the affected area. Sometimes it takes from 10 to 30 minutes. If you adjust the joint with tense muscles, you can damage the ligaments and break the bone.
Dislocation treatment
Conservative treatment of dislocation involves the use of various medications, used after the reduction of the joint. They are aimed at relieving pain, swelling and restoration of muscles and ligaments stretched during trauma. They are prescribed by the doctor, indicating the dosage and regimen.
From pain it is proposed to take "Ketorolac", "Ibuprofen" or "Diclofenac", since these drugs also relieve inflammation.
Widely used therapeutic ointments of local action - "Hydrocortisone", "Prednisolone", "Diclofenac", "Indomethacin", "Ketonal", "Ketoprofen". There are also products containing natural ingredients such as bee or snake venom. This is Viprosal, Capsicam or Capsitrin.
Ointments should be applied by gently rubbing them into the skin. This speeds up their absorption and has a therapeutic effect on soft tissues, as it is a soft massage.
Surgery
If dislocation was accompanied by ruptures of ligaments, blood vessels or nerve fibers, surgical treatment is performed. During the operation, all damaged soft tissues are sutured, but it is especially important to restore blood circulation and the ability to move the hand.
The technique of the operation is selected depending on the type of dislocation and its associated damage. The operation is performed under general anesthesia.
Postoperative joint repair
Usually after surgery or (if it was not performed) after the joint has been repaired, the arm is fixed at the site of damage for a long period (from 1 week to 4). During this time, the arm muscles lose their tone, and the nerve fibers conductivity. To restore the functions of the wrist, restorative therapy is used. It includes a number of physiotherapeutic techniques, for example, shock wave therapy, magnetotherapy, paraffin baths and so on.
Medical massage is widely used, during which blood circulation in the soft tissues and joint mobility are restored.
An important aspect of joint therapy is therapeutic gymnastics. You can start doing it while still in a cast or tight bandage. For this, manual expanders are used, which are a rubber ring, ball or spring with finger rests.
The sooner you manage to start gymnastics, the faster your wrist function will recover.
Gymnastics can be carried out independently in any free time. To do this, put your hand on any emphasis palm up, take a dumbbell or steel ball in your hand and slowly bend and unbend the joint.
You can gradually accustom the joints of the hand to the load, leaning your hands on the table and transferring body weight to the hands, each time increasing the load.
Joint treatment with folk remedies
There is a technique for treating a dislocated joint with compresses made from herbs and roots. Such therapy is effective only in combination with drug treatment and only after the dislocation is corrected. Not a single compress will set the bones in the joints. This must be understood.
In general, such therapy relieves swelling and inflammation, but before using this method of treatment it is necessary to consult a doctor.
The most commonly used root is bryonia or elecampane root. The plant must be ground into a fine powder, pour boiling water in a ratio of 1 tbsp. l funds per 500 g of water and boil for about 15-20 minutes. After cooling the broth, you need to strain it, soak a bandage in it and bandage the joint.
An ointment is made on the basis of the rubbed roots of the plants. To do this, you need to mix the resulting powder with vegetable oil until a state of homogeneous gruel and apply the resulting product to the damaged joint.
Conclusion
A very unpleasant and dangerous injury is a dislocation of the hand. What to do in such a situation should everyone know. The main thing to remember, without timely medical attention, an injury can develop into a serious pathology. Independent actions are not welcome. It is only necessary to provide first aid. All further manipulations should be carried out by an experienced specialist. Depending on the type of injury, appropriate treatment is selected.