No matter how colorful our life is, sometimes there are situations that unsettle us. These are some psychological problems, lack of money, just a bad mood or something else. But, of course, the most unpleasant of this long list can rightly be considered health problems, regardless of whether this happened to us or to our loved ones. One of such unpleasant situations is a dislocation of the arm at the elbow.
Joints
There are three types of bone connection:
- motionless suture (for example, in the skull),
- semi-mobile cartilage (thus connecting the vertebrae,
- movable joint, allowing a person to make the whole range of various movements.
Joints connect the humerus and collarbone, which makes it possible to raise and lower the arm; the femur and pelvis (the so-called hip joint), thanks to this we walk and raise our legs. And this is only part of the huge number of important joints that allow a person to do those things that he likes, whether it's dancing or sports, sewing or another hobby.
But one of the most important joints, thanks to which we make movements with the hand, is, of course, the elbow. With it, a person is able to perform flexion or extension of the arm at the elbow one hundred and forty degrees! Therefore, with injuries of this joint, a person’s life ceases to be full until it is fully restored. Dislocation is a very unpleasant problem that constantly threatens him.
The structure and function of the elbow joint
In order to figure out what to do when the elbow is dislocated, you need to understand its structure. The joint connects three bones at once. Two of them are located in the forearm zone: the radius (its narrow end fits the elbow, and the wide to the wrist) and the ulna (on the contrary, the narrow to the wrist and the wide to the elbow, hence the name). And one in the shoulder area is the humerus.
Since the elbow joint is complex, it consists of three simpler capsule tops. Each of them has its own function, and their combined work gives the elbow the opportunity to make all the movements that it is capable of. The first joint is the one that connects the humerus and ulna and, accordingly, is called the brachioradialis. The second is the ray-elbow, and the third is the shoulder-elbow. Soft cartilage is located between the bones, and the joint capsule is filled with fluid that prevents friction from destroying the tissue.
The elbow joint allows four types of movement. The first two are committed in the frontal plane - this is flexion and extension. The first is the direction of the hand to the shoulder, and the second is the abduction, straightening the arm. And the other two are in the vertical plane of the radius. Extend your hand in front of you, with your back side down, and remember the phrase "Soup carry." The movement in which the palm goes into this position is called supination. And if you turn your hand so that the back of your hand is pointing up, pronation will occur. Here you can use the phrase "Soup Spilled" to remember. All these movements are carried out not only thanks to the joint, but also thanks to the muscles. For example, triceps (triceps extensor) and biceps (biceps extensor).
How does a dislocation occur?
This type of injury can be divided into directly dislocation and subluxation. In both cases, there is a displacement of the articular surfaces in different directions, and as a result of this a further inability to function. Dislocation occurs with complete displacement, that is, when no contact occurs between the articular surfaces of various bones. In the second case, on the contrary, their partial contact remains.
The dislocation of the arm at the elbow (or subluxation) and in the direction of the displacement of the bones are also classified. In addition, the displacement itself can occur both with the entire forearm as a whole, and with a single bone.
Rarely does a person receive only a dislocation. More often this injury is accompanied by a fracture, rupture of the tendons and joint bag, hematoma, muscle damage .
Causes
The cause of dislocation of the joint of the elbow is the incorrect effect of force. The effect can be direct, that is, directly on the elbow joint (direct injury), and indirect (indirect injury). For example, the first impact can be attributed to a random blow with a hammer to the elbow, and the second - a fall on the palm with the transfer of force through the forearm. Sometimes dislocation occurs with a sharp movement of the arm.
But the latter case is very rare and most likely to occur in people with a predisposition to such an injury. For example, such prerequisites include the weakness of the ligamentous apparatus of the elbow joint, flattening of the lunar notch of the ulna. In addition, people rarely involved in sports have a much greater chance of getting a dislocation than trained people.
Dislocation in children
Dislocation of the elbow in a child is accompanied by the same symptoms as in an adult. Only children have another circumstance in which he can get injured. This situation, familiar to many by hearsay, is commonly called the "nanny's elbow." When a child walking with an adult in the street stumbles and begins to fall, the parent or other person accompanying him is likely to grab him by the elbow. Agree, in adults this happens ... less often. But this is fraught with unpleasant consequences, so you can’t do this!
Symptoms
In general, it is unlikely that a person with a dislocation will stand up (if he fell), waving his hand and, as an example, will go catch butterflies. Distinguishing an injury is simple enough. But even if you make a mistake and the symptoms of elbow dislocation will be accompanied by another injury, you will not be redundant to see a doctor. Because all these signs will not speak of a completely healthy limb. Now to the very symptoms of a dislocation of the elbow.
- Unnatural angle of bend of the hand. For example, the palm is very twisted, but there is clearly no damage to the wrist. However, here long explanations will be redundant, it is noticeable. The shape of the elbow itself may also be unnatural. For example, the head of the joint protrudes or the upper end of the forearm has gone above where it should be.
- Swelling of the elbow and / or entire arm. Loss of motor ability of the hand (or several times intensifying pain during flexion, extension at the elbow, movement of the fingers, raising the arm, supination and pronation). In the elbow joint (as in any other) there is a huge number of nerve endings, so it is unlikely that the injury will not be noticed by the nervous system. She, noticing something was wrong, will quickly try to transmit the signal of the violation to the brain, and the person who is “lucky to earn” a dislocation of the elbow will find out about this in the form of pain, most likely severe.
- In addition to pain, loss of sensitivity and numbness in the area of ​​injury are also possible.
- At the same time, fever and chills will not be unusual.
First aid
Imagine a situation in front of us is a person who, by all indications, is elbow dislocation. What to do? First of all, you should calm down, put aside emotions and act according to the following rules (attention, the rules are recommendations, not a complete instruction).
- First of all, you need to immobilize (immobilize) a limb. This can be done with the help of a tire, a stick, tying to the body. It is necessary to fix so that the shoulder joint, the ulnar and the carpal, does not move; the arm should be bent ninety degrees. But if you are in a village, it is better to leave the limb bent (also 90 degrees) and ask the patient not to move it (it is unlikely that he will want to swing it in all directions). A specialist who came to the ambulance himself immobilizes it in accordance with all the rules.
- Apply cold. Wet cloth will do.
- Call an ambulance immediately. If there are other people besides you, ask them to call her at the time you provide first aid. You can also take it yourself to the emergency room, but in this case it is better to immobilize the limb.
It is impossible! In no case should you straighten your hand yourself! This should be done only by a specialist and after a thorough study.
In addition, if the dislocation is accompanied by bleeding (for example, caused by an open fracture that accompanies the dislocation), measures should also be taken to stop the bleeding. In arterial (scarlet blood, pulsating stream) - a tourniquet above the site of blood flow and a bandage on the wound. With venous (dark blood, weakly poured out) - a tourniquet below the bleeding, also a bandage. Be sure to sign the time and date of application of the tourniquet in both cases and put under the tourniquet itself! If bleeding, be sure to contact an ambulance.
In trauma
Here is the person who received the injury, taken to the hospital and enters the office of the traumatologist. First of all, the doctor does an external examination, if necessary, checks the sensitivity of the hand. After this, the sufferer must be sent for x-ray (two pictures are taken - side and front) so that the doctor can determine the type of dislocation, whether it is accompanied by any other injuries and other information important for the treatment. Sometimes during radiography, a contrast agent is injected into the joint capsule, which allows you to draw more accurate conclusions about the condition of the elbow and the arm as a whole.
Below in the photo, elbow dislocation (x-ray, side view) can be studied.
After an x-ray, the traumatologist decides what to do next. In the event that only a dislocation is observed, it is most likely that the joint will be repaired under local or general anesthesia (local - the introduction of an anesthetic, such as novocaine, to eliminate pain in a certain area; general - lulling a person for a certain time). After that, they are sent for a control x-ray, the limb (in case of a successful reduction) is fixed with gypsum at an angle of 90 degrees and fixed with a bandage through the neck.
They also take an x-ray from a different angle. Front view can be seen in the photo below.
But in some cases, surgery is required. Most often this happens if the dislocation is accompanied, for example, by an open fracture. For some operations, fixing elements are also used - titanium spokes, plates. After surgery, the arm is also immobilized. Further, wearing gypsum on the arm is required for some time (regardless of whether there was surgery or not). Usually this time is 2-4 weeks. During this period, the joint should overgrow with new tissue in those places in which the past was broken.
Recovery
Already behind all the torment - they removed the plaster. But no matter how ... After a dislocation of the elbow, recovery is necessary. The fact is that even after successful overgrowing of an injury, a limb cannot instantly regain all motor functions. Therefore, it is required to help her with this. First of all, this, of course, exercise therapy - physiotherapy exercises. In this case, the person performs all the necessary exercises for the elbow joint, gradually increasing the load. Naturally, all this is carried out under the supervision of a doctor.
Supporting procedures are massage and other physiotherapy (magneto, laser therapy, ultrasound). The entire recovery period can be carried out while being on an outpatient or inpatient basis. During inpatient treatment, the patient lies in the hospital, where the recovery period passes. And on an outpatient basis, she regularly visits her.
The consequences of a dislocation of the elbow
Other injuries may develop after injury. For example, osteoma is a benign tumor of bone tissue, inflammation of the ulnar nerve. In addition, it is not always possible to restore the former mobility to the joints that suffered such an injury, especially if it happened in combination with others. It is also possible for the joint to react to a sharp change in atmospheric pressure - aching pain, weakness.
Conclusion
Dislocation - a dangerous injury. It’s better, of course, not to receive it at all, but you won’t be safe from everything. Therefore, it is always better to know how this happens and what to do in order not to harm, and even better to help the person who received this injury.