The elbow joint has a rather complex structure. The presented part of the upper extremities is formed by the radius and ulna bones that connect to the brachial tissue. Inside the main elbow joint there are several small ones. Large nerves and blood vessels passing through the presented region are responsible for the mobility of the entire limb. Therefore, fractures of the bones of the elbow joint, in addition to obstructing motor functions and developing serious pain, are fraught with a whole host of complications.
What therapy is used for damage to this plan? How to treat fractures of the elbow joint? What is required for rehabilitation? We will try to answer the questions presented.
Causes of Injury
The elbow joint is extremely vulnerable to damage, since there is no dense muscle frame that can provide reliable support and protection of the presented part of the upper limb. This area is especially often subjected to stress in babies who are overly active and often end up in situations fraught with the occurrence of trauma.
An elbow fracture can be obtained both as a result of a fall, and as a result of a significant shock load on this area. Most often, bone damage here has an internal character.
Types of Fractures
The following types of injuries of the bone tissue of the elbow joint are distinguished:
- A closed fracture of the elbow joint is characterized by damage to the radius, its neck and head. Most often occurs as a result of excessive load with emphasis on the direct limb.
- Open fractures of the elbow joint - in addition to the occurrence of cracks in the bone structure, soft tissues are damaged by fragments. In severe cases, rupture of the skin occurs, a gaping wound forms, which is accompanied by profuse loss of blood.
- Fracture of the coronoid process occurs due to significant shock loads on the bone tissue. Such injuries are rare. Damage to this plan is characterized by consequences in the form of displacement and dislocation of the forearm.
A fracture of the elbow joint with and without displacement is also distinguished. Often with such injuries, one bone suffers.
Symptoms
The following signs can indicate a fracture of the elbow:
- The presence of sharp, persistent pain that radiates to the hand and wrist.
- Limited limb mobility or its complete paralysis.
- Unhealthy, unusual for a person mobility of the arm in the area of the elbow joint, for example in the lateral direction.
- The occurrence of edema, the formation of cyanotic hematoma, subcutaneous bruising.
- Neurological symptoms - numbness of fingers and hands, tingling of the forearm.
- Damage to blood vessels, muscle tissue, skin (open fractures of the elbow joint).
A clear sign of serious damage to the elbow joint is severe pain in the back of it. Gradually, swelling and hematoma form on the front surface of the injured area. Subsequently, the ability to bend the arm is lost. A damaged limb hangs limply. When performing a forearm movement, muscle stiffness is felt.
After a fracture with bone displacement, the ability to extend the arm remains. However, raising the limb and turning it to the sides cause significant discomfort.
First aid
First aid tactics for fractures of the elbow joint are selected based on the specifics of the damage and its severity. Be that as it may, the primary task here is the complete immobilization of the limb. To do this, it is recommended to resort to tire overlay. In this case, the arm is bent at a right angle, after which it is securely fixed. If it is necessary to eliminate an intolerable pain syndrome, analgesics are used.
Conservative treatment
In the absence of injury in an open form, resort to conservative therapy. During the first 6-7 days after the fracture, volumetric edema usually occurs. Until the pathological manifestation disappears, a cast gypsum dressing is applied to the arm. Avoid loading on a damaged limb for up to 3 weeks.
As the bone tissue joins, the arm is periodically released from the cast to develop the joint. Over time, such a bandage is replaced by a rigid retainer, which has a system for adjusting the amplitude of movements.
Operative therapy
Open fractures of the elbow joint, which are characterized by displacement of fragments, require surgery. Otherwise, the flexion ability of the forearm may not be restored.
The success of surgical therapy directly depends on the accuracy of the actions of the trauma surgeon, in particular, the comparison of bone fragments, their accurate fixation in an anatomically correct position. The center of traumatology and orthopedics is capable of providing such an operation.
With normal damage to the structure of the end of the ulna, therapy is aimed at contracting tissues with a medical wire loop. Sometimes additional fixation of bones in a static position with needles is required.
If you have to treat internal fractures of the elbow joint with the formation of fragments, therapy is based on bone grafting. In such situations, it is difficult to tighten the tissues with a loop, as this can lead to a shortening of the articular surfaces. Instead, resort to the use of compression dynamic plates.
In cases where there are signs of bone fragmentation, the center of traumatology and orthopedics can offer the patient replacement of body tissue with a special prosthesis. Implants are made of plastic and metal. Their installation occurs using bone cement.
Possible complications
The disappointing consequence of a fracture of the elbow joint may be a complete or partial loss of limb mobility. A prerequisite for this is the preservation of discomfort or impressive pain at the end of the course of therapy. Such manifestations can be avoided by following the recommendations of the attending physician exactly.
In order to prevent complications in children, in particular loss of limb functionality, treatment should be carried out under the supervision of adults. First of all, the injured arm should be completely at rest throughout the course of therapy. The child should not load the limb, perform sudden movements. The assumption of such negligence can lead to a second fracture.
Rehabilitation
Actions aimed at restoring the healthy functionality of a limb suggest:
- massage;
- medical gymnastics;
- physiotherapeutic procedures.
Joint development with physiotherapy exercises is possible on the first day after the limb is fixed with a plaster cast. Naturally, in this case, bending the arm at the elbow is avoided. The main emphasis is on the movement of the fingers and wrist. The victim is recommended to lay the injured limb behind the head while lying down, tensing the muscles of the forearm and shoulders. Such decisions contribute to the removal of puffiness as a result of increased outflow of lymph from the tissues.
When restoring the ability of the joint to bend, they proceed to its gradual development. To do this, the main part of the plaster cast is removed, after which measured, unsharp movements of the limb are performed. During rehabilitation with medical gymnastics, it is forbidden to bend and unbend the arm completely, as this can cause a second fracture.
They resort to massage only after the plaster cast is completely removed. Moreover, they exert influence on the muscles of the shoulder girdle and back in a sparing mode. The regular implementation of such procedures allows you to eliminate pain, strengthen atrophied muscles, stretch the ligaments and ultimately completely restore the mobility of the arm.
As for physiotherapeutic procedures, it is recommended to alternate them with therapeutic exercises. Here they resort to methods of UHF, magnetic therapy, electrophoresis, treatment with healing mud.
Finally
As a result, it is worth noting that a victim needs to clarify several issues for himself after discharge from the hospital. It should be clarified with the attending physician how it is better to make movements in the elbow joint, when the limb can be weighed, how to avoid relapses and complications, which can be expected in the near future.