Dislocation of the wrist significantly limits the person's ability to work. It is impossible to perform even simple actions with a damaged hand. Such an injury is quite common in both adults and children. The wrist consists of many bones, this part of the arm is very vulnerable. Often, damage occurs not only with a bruise or shock, but also with awkward movement. Only a specialist can diagnose and treat an injury. However, each person needs to know about the symptoms and treatment of wrist dislocation in order to provide first aid to the victim in time.
What is a dislocation
Dislocation is the displacement of the articular bones relative to each other. In this case, damage to other tissues is often noted. Human joints provide movement. This is their function. But if the movements are too sharp and go beyond the capabilities of the joints, then a dislocation occurs. For example, a person can dislocate his jaw, opening his mouth excessively wide.
The wrist bone apparatus consists of the upper and lower row:
- The lunate, trihedral, pea-shaped and scaphoid bones belong to the upper.
- The lower row includes the capitate, trapezius and hook-shaped bone.
The top row of bones is located closer to the forearm, and the bottom is adjacent to the fingers.
In the vast majority of cases, the following types of dislocations are noted:
- Lunar With this injury, the lunar bone rotates towards the palm of the hand and the capitate is displaced upward.
- Perilunar. The capitate is separated, and all other bones are displaced.
The capitate and lunate bones are the most vulnerable and are most likely to be injured upon impact or awkward movement. Dislocation of the wrist is always accompanied by severe damage to the ligaments and rupture of the joint capsule.
Causes of injury
What could trigger such an injury? The immediate cause of damage is a sharp bending or extension of the joint, beyond its natural mobility. Most often, the following situations lead to a dislocation of the wrist:
- The most common cause of injury is a fall in the palm of your hand. Often a person puts his hands forward. However, in this case, the main blow falls on the palm of your hand. There is a sharp bending of the wrist joint and bone displacement.
- Dislocations are often observed in children. There are times when, while walking or learning to walk, adults hold the baby too tightly by the wrist. If the child falls, and they try to hold him, then a dislocation can occur.
- The cause of the dislocation may be a direct hit in the wrist during a fight or martial arts.
- Such injury is possible when playing volleyball or basketball, as well as during weightlifting. Too much impact on the ball or a sharp lowering of the bar can provoke a dislocation.
It is important to remember that only a doctor can correct displaced bones. With self-medication, a secondary dislocation of the wrist may occur. This is not uncommon. When a person ineptly tries to correct a dislocation, the remaining bones of the wrist are displaced. As a result, the situation is getting worse.
Varieties of dislocations
Dislocations of the wrist bones can be accompanied by a complete displacement of the bone tissue. However, such an injury is rare, in about 10% of cases. In this case, the surfaces of the joints of the wrists are completely displaced relative to the radius. This type of damage is often complicated by fractures. In this case, doctors talk about a true dislocation.
Injuries are much more common when the articulation of the lunar and radial bones remains, but all other parts of the wrist are displaced. Such damage is observed with perilunar dislocation.
Symptoms
Symptoms of a wrist dislocation may resemble a fracture or a bruise. Only a traumatologist can determine the type of damage. The following signs of dislocation can be distinguished:
- A person at the moment of injury immediately feels a sharp pain. This is the difference between signs of dislocation and fracture symptoms. When bone integrity is impaired, a person may initially not feel pain due to shock. Unpleasant sensations increase with time. With a dislocation, pain is always instantaneous.
- The damaged area is swollen. Tissue swelling is more pronounced than with ordinary bruising.
- A hematoma appears on the affected area.
- The joint looks deformed. This is also a characteristic symptom of a dislocated wrist. With a fracture, such a symptom is rarely observed. However, if the integrity of the articular bones is violated, then deformation is possible.
- Movement in a dislocated joint is sharply limited. A person cannot bend a brush in his wrist and take objects with a sick hand.
- With some types of dislocations, the patient cannot move his fingers.
- If nerve damage occurs, the entire hand or individual fingers may become numb.
Sometimes it is very difficult to distinguish the dislocation from the strain by external signs. Moreover, these two types of injury are often found together. Therefore, a final diagnosis can only be made after an x-ray.
First aid
What to do with a dislocation of the wrist? As already mentioned, in no case should you try to independently adjust the displaced bones. This will only lead to additional injury. It is necessary to deliver the patient to the emergency room as soon as possible. At the pre-medical stage, the patient should be given the following help:
- Cold should be applied to the sore spot. It is advisable to use an ice pack. This will help reduce swelling and pain.
- It is necessary to provide complete rest to the injured place. To do this, put a tire. It can be made from a wooden ruler or stick. The damaged hand is bandaged to the tire and tied with a scarf to the chest. This position helps to reduce swelling.
- With severe pain, you need to give the patient a tablet of Nurofen or Paracetamol.
Before visiting a doctor, movements with a damaged hand should be avoided.
Diagnostics
The main method for diagnosing dislocation is radiography. The examination is carried out in several projections. In the image, the displacement of the bones relative to each other will be noticeable.
In some cases, CT or MRI are additionally prescribed. Such examinations are carried out if there is a suspicion of damage to the nerves or ligamentous apparatus.
Conservative treatment
Wrist dislocation treatment begins with the reposition of displaced bones. This procedure is performed under local anesthesia. A traumatologist and an assistant eliminate bone displacement.
Then, a plaster cast is applied to the injured limb. It must be worn for 2 weeks. After this period, a repeated x-ray examination is carried out.
Instead of gypsum, you can use an orthosis. This is a more convenient device for fixing a damaged limb. The orthosis does not rub or irritate the skin and is resistant to water.
To stop the pain, the following drugs are prescribed:
- Ketanov
- Nise
- Ibuprofen
- Celebrex
With severe pain, the appointment of analgesics with codeine is indicated: "Sedalgin", "Pentalgin", "Nurofen plus". However, such drugs are strictly prescription. Only a doctor can decide the need for their use and determine the dosage.
In severe cases, injections of corticosteroid hormones and local anesthetics directly into the joint cavity. Treatment is continued until the pain subsides.
Surgical intervention
Surgical treatment of wrist dislocation has to be resorted to in advanced cases. If a person seeks help only 2-3 weeks after the injury, then usually conservative therapy is ineffective. In this case, an open joint operation is performed. It is done under general anesthesia.
The surgeon brings the displaced bones to the correct position. Then their ends are fixed with a metal rod. This device is passed through the skin and after some time removed.
The recovery period after surgery can take quite a long time - from 6 to 12 months. Therefore, with a dislocation, one should not delay the visit to the traumatologist. This will help to recover and recover faster.
Rehabilitation period
The main task of rehabilitation after an injury is the restoration of movements in the wrist. To this end, the following activities are carried out:
- Massage. This procedure is performed to prevent muscle atrophy. Massage the hand, starting with the shoulder and forearm. The wrist area can only be exposed to very mild effects.
- Physiotherapeutic procedures. Prescribe treatment with a laser, magnet, ultrasound, as well as UHF therapy. This helps to improve blood circulation in the tissues and rapid regeneration.
- Physiotherapy. Carry out exercises for flexion and extension of the hand and fingers, circular movements, holding various objects, squeezing the ball. This helps restore joint function.
The duration of the rehabilitation period may be different. It depends on the type of dislocation, the presence of damage to nerves and ligaments, as well as possible complications. If the call to the doctor was timely, then in most cases the movements in the hand are restored quickly. If the patient underwent open surgery on the joint, then the rehabilitation process can drag on for many months.
Consequences of injury
Even after a complete cure for the dislocation of the wrist, a person can still feel the effects of trauma for a long time. The patient may be disturbed by recurrent pains in the healing joint, which sometimes become chronic. Here a lot depends on how timely the patient sought medical help. The earlier the dislocation was corrected, the more likely it was that the damage would pass without complications.
Dislocations, accompanied by nerve damage or complicated by osteoarthritis, are especially difficult to heal. If a person had inflammation in the wrist joint before the injury, the rehabilitation process will be long.
The dislocation passes without consequences if the damage was small, and help was provided in a timely manner. If the visit to the doctor was belated, then even after treating the injury, not only pain, but also impaired mobility of the hand or fingers, are often noted. In this case, a long rehabilitation may be required.
Prevention
How to prevent wrist dislocation? To avoid injury, you must adhere to the following recommendations:
- To avoid falling, care must be taken when walking on slippery surfaces. In winter, you should wear shoes that provide a tight grip on the sole with ice.
- During falling, straightened arms cannot be advanced.
- You should regularly eat foods rich in calcium. This will help strengthen bones and joints.
- It is useful to perform exercises to strengthen the muscles of the lower extremities. like walking fast. This will help to stay on your feet and avoid falling.
- During sports, you need to protect your wrists with special equipment.
These simple measures will help minimize the risk of dislocation.