Fracture of elbow joint( elbow) - Causes, symptoms and treatment. MF.

The elbow joint is formed by connecting the forearm bones and the proximal( lower) arm section. To fractures in the area of ​​the elbow joint are: a fracture of the ulnar process, fracture of the head and neck of the radius, and fracture of the coronoid process of the ulna.

Symptoms of fractures of the elbow joint

Fracture of the elbow process is a common hand injury. With a fracture of the ulnar process, pain is seen on the back of the elbow joint, pain can be given to the shoulder and forearm. Tumescence and bruising extend to the anterior surface of the elbow joint, which is associated with the outflow of blood to the elbow joint area. Also, with the fracture of the elbow process, active extension in the elbow joint was violated, tk. The three-headed muscle of the shoulder is attached to the elbow process, which is responsible for the extension of the forearm. Rotational movements of the forearm( supination and pronation) suffer to a lesser extent. A crunch of fragments and visible deformation are felt when there is a displacement of the fragments.

Fracture of the ulnar process: a) without bias, b) with an

offset. If the head and neck of the fracture, the pain is felt on the front surface of the elbow joint, it can be deposited in the forearm. Bruising and swelling are not very pronounced. Rarely a crunch of fragments is heard, and visible deformations are not observed, even with the displacement of fragments. A distinctive feature of this fracture is a sharp limitation of the rotational movements of the forearm.

The fracture of the coronoid process of the ulnar bone is accompanied by pain on the anterior surface of the elbow joint, the pain is amplified by palpation. Limited flexion and extension in the elbow joint. There is a slight swelling above the elbow joint, no deformations are observed.

First aid for fracture of elbow

For fractures in the elbow joint area, the first help is to immobilize the elbow joint with a tire from improvised means, but remember that if you can not get a tire yourself, it's better not to experiment, but tie your arm around the kerchief. The pain syndrome is eliminated by any improvised analgesics: ketorol, nimesulide, analgin. Do not move the damaged joint and try to fix the fracture independently.

Diagnosis for fracture of the elbow joint

For diagnosis, an X-ray examination is performed. In some cases, a CT scan is done to confirm the diagnosis.

Treatment of fracture of the elbow joint

Fracture of the ulnar process without bias is treated by applying a cast band from the upper third of the shoulder, with the seizure of the ulnar and wrist joints. Gypsum must be worn for 6 weeks.

If the fracture is offset , then the operation is performed and the fragment is fixed with the help of metal wire and spokes. The direction of the displaced fracture rarely brings a positive result, which is due to the tension of the fragments with the triceps brachium muscle. Next, a gypsum langeta is applied for 4-6 weeks. After removal of gypsum, they start rehabilitation, the general term of treatment is 2-3 months. Spokes are removed a few months after the injury.

In case of fracture of the cervix and the head of the radius without displacement of the , gypsum immobilization lasts 2-3 weeks. If there is a bias, then they try to correct it, in case of failure, an operation is performed to remove the broken fragment of the bone. The general term of treatment is 1-2 months.

A fracture of the coronary process of requires a gypsum immobilization for a period of 3 to 4 weeks. The general term of treatment with rehabilitation is 1-2 months.

Rehabilitation for fracture of the elbow joint

From the first days after the injury, we actively move the fingers of the injured arm and the shoulder joint.
After 7-10 days we proceed to isotonic contractions of muscles( muscle tension without making movements) under the gypsum.

Two weeks after the injury, physiotherapy is prescribed - magnetotherapy. After removal of gypsum, the range of procedures is expanded, ozokerite, UHF, electrophoresis, baths with sea salt and mud therapy can be used.

After removal of the plaster bandage, we proceed to develop the movements in the elbow joint of the damaged arm. All exercises are done together with the elbow joint of the healthy side for 10-15 repetitions, with gradually increasing load, 3-4 times a day. Part of the exercises are performed in the bath with sea salt, which improves recovery of the function and relieves pain syndrome.

Exemplary set of exercises for developing the elbow joint:

• Brushes are closed with a lock, we do exercises like throwing a fishing rod, alternately setting the lock for the left and right ear;
• Same, but throwing the brush over the head;
• Try to close hands on the back;
• We put our hands behind the head, the brushes are closed in the lock and stretch, spreading the lock with the palms upward;
• We take a child's typewriter in a brush and roll on the table, making movements in the elbow joint;
• We play with the ball;
• We perform various exercises with a gymnastic stick, the main emphasis is on flexion and extension at the elbow joint;
• After sufficient reduction of the pain syndrome, we proceed to exercises with dumbbells( weighing not more than 2kg);
• Development of rotational movements in the forearm( supination and pronation) - bend the elbow joint to a 90 degree angle, then do the forearm movements around its axis, it is important to do rotational movements with the forearm, not with the shoulder.

It is worth remembering that the elbow joint is the most "whimsical" for the development of movements. In some cases, the use of special apparatus for the development of persistent disruption of movements in the elbow joint is required.

From the massage in the elbow area in the first time should refrain, and you need to massage the muscles of the forearm and shoulder. Only after the removal of the inflammation and pain syndrome can you proceed to a gentle massage of the elbow joint.

Forecast for an elbow fracture

Fractures of the elbow joint can result in both a rapid recovery and restoration of the function, and a prolonged, not bringing a weighty result, the development of movements. All these fractures are intra-articular lesions and are fraught with the development of contracture( restriction of the volume of movements) of the elbow joint or arthrosis in a remote, after a few years, period after injury.

Doctor traumatologist Voronovich VA