Dislocation of the elbow joint of the hand - Causes, symptoms and treatment. MF.
Jun 11, 2018
The dislocation of the elbow joint is the displacement of the articular surfaces of the forearm bones( ulnar and radial) relative to the humerus. Trauma occurs as a result of a fall on the elongated arm and excessive extension in the elbow joint.
Dislocation of the elbow joint( forearm bones)
Symptoms of dislocation of the elbow joint( forearm bones)
• Pain in the elbow joint region;
• Severe deformity of the elbow joint, sprained bones can bulge and under the skin;
• Sharp restriction of movements( passive and active);
• Edema is expressed in the elbow area and often passes over to the forearm and hand;
• In case of damage to the brachial artery( the brachial artery is clamped between the bones when it is dislocated or torn due to stretching), numbness and coldness of the fingers and hands are observed, there is no pulsation of the radial artery above the wrist joint. Damage to the brachial artery - a frequent complication of dislocation of the elbow joint.
• If the nerve is damaged, the hand or fingers are paralyzed.
First aid for dislocation of the elbow joint
The main principle of first aid for dislocation of the elbow joint is not to harm. You can not try to fix the dislocation independently, you can not resort to movements in the damaged joint, you can not overdo it with imposing immobilization tires. Any excessive movement or pressure can cause damage to the artery or nerves that pass around the elbow joint.
The injured arm should be suspended on a bandage-kerchief, and the patient should be given an anesthetic from a home medicine chest( nimesil, ketorol, analgin, aspirin, etc.).
Diagnosis of elbow joint damage
Radiography is performed for the diagnosis of dislocation of the elbow joint. If the nerves are damaged, electromyography can be performed.
Treatment of dislocation of the elbow joint
The main method of treatment is a one-stage dislocation of the dislocation under general anesthesia, after the correction is applied a gypsum tire from the middle third of the shoulder to the heads of metacarpals( "bones" on the wrist), the immobilization period is 7-10 days. After a short-term immobilization, they start rehabilitation measures. The general term of treatment of uncomplicated elbow joint dislocation is 5-7 weeks.
Gypsum with dislocation of the elbow joint
If the dislocation is complicated by nerve damage, special treatment is required from a neurologist. With a complete rupture of the nerves, surgical treatment is performed( nerve stitch on the basis of microsurgical hospitals).In case of damage to the artery and impaired blood circulation in the hand after correcting the dislocation, surgery is also required, aimed at restoring blood circulation in the damaged arm.
Rehabilitation after dislocation of the elbow joint
In a short period of 7-day immobilization proceed to movements in the fingers of the hand. The main rehabilitation measures are carried out after the removal of the plaster bandage. Physiotherapeutic procedures are prescribed: magnetotherapy, laser therapy, ultrasound with a course of 10-15 sessions. Thermal procedures with dislocation of the elbow joint are undesirable, since they can cause the formation of ossicata in the elbow joint. Ossicata is the deposition of calcium salts and other components of bone tissue outside the bone, their deposition in the soft tissues of the elbow joint can lead to the development of joint contracture( limitation of the volume of movements).Massage can be done only in the area of the forearm and shoulder, massage procedures on the elbow joint should be postponed until a later recovery period( after 4-6 weeks).
After removal of gypsum, most attention is paid to the development of movements in the elbow joint, because the elbow joint is most often complicated by the development of contractures after injuries.
An approximate set of exercises for the development of elbow joints:
• 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 around 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 in the elbow joint;
• After a sufficient reduction in 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 movement around its axis, it is important to do rotational movements with the forearm, not with the shoulder.
All the exercises do 10-20 repetitions 3-4 times a day. After 2 weeks, you can go to the gym in the pool or salt water. Occupations with severe physical exertion( over 7-10 kg) are allowed only after 2 months after the injury.
Prognosis after elbow dislocation
In case of uncomplicated dislocations - the prognosis is favorable, movements and strength are restored quickly, which is associated with short-term immobilization. If the nerves and brachial artery are damaged, treatment can be delayed for many months and years.
Doctor traumatologist Voronovich NA