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Injury to the shoulder girdle, as well as to the upper extremities, is a phenomenon that is not only faced by professional athletes, as most people usually assume. Dislocations, fractures, ruptures of ligaments and muscles, penetrating, penetrating and blind injuries can be obtained at work, during car accidents, when falling, unsuccessfully jumping into water, or lifting weights at home. According to the World Health Organization, approximately 80% of all injuries with which people end up in surgery and traumatology are injuries of the musculoskeletal system, and half of them relate to the upper limbs and shoulder girdle. That is why it is important for every person to understand and be able to differentiate different types of injuries, as well as to master first aid and dressing techniques.
Types of injuries of the upper shoulder girdle and limbs
Injuries to the arms, shoulders and forearms can have a different character.
But, in general, this term refers to a violation of the normal state and integrity of bones, soft tissues and skin, which causes pain, and significantly limits the mobility of the limbs and trunk as a whole.
When examining the victim at the scene, it is necessary, first of all, to determine the main visible deformations and injuries.
If the affected person is conscious, it is necessary to interrogate him, clarify the nature and localization of pain from him. In addition, palpation of damaged areas is performed, however, it must be carried out very carefully and without sudden movements, since any damage can be accompanied by injuries to internal organs. The main division of injuries of the upper shoulder girdle implies the presence of two large groups of injuries – open and closed.
Open injuries are injuries associated with a violation of the integrity of the skin at the site of injury, therefore, during visual inspection, internal tears, fractures and other wounds can be seen.
Closed injuries are more dangerous – they hide under the skin and subcutaneous fat, which remain intact in this case. To identify such injuries, a simple examination is not enough, which greatly complicates the provision of adequate first aid. This classification is the most general, and each type of injury should be considered separately. Common injuries are:
- bruises;
- dislocation;
- sprains and ruptures of ligaments;
- cracks and fractures of bones.
Characterization of specific injuries of the shoulders and forearms
A bruise is called damage to soft tissues, in which the integrity of the skin is not violated. The cause of the occurrence is usually a sharp mechanical impact, such as a fall or impact. A pain sensation appears at the site of the bruise, due to which there may be a limitation of mobility. After a few hours, a bruise and swelling of the tissues may appear at the site of the bruise. Over time, the color of the bruise changes from purple to yellow-greenish. Such injuries may be independent or accompany more dangerous injuries, such as fractures.
Positional compression of the upper limbs is a process of pressing soft tissues, due to which blood circulation is disturbed in them, the sensitivity of the limb and its mobility deteriorate.
A person feels numbness of the arm or shoulder, and the skin in the place of compression becomes pale and cold, cyanotic. There is also a weakening of the pulse. The danger of such lesions lies in the fact that in the future, because of them, tissue necrosis may develop.
Violations of the integrity of the ligaments can occur as a result of sudden movements of the joint, which exceed its mobile ability. At the same time, the ligaments almost do not stretch – ruptures or micro-ruptures occur at the places of greatest stress. The victim feels pain in the joint, he has swelling in the affected area, and limited mobility. Not only muscles and ligaments are damaged, but also the vascular system – blood and lymphatic vessels.
A dislocation is a functional violation of the normal state of the articular apparatus. The articulating parts of the bones that form the joint, as a result of mechanical action, cease to interact normally, change their location. Pathology is accompanied by severe pain, decreased mobility, pronounced edema.
Upper limb fractures represent approximately 50% of all fractures. They can occur as a result of a sharp blow, a fall, a car accident. This condition is dangerous for a person, as the bone loses its strength and integrity, ceases to function as a “frame” for a limb or joint. Incorrectly fused bones greatly complicate the life of its owner.
General first aid rules
Considering that lesions of this type can be completely different – from a bruise and a bruise to severe bone fractures, of course, the first aid algorithm for victims differs in each specific case, depending on the type of wound or injury.
However, general care requirements are mandatory for all types of injuries. It is necessary to make an external examination of the victim, assess the severity of his injuries, as far as visually possible. If a person is bleeding, and pulse and breathing are not observed, resuscitation measures must first be taken in relation to him.
Stopping bleeding is the first thing you should pay attention to. For this purpose, a tourniquet or pressure bandages can be applied to the limbs, or you can use the method of finger squeezing of the damaged vessel. You should remember the rules of asepsis – before starting any manipulations, the hands and all materials used must be disinfected.
In the absence of breathing and pulse, it is necessary to do resuscitation measures – heart massage, artificial respiration.
With dislocations, ligament ruptures and bone fractures, the main thing is to ensure complete immobilization of the damaged area. For this purpose, tight bandages or splints are applied to the injured limb or joint.
If we are talking about a minor bruise, help with it will be to ensure the disinfection of the injured area, the application of a cold compress, and, if necessary, the administration of painkillers.
Severe bruises and crushing of tissues, as well as positional compression, require immobilization of the damaged area, and when tissue is squeezed, blood circulation must be restored in them.
Bandage Algorithms and Techniques
If the damage affects the fingers, a narrow bandage is used to bandage them. The dressing begins with several fixing moves in the area of the wrist. Next, the bandage in an oblique direction is carried out along the back of the hand to the affected finger. It is wrapped around in a spiral, while the tip of the finger remains open. The bandage is led back to the base of the finger, and again along the back of the hand to the wrist, where it is fixed.
You can also use a cloth fingertip with special ribbons for applying a contour bandage. To close the end of the finger, the bandage is passed along the palmar side of the finger through its tip to the back, and then to the base. This move is strengthened by turning the bandage in a spiral, and then the actions are repeated the required number of times. After that, the bandage is held along the back of the hand to the wrist, and makes two circular turns on it, passes to the finger, which turns around in a spiral, and is fixed on the wrist.
In such ways, it is possible to bandage not only one finger in isolation, but also several, or all at the same time – in this case, after bandaging one finger, the bandage is held along the back of the hand on the wrist, and from there it passes to the next finger until all of them are bandaged. The palm remains free. How to fix the thumb? For this, a spike-shaped bandage is provided. Its locking moves are attached to the wrist. To bandage the hand and four fingers, a wide bandage is used. It is led from the wrist to the ends of the fingers, bent over them, returned to the forearm along the palm, and fixed in a circular motion. This cycle is repeated 2-3 times, and the bandage is fastened with eight-shaped passages that pass from the wrist joint through the hand to the fingers.
A scarf can be useful if you need to bandage all the fingers together with the brush – the material must be unfolded, and the brush is placed on it so that the fingers are located towards its top. The base of the scarf lies above the wrist joint. That part of the material that lies in front of the fingers is wrapped back along with the top of the scarf – thus, it covers the back of the hand and fingers. The ends of the kerchief are held in a circular fashion around the wrist over the laid top. They are strengthened with a knot, and the top is pinned with a pin or sewn with threads over the knot directly to the dressing.
The forearm is bandaged in a spiral way with a kink in its upper part, which has a conical shape. The coil of the bandage is taken in the right hand, its end – in the left. The bandage is applied to the lower third of the forearm, after which two or three fixing rounds are made around it. The next moves of the bandage are applied with an offset from the previous ones, and where the bandage does not fit tightly to the affected area, the bandage is carried out with an inflection and then applied in spiral moves. The dressing ends in the upper part of the forearm with several fixation tours of the bandage.
The so-called “turtle” bandage of the figure-eight type is superimposed on the elbow joint. Exists:
- converging;
- divergent tortoiseshell bandage.
The convergent bandage begins with a circular motion of the bandage on the shoulder, and then it is lowered in “eights” to the forearm, crossing in the flexion region of the elbow. Before this, the arm must be bent at a certain angle. Eight-shaped moves gradually bring together, with each subsequent move being shorter than the previous one. The end of the dressing is carried out in a circular motion through the elbow joint, after which the bandage is led to the shoulder, where it is fixed.
The divergent type of dressing begins through the joint with a circular course, then continues with “eights” with an increase in the size of the loops of the course. The bandage is fixed on the shoulder. It is convenient to fix the shoulder with simple spiral or circular bandages using cleol.
A bandage bandage on the shoulder made of “retelast” material is applied according to the scheme of the anterior, posterior or lateral spike-shaped dressing. For this, a wide bandage is suitable, which is fixed in the area of uXNUMXbuXNUMXbthe upper shoulder. Then it is led in an oblique direction upward through the shoulder joint to the forearm. The bandage crosses the chest in front, goes under a healthy armpit, and returns to the back to the affected shoulder girdle. Here the first course of the dressing is crossed, after which it is sent to another armpit, and again brought to the shoulder. Thus, the course of the bandage makes a full “eight”. The moves must be repeated so that each subsequent one overlaps the previous one by about half – due to this, the forearm is covered. You can strengthen this type of dressing by sewing it with threads.
The kerchief covers the shoulder joint and armpit. One or more kerchiefs can be used for this. One scarf should be folded twice, parallel to its base, to make a “tie”. The middle of the material is inserted into the armpit from the damaged side, one of the ends of the resulting tie is passed along the front surface of the shoulder joint, after which it is thrown over the back over the shoulder girdle. The second end is circled along the back surface of the joint, and is superimposed on the chest. They are connected in the armpit on the healthy side – there they are tied, fixing the bandage.
The upper shoulder girdle, together with the upper limbs, is a mobile part of the human body, which actively interacts with the outside world, which can cause injury. Applying bandages on the shoulders, forearms and upper limbs is one way to achieve bleeding control and immobilization of the damaged area before the victim can receive full medical care.