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What is a hand fracture?
Broken arm is an injury to one or more bones of a limb. This concept combines fractures of the humerus or forearm, fractures localized in the elbow joint. This also includes related injuries to the hand and fingers. Proper fusion of bones and normalization of hand functions are extremely important for a person, because the upper limb allows you to work, rest, develop, in general – live fully.
Injury to the upper extremities is common, most of all people seeking medical help with fractures of the metacarpal bones of the hand, with fractures of the radius, and also with an injured neck of the shoulder. The most common cause is a fall on a limb. Also, a fracture can be the result of a strong blow or the result of increased physical stress on the arm, the bones of which have been weakened by various diseases (bone tumor, osteoporosis, osteomyelitis, bone cyst, hyperparathyroid osteodystrophy) or have undergone characteristic age-related changes. Depending on the cause of the injury, fractures are divided into traumatic and pathological. If the bone was broken, but did not completely break, then we should not talk about a fracture, but about a crack, but if a small area broke off from it, then we should talk about a marginal fracture.
Hand fracture symptoms
Knowing the main symptoms of a fracture, you can differentiate it from just a severe painful bruise of the soft tissues.
As signs of obvious, not in doubt that a person has a fracture of the arm, the following can be distinguished:
Uncharacteristic position of the upper limb. The hand is unnaturally curved, has a corresponding appearance.
In the place where there is no wrist, elbow and shoulder joint, mobility can be observed.
When probing, a crunch characteristic of a fracture occurs, called crepitus. When compared with similar sounds, it resembles codfish that salt emits when it is toasted. Sometimes crepitus can be heard only with the help of a phonendoscope, and sometimes without specialized instruments.
Bone fragments may be visible and there may be an open wound that bleeds heavily. In this case, we are talking about open trauma.
There are also relative symptoms that make it possible to suspect the presence of a fracture, but an accurate diagnosis can only be established by conducting a complete examination:
Feeling of pain, which can be localized both at the site of injury, and move to neighboring areas. In particular, when the ulnar bone is broken, the pain can radiate both to the shoulder and to the forearm. Its character is intense even when the limb is at complete rest, if you try to give the arm a load or move it, then the person will experience backache, and the ache itself will intensify.
Swelling of the injury site and the presence of bruising. Regardless of the location, swelling with a fracture always occurs. The size of the swelling can vary, it will be larger the closer the injury is located to the hand or to the elbow joint.
A symptom of a cold limb is a very dangerous sign, indicating that there has been a violation of blood circulation due to rupture of large main arteries. Although this rarely happens. Another reason for the coldness of the hand can be thrombosis, which develops against the background of a rupture of the intima of the artery and carries a mortal threat. More often, this condition is observed in people of mature age.
The presence of a hematoma. If a pulsation is noticeable at the site of the bruise, then this indicates a profuse hemorrhage, which is located in the subcutaneous tissue.
The arm was deformed and became shorter than the uninjured limb. This symptom is typical for displaced injuries. The deformation becomes especially noticeable when the bone of the forearm is damaged.
Depending on the location of the injury, there will be limited mobility in the joint closest to which the fracture is localized.
If the nerves are damaged, then paralysis is observed. The fingers will be immobilized and insensitive.
Types of hand fracture
There are several types of injury, they are classified depending on the location of the injury, severity, characteristic features.
Here are a few approaches to determine this or that type of fracture:
From the type of damage: open, when the skin and soft tissues are damaged, and the bone is visible (they are additionally divided into primary and secondary open) and closed, which are complete (absolute fracture of the bone) and incomplete (bone fracture or separation of its tubercle).
From the location of the fracture line: diaphyseal (the line is on the body of the bone), metaphyseal or periarticular (the line is between the end and the body of the bone), epiphyseal or extra-articular (the line is at the end of the bone).
From which direction the fracture line is directed and from its nature: longitudinal (the line runs parallel to the bone), stellate, B and T – shaped, helical (the line runs in a spiral), transverse (the line runs perpendicular), oblique (the line is located at an angle to the bone), crushed (with the presence of many fragments of small sizes), comminuted (more than three fragments).
From the number of damaged bones: multiple and isolated.
Whether there is an offset. Displaced fractures are divided into primary (which are formed immediately at the time of injury due to the force applied to the limb) and secondary (formed as a result of the impact of muscles attached to broken bones). Displacement can be rotational, angular, across the width or length of the limb.
From the possibility of movement of fragments: stable (fragments remain in one place) and unstable (there is a secondary displacement of the formed fragments).
From the presence of complications. They are divided into complicated (with bleeding, fat embolism, infection, blood poisoning, osteomelitis) and uncomplicated.
A separate subspecies of a fracture is a combination of trauma with a dislocation of the bone. Most often they are complicated by severe damage to blood vessels and nerves. One of the most dangerous and serious types of injuries is a Galeazzi fracture, when several different types of damage are collected in one area. There is a fracture of the radius, with a displacement of the fragment down and eversion of the head.
Closed hand fracture
They speak of a closed injury in the case when the bone did not break through the soft tissues and skin, but remained inside, held by the muscles. Such a fracture may or may not be accompanied by displacement. The cause of the occurrence is most often a fall on an outstretched hand.
Symptomscharacteristic of a closed injury: acute pain, loss of limb functionality, deformity of the hand at the site of injury. Edema and discoloration of the skin may appear, the very moment of injury is accompanied by a characteristic crunch.
First aid for a person with a closed hand injury is to immobilize the injured limb. This is done so that the bone does not move even more during movement, fragments do not form. If fragments were formed at the time of injury, it is important to fix them in the place where they were originally located so that secondary displacement does not occur. In order to immobilize the hand, a splint of any even and hard objects is superimposed on it.
Then the design is securely fixed. It is not always possible for a person without medical education to provide a state of rest for the elbow joint with a splint, so it is better to use a piece of fabric that is suitable in size and hang your hand on a scarf. You should not try to align your arm yourself, try to set the bone, etc., in this way you can cause unnecessary harm to a person and cause additional suffering. It is enough to give the victim an anesthetic and go with him to the doctor, either on his own or wait for the ambulance to arrive.
Another important point when providing first aid during a closed injury, all jewelry must be removed from the hand: bracelets and, of course, rings. This is done in order to protect the soft tissues of the fingers from necrosis due to edema.
After the victim is delivered to the hospital, the necessary diagnostics and determination of the type of fracture will be carried out. If there is no displacement of the bone, then a plaster cast will be applied to the victim, but if it has happened, then a preliminary reduction will be required, and only then fixing the limb with the same plaster. Shrapnel injuries will require surgical intervention and the installation of a certain type of metal structure.
Open fracture of the hand
With an open type of injury, damage and rupture of the soft tissues of the arm, muscles and skin occurs. A bone or a certain fragment of it that has undergone damage will be visible.
Diagnostics this type of damage is not difficult, since all the symptoms are obvious: bleeding, bone protrusion, severe pain, inability to move the limb, swelling.
Since open injuries are always accompanied by bleeding, it must be stopped. Do it yourself with a tourniquet should only be in the case when it is arterial in nature. This can be determined by the following signs: the blood has a bright scarlet color, the bleeding itself is pulsating and very plentiful. If these indicators are not detected, then it will be enough to confine itself to applying a bandage from bandages. After performing these manipulations, you can give a person an anesthetic drug, but only one that does not raise doubts about its action. It can be ketoral, nimesulide, analgin, etc. Then you need to wait for the ambulance to arrive.
Treatment of an open injury operational, with the installation of rods, screws, spokes or plates. Only after this is shown the imposition of gypsum. The terms of rehabilitation increase, in comparison with the restoration of a limb after a closed injury.
Consequences of a broken arm
Even with the timely provision of qualified assistance, not a single person is immune from the unpleasant consequences that may result from a fracture:
If the bones have grown together incorrectly, then this is fraught with a violation of the functionality of the limbs, as well as its deformation. The hand itself will give the victim a lot of anxiety, both the bone itself and the joints located next to it will start to hurt. If an improper union of a diaphyseal fracture has occurred, then surgical intervention will be required, which consists in opening the bone and repositioning it. Most often, the prognosis for improper fusion of the bones of the hand and their correction is favorable, and the limb after surgery restores its previous functions. This is especially true for patients who clearly followed all the doctor’s instructions at the time of rehabilitation.
Infection of the wound, with an open fracture and the development of purulent-septic complications. When soft tissue is exposed, there is always the potential for pathogens to enter. Therefore, only a sterile dressing is required, treatment with an antiseptic solution, it is important to conduct an examination under sterile conditions. It is necessary to clean the surface from foreign inclusions.
Damaged skin requires excision, non-viable muscles must be removed, as bacteria begin to multiply in them. Tendons, like nerves, should be tried to sew. All bones that have completely detached from the soft tissues should be removed, unless their fragments are too large or belong to the joint. Disinfection is extremely important, as the life of the patient depends on it, and even a broken arm can be fatal.
Contracture may develop. It is caused by the fact that changes in the soft tissues occur, which causes a limitation of the mobility of the joint. The reason is the complete absence of reposition, the assumption of inaccuracy when comparing fragments.
Fat embolism is another possible consequence of a hand injury. It can occur even after a successfully completed operation. Despite the fact that physicians are always wary of this type of complication, nevertheless, fat embolism can often be diagnosed late. The reason is that it disguises itself as a traumatic shock and often occurs against its background. If there is a suspicion of the possible occurrence of this complication, then manipulations for the reposition of fragments, as well as osteosynthesis, must be abandoned for a while.
How long does the arm hurt after a fracture?
Pain after injury is pulsating in nature, gradually it begins to decrease. When the plaster is applied, the limb will hurt for a few more days, but not so intense.
In general, soreness persists for the first two weeks, therefore local application of cold is indicated, such a compress should be kept for no more than 15 minutes. Can be repeated every hour. If a person is not able to endure pain, then he is shown the appointment of NSAIDs.
In general, the timing of fusion depends on the location of the injury and its severity. So, broken fingers are restored in about a month, a hand or forearm after two, the radius after 1,5 months. As the healing progresses, so will the pain.
Pain may also occur after the cast is removed. But with normal healing and bone fusion, all discomfort should stop bothering a person after a week.
Edema after a broken arm
Puffiness is a fairly common phenomenon after receiving this kind of injury. This trouble is temporary, but until the swelling has subsided, regular monitoring by a doctor is necessary. To reduce the severity of edema, it is recommended to apply ointments or gels, which will help restore blood circulation in the damaged area.
Sometimes puffiness does not subside for a long time, then special procedures are required to eliminate it. This can be phonophoresis, electrophoresis, electrical muscle stimulation or ultraviolet irradiation. Excellent help to cope with swelling professional massage and therapeutic exercises.
If the edema does not subside after two weeks, you should definitely go to the doctor and ask a professional about the possible causes of this phenomenon.
After a fracture, the arm becomes numb, what should I do?
Numbness of the limb after the injury occurs often. With a similar problem, a large number of people turn to traumatologists. To begin with, it is necessary to determine the area in which temporary or permanent insensitivity is observed, whether it is accompanied by pain in the joints. If such sensations occur after a short time after the injury, then you should not worry – this is a completely normal process.
It is necessary to start worrying when the loss of sensitivity is observed after the removal of the cast, for several days and does not go away. Then it is necessary to undergo additional studies that will show there is damage to the nerve endings or vascular disease. Only a doctor will be able to identify the true causes of limb numbness after a fracture and prescribe adequate treatment. But you should tune in in advance to the fact that the ailment may not completely go away, and the feeling of numbness will bother the person again, for example, when the atmospheric pressure changes.
In the absence of indications, you can try to get rid of the complication of the injury yourself with the help of salt baths or proper massage. Special exercises aimed at developing the joints can also help, because the limitation of mobility is often associated with the fact that the limb has been in a cast for a long time. Operations carried out to fix damaged nerve endings and tendons will also have an effect. In this case, exercise therapy is a prerequisite for recovery. Sometimes a course of acupuncture can help.
Also, breaks in work, proper nutrition, sufficient intake of vitamin B 12 in the body are important to restore sensitivity. It is worth spending more time in the fresh air, actively moving. Most often, patients manage to cope with this problem completely.
How to develop a hand after a fracture?
After such a serious injury as a fracture has been received, it is unlikely that it will be possible to forget about it forever. Most often, the limb requires competent rehabilitation aimed at its restoration and development of functions. Often it is with the question of how to restore the working capacity of the hand that patients turn to doctors.
When the long-awaited moment arrives and the plaster is removed from the limb, the patient is surprised to find that the hand has become as if “alien”. Such conditions are explained by the fact that she was immobilized for a long time, her muscles weakened, and the blood supply was insufficient. There may be swelling.
In order to relieve swelling, you can try the following exercises:
First you should try to squeeze your palm. This will determine the degree of power loss. Do not immediately try to use a limb, take its cups of tea or perform more complex actions. For starters, you can practice on regular plasticine. To do this, you need to try to warm it up with your fingers, kneading the torn off piece. If you manage to cope with the task, you can afford to take a break. Should be repeated after class. This simple exercise should be performed for a month, several times a day.
The following exercise will help disperse the blood, make it circulate faster through the injured limb. To do this, while in a sitting position, stretch your arms in front of you. Turning the clenched palms to the right and left, you can feel how the hand gradually begins to function. But you should not press hard on the broken limb or rotate it too actively. The exercise should be done slowly and without jerks.
An ordinary tennis ball, which you just need to throw at the wall and try to catch, perfectly helps to remove puffiness. Again, do not get too actively involved in the task and overload the limb too much. Otherwise, you can only do harm.
You should place three tennis balls in the palm of your hand and try to touch them with your fingers. You should not stop the exercise, even if they fall out of your hand all the time. After all, its goal is to remove puffiness, which means that movement is necessary, otherwise the blood will not fully circulate through the vessels clamped with gypsum.
These simple exercises are recommended but not required. Those classes that the doctor advises will need to be performed in full and without gaps. To develop a hand after an injury, there are specialized exercise therapy, as well as massage courses that are clearly aimed at rehabilitation. Specialized occupational therapy helps to develop a hand perfectly, which consists in knitting, embroidery, drawing, performing simple tasks around the house or garden. Gradually, a person will be able to return to the full life that he had before the injury.
Exercise therapy after a broken arm
Therapeutic exercise is an effective way to return lost mobility.
To do this, perform the following exercises:
Raising the shoulders up and lowering them down.
With support on the table: extension of the hand, raising the forearm, rotation with the palm hanging down, squeezing the fingers into the lock.
Circular rotations. To do this, you need to bend your arms at the elbows and turn them in different directions. Similarly, rotations in the shoulder joint are performed, only the limbs in this case should not be bent.
Raise your arms to the sides and up above your head, then raise your arms in front of you and up again.
Exercise “correct hair.” The arm bent at the elbow must be rotated, touching the head clockwise and vice versa.
Claps in front of you and behind your back.
Rotation with a brush, which can be held at first with a healthy limb.
Finger stretching. To do this, each of them needs to be seated on a twine, as it were.
Water exercises. To do this, you need to fill the pelvis, place your hand there, trying to bend and unbend the limb in it. You can squeeze and unclench your palm there.
Another effective exercise with the help of a basin of water is to lift small objects from its bottom, such as coins or buttons.
It is worth noting that, depending on the stage of rehabilitation, the exercises must necessarily differ. You should select them according to the principle – from simple to complex, gradually increasing the load:
To begin with, you can simply move your fingers, bend your arm at the joint, freely chat with it.
After that, you should concentrate the main efforts on the wrists, to restore the functions of the fingers and hand.
At the final stage, the load should be evenly distributed over the entire limb, with emphasis on the interphalangeal joints.
Massage after a broken arm
Massage is one of the basic components of treatment aimed at restoring limb mobility. You can start it even before the plaster was removed. To do this, small holes are made in it and pointwise act on the damaged limb. This can be done with a special druse made of quartz, which has a blunt tip.
Working with the muscles will contribute to the flow of blood to the arm, its nutrition and saturation of the tissues with oxygen. Edema will come down faster, hematomas will be better absorbed, pain will decrease.
After I remove the cast, the massage is carried out more intensively, but still carefully, with classical movements:
First you need to run along the entire length of the limb with your fingers, transverse and longitudinal strokes.
Then you should move on to rubbing. In this case, it is already possible to produce some weighting.
This is followed by kneading with your fingers, which promotes tissue regeneration.
Vibration movements are the final stage of the massage. Pressing alternates with stroking.
To carry out manipulations, you can use special massagers, applicators and rollers. For better glide, certain oils are always used. In case of a fracture, fir is best suited. To enhance the effect, you can mix it with creams and ointments that eliminate puffiness and have a warming effect.
How long does it take to develop a hand after a fracture?
The terms of rehabilitation measures vary, and depend on the nature of the injury received, as well as on the speed of recovery. For some patients, a couple of months is enough to fully return to normal life, and some may need prolonged treatment up to six months or even more.
In any case, after the plaster is removed, it is necessary to carry out a mandatory program aimed at recovery for at least a month:
The neck of the shoulder fully recovers after 3 months of treatment, plus a month of rehabilitation.
The body of the humerus recovers after 4 months, plus 1,5 months of rehabilitation.
The bones of the forearm are completely fused after 2 months, plus 4 weeks of restorative procedures.
The radius bones will recover in 1,5 months, plus the same rehabilitation period.
The bones of the hand fuse after about 2 months, plus 1,5 months of development.
Fingers recover faster than any other bone, they need a month to heal and a month to rehab.
If there are joint contractures, then the process of recovery and development will be long and will be at least six months. When nerves have been hit or the fracture has become complicated by infection, the healing and recovery process can take several years.