Dislocation of the hand: symptoms and treatment

Dislocation of the hand: symptoms and treatment of the wrist joint

Dislocation of the hand - the injury is quite common, especially for the child. There are two main reasons for such damage: a fall or a severe impact on the wrist joint. When you fall on the wrist, the weight of the victim's entire body is affected.

Dislocation of the hand in the wrist (perilunar dislocation in the hand or a dislocated vertex) has characteristic symptoms.

Therefore, this trauma must be distinguished from a fracture or contusion of soft tissues, since the correct treatment depends on the diagnosis.

Dislocation of wrist joint - trauma features

Dislocations of the wrist are often found not only in the child, but also in the adult.

Although the adult group of patients is much less likely to receive such injuries, due to decreased motor activity.

Dislocations of the hands of children are much more common, and not always the cause of injury lies in the high activity of the child.

Children often have anomalies in the development of the wrist joint, in which the cavities of the articulation have a lesser depth and area. This pathology is considered genetic and explains the predisposition of a small patient to dislocations.

However, over time, with the correct formation of bones and the growth of the skeleton, the defect can be compensated. Therefore in the future the probability of getting a dislocation in the brush will be minimized.

Dislocation in medical terminology is understood as the pathological change in the structure of the joint caused by trauma, in which the displacement of the terminal bones facing the joint is observed.

Because of this, a pronounced pathological change in the location of certain elements develops in the joint of the child.

Emergency help with dislocation

Dislocation in the hand has its own peculiarity - at the time of the injury, the brush moves towards the action of force.

In other words, if a person falls on his hand, the back of the hand moves toward the radius of the bone when falling, and when applied directly to the surface of the brush, the structures move downward.

Dislocation of the hand in the wrist has two types:

1. The true dislocation. This variant of dislocation is rare, in only 10% of cases. It is characterized by a complete displacement of the surfaces of the articular elements of the bones of the wrist relative to the radial bone. With such trauma, both back and palmar dislocation can be observed. Often this damage is accompanied by a fracture of the radius.
2. Periloonal dislocation in the hand occurs in 90% of cases, therefore it is considered the most common. The contact between the semilunar and the radius is preserved in this trauma, but it is absent with other wrist elements. For damage is characteristic displacement to the rear or center.

Much less often the dislocation of the wrist can be observed in a newborn baby. These injuries are qualified by a separate species.

Symptoms characteristic of a wrist injury

When the wrist is dislocated, the symptoms are quite numerous, due to changes in the location of the bone structures. However, for someone who has never dealt with such injuries, it is very difficult to independently distinguish a dislocation from a severe injury or fracture.

Therefore, the affected child should immediately be shown to the doctor. It is also necessary to know what first aid should be in case of dislocations.

If a wrist dislocation really does occur, the symptoms of injury will indicate the degree of damage to the hand. For the dislocation of the brush, the following symptoms are typical:

• strong pain;
• minor hematoma;
• relatively small swelling;
• Wrong position of the brush;
• complete immobility or limitation in the movements of the hand;
• when dislocated in the rear, swelling at the rear of the hand is observed;
• when trying to move with a brush, the resistance of the muscles is noted;
• rapid or slow heart rate.

Most patients can not do basic things with their hand, they can not move their fingers or turn their wrists. Any attempts to move the hand cause the child unbearable pain. Even more painful pain in palpation.

What to do with dislocation of the joint, what should be the treatment

Treatment of a dislocation, that is, first aid should be done very carefully.

Independently change the position of the damaged brush, and even more so try to fix it in any case impossible.

If the victim has symptoms of dislocation, the treatment can be performed only by a trauma doctor.

Emergency care for dislocation of the wrist joint requires its fixation, and the pathological position of the brush is unacceptable. To immobilize it is best to put a tire on the limb and fix the hand with a bandage on the chest.

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In this situation, the chance of edema development decreases. If the victim has a long time to get to the nearest hospital, a cold compress should be applied to the joint.

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For modern medicine, the treatment of dislocations is not particularly difficult.

Nevertheless, these injuries require a long-term rehabilitation, in the process of which the joint returns lost elasticity and mobility.

If the patient does not receive full recovery procedures, the joint structure weakens, resulting in dislocations.

In a medical institution, an x-ray examination is performed in three projections to clarify the diagnosis.

Local anesthesia is advisable only with a "fresh" injury.

The procedure for correcting the dislocation is performed by the surgeon and his assistant, after which the injured person is sent to the control radiography. If the picture showed a satisfactory result, the wrist joint is fixed for two weeks with a plaster bandage.

Treatment of chronic dislocation of the wrist joint is carried out in two stages.

At the first stage, the doctor removes puffiness, while on the second stage the joint moves and fixes in a natural position.

Then the doctor makes a complex of physiotherapeutic procedures and exercises for the affected child. All these measures are necessary for the rehabilitation of the affected joint.

A source: http://sustav.info/travmy/vyvikhi/vyvih-kisti-ruki.html

Dislocation of the hand: causes, symptoms, treatment and recovery

The attitude of some people towards dislocation of the hand (or other part of the body) is usually disdainful.

There is a strong belief that it is enough to "pull" the limb, and "the bones will get in place."

Is this really so? What to look for when you dislocate the hand, what to do immediately, and what treatment will be needed later? About this further.

Causes

A dislocation of the hand occurs when the area is overloaded. This can happen for several reasons:

• A fall.Instinct forces us to stretch out our hand during the fall, for example, when it's ice.
• Hit.Increased pressure on the wrist and subsequent trauma can occur when striking a punching bag in the absence of training in humans. An unsuccessfully caught basketball or volleyball can also cause injury.
• An awkward move.It can occur, for example, during a fight, when the opponent grabs the hand and pulls it hard in a physiologically unacceptable direction. The same happens when an adult, leading a child by the hand, sharply pulls him up.

In the group of risk athletes, young children and amateurs find out the relationship with their fists. Here you can also include people who, due to circumstances (age, joint disease, genetically peculiarities), a weak ligamentous apparatus.

Types of trauma

There are several types of dislocation of the hand. It depends on the characteristics of the connective tissue, the load on the joint and other factors.

In some cases, a dislocation is accompanied by a fracture of any carpal bone, which can not be detected visually.

This once again shows that even with the slightest trauma you need to turn to a specialist and make an X-ray.

True

The true dislocation of the hand is characterized by a complete shift of the radial bone and wrists in relation to each other.

Such traumas in medical practice are fixed in rare cases, and are represented either by the rear option, or by the palmar (that is, downward or upward).

This type of dislocation is often accompanied by damage to the radius - its fractures or tearing apart parts.

Periloonary

Characterized by the movement of the wrist bones simultaneously with the capitate in the outward direction. They are the most common cause of treatment in trauma.

Dislocations of this type of hand are caused by a sharp support on the hand during the fall, as well as in case of excessive bending.

Concomitant lesions can be fractures of the bones of the forearm.

Other

Less common are other types of brush dislocation:

1. pereladevidno-perilunary, in which the perilanar trauma is accompanied by a fracture of the scaphoid bone;
2. transversely fulminant, characterized not only by the displacement of bones, but also by fractures of scaphoid and semilunar fractures;
3. pereladevidno-lunar - in its place remain only navicular and semilunar, and other bones are subjected to displacement;
4. peritrehgranno-lunar - the displacement does not affect only the scaphoid and trihedral bone.

Symptoms of dislocation

The severity of symptoms with a dislocation of the hand in each individual case will be different. The most characteristic features of this trauma are the following:

• pain that occurs spontaneously (may intensify at night);
• restrictions in motion, compression of fingers;
• a feeling of numbness;
• swelling at the site of injury;
• deformation, the appearance of protrusions under the skin;
• loss of sensation of the joint.

In some cases, there are bruises and abrasions in the damaged area.

How to distinguish yourself from dislocation

Determine what type of injury, dislocation or bruise, takes place with trauma, you can yourself. The main differences are:

1. The bruise is also characterized by severe pain, but it gradually subsides, while with the dislocation the pain sensations only increase;
2. bruise, although it causes pain, but does not completely restrict movement in the joint;
3. after a bruise on the damaged area, swelling is observed, but not deformation;
4. the axis of the arm does not change with a bruise.

To accurately determine the type of damage, you need to take an X-ray.

Diagnostic methods

What is the basis for the diagnosis of a dislocation of the hand? First of all, this is an examination and palpation.

The traumatologist, having found out the reason of damage, will feel the wrist, will determine the degree of change of its shape and mobility, fixes external manifestations (puffiness, discoloration of the skin, the presence of additional external damage).

An X-ray examination of the joint is mandatory. It makes it possible to detect the presence of cracks or fractures. If there is a suspicion of nerve compression or damage to the tendons, ultrasound or CT may be performed.

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These same methods can detect the rupture of the joint capsule, the violation of the integrity of blood vessels and so on. In some cases, immediate hospitalization of the victim and urgent surgical intervention are required.

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First aid for trauma

It is not always possible to quickly contact a trauma center. Therefore, everyone should know the basics of the first emergency aid with a dislocation of the hand:

• The affected area is covered with cold (ice or just cloth soaked in cold water).
• Along the forearm and the hand have any solid and straight object.
• Fix an object on the hand with a bandage, scarf, piece of cloth.
• If the victim experiences severe pain, then he is given an analgesic.

Healing procedures

Treatment of dislocation of the hand can be divided into several stages:

1. Correction of bones.
2. Medication and limb immobilization.
3. Restoration of the functional activity of the joint.

The duration of each depends on the severity of the injury. Sometimes there is a question about an operative measure. Most often, the operation is done with vascular lesions.

Restoration of the joint of the hand

The procedure for restoring the joint with a dislocation of the hand is carried out after preliminary anesthesia. Its different types are used: conductive, local or general anesthesia. To put the bones in the starting position, the trauma specialist needs an assistant.

The assistant holds the shoulder, and the doctor pulls the brush toward him, holding her fingers with both hands. In the process of stretching, the traumatologist presses on the protruding parts of the joint bones.

Then the brush is put in a position at a certain angle to the radius bone and a plaster is applied.

14 days after the procedure, the patient must again come to see a doctor. Gypsum bandage is removed, the brush is straightened, and then fixed again for another 14 days.

Every time an X-ray is taken. If it shows the instability of the joint, the bones are fixed with the help of spokes.

They are inserted obliquely in such a way that they pass through the radial bone, the joint itself and the fifth bone of the pastern.

Medication

Drug therapy with a dislocation of the hand is aimed at preventing the development of the inflammatory process, the removal of pain, swelling, normalization of metabolic processes in the joint. For this purpose, the following groups of drugs are prescribed:

• analgesics;
• NSAIDs;
• muscle relaxants;
• decongestants;
• vitamins of group B.

To ensure the restoration of damaged joint structures, the use of chondroprotectors is indicated.

At the initial stage of treatment, depending on the degree of damage, drugs are used in the form of injections, then switching to tablets or capsules. If there is a need, then after removing the gypsum, use external means.

How to treat a dislocation of the brush at home

Home treatment involves, first of all, compliance with the recommendations of a doctor. This: the provision of damaged limb rest, regular intake of medications, compliance with the regime (full rest and sleep).

Ration, too, will require a revision - you need to make it more products containing vitamins, protein, calcium, collagen.

At the same time, you should not run to the pharmacy and buy the most popular vitamin and mineral complex, you only need to select these substances individually.

At home, if you dislocate your hand, you can use folk recipes:

1. A hot milk compress is warming and stimulating the blood flow.
2. Lavender oil, mixed with any vegetable in the proportion: 0, promotes the acceleration of metabolic reactions in the damaged area. The composition is enough to rub in the wrist 2 times a day.
3. Onion gruel, which is added a little sugar, has an anti-inflammatory effect.

Operative intervention

Surgical intervention is not often used when a hand is dislocated. Indication for the operation is nerve compression, true dislocation, as well as improperly conducted earlier correction.

If the damage occurred 2-3 weeks before contacting a doctor, then such a dislocation is also corrected surgically.

Carrying out of operative measures can be demanded also in a case when to eliminate damage in the closed way it is not possible.

If necessary, it is possible to dissect the joint capsule. To ensure the stability of the joint use a fixation with knitting needles.

After the bones are brought back into place, and the spokes are set, stitches are placed on the cut site (layered).

When a true dislocation or chronic forms accompanied by arthrosis, apply arthrodesis. In all cases, after the end of the treatment, a plaster is applied. The duration of fixation depends on the complexity of the operation performed and can range from one to three months.

Features of dislocation of the hand in the child

Parents should be especially careful if the child's hand is damaged. Delay in treatment or its absence can subsequently lead to disability.

Be sure to consult a doctor if the baby has symptoms such as:

• The unnatural position of the hand relative to the forearm;
• impossibility of movement in the joint;
• cyanosis of the integument, hematomas in the area of ​​injury;
• severe pain (if the child is very small, he will cry and pull his hand when trying to examine it);
• swelling of the joint;
• traumatic shock.

The faster the diagnosis and treatment is administered, the more likely it is to keep the joint and avoid complications.

Recovery after injury

The recovery period with a dislocation of the hand consists in a gradual increase in its functional activity. To do this, use physical therapy, massage, physiotherapy.

In each case, the duration of the sessions, the duration of the course of treatment, the dosage of medications and other nuances are determined by the physician, and corrections are made as recovery proceeds.

Preventive actions

Strengthening the ligamentous apparatus of the wrist joint in some cases will avoid injury. Exercises that are shown in the recovery period, you need to do and after the complete healing of tissues.

This significantly increases their elasticity, and reduces the likelihood of repeated damage. Athletes are recommended to use special protective equipment - elastic bandages, the choice of which is carried out, strictly based on individual characteristics.

With poor heredity, it will be necessary to limit the strain on the wrist and hand.

With careful consideration of your health, you can avoid not only many injuries, but also negative consequences. Timely appeal to a traumatologist with a dislocation of the hand will return the lost quality of life and reduce the risk of disability to zero.

A source: http://zdorovue-systavi.ru/travmy-i-ushiby/vyvix-kisti-ruki/

Dislocation of the wrist joint of the hand: symptoms and treatment of the wrist, first aid

The wrist joint is a complex joint formed from the bones of the forearm and the human hand. And, like almost all the joints in the human skeleton, he is prone to injury, the most frequent of which is a dislocation.

Joint dislocation is a pathological condition characterized by displacement of the joint surfaces relative to each other.

Such damage is a fairly common phenomenon, most often appearing as a result of falls or bumps.

Dislocations respond well to treatment, but in order for it to be successful and quick, you need to know the basic rules for providing first aid to the victim.

The dislocation of the wrist joint of the hand has its own peculiarities, therefore we will consider the main points of treatment and rehabilitation of this pathology.

The most common causes of injury

The human brush is the most mobile part of the skeleton, performing quite a lot of important functions.

Every day with its help a lot of actions are carried out, some of which carry a certain load on the joints of the hand.

The most unstable joint in the wrist is just the wrist, so it is prone to injury the most.

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The composition of its proximal surface (the one closest to the body) includes the radial bone and the cartilaginous disk of the ulna. The distal surface (the one farthest from the body) - includes the small bones of the first row of wrists (navicular, semilunar, trihedral and pea-shaped).

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This structure provides many opportunities for a variety of manipulations, but it makes the joint particularly vulnerable, resulting in quite frequent are dislocations of the wrist joint, which can contribute to a fall with an emphasis on the wrist or a straight blow to the wrist (for example, during fights).

Symptoms and types of wrist dislocation

Recognize the dislocation of the hand does not always succeed immediately, sometimes it is mistaken for a simple bruise, which complicates the treatment. since when dislocation it is very important to quickly diagnose and fix the bones in place. Therefore it is important to knowmain hand dislocation symptoms:

1. Immediately after the impact there are sharp painful sensations in the area of ​​damage;
2. During the first 5 minutes, severe swelling develops;
3. The shape of the brush changes, there are bulges in the place of the exit of the bone and the joint bag;
4. Limited movement with a brush.

The shape of the wrist with trauma depends on which part of the joint the pathology has appeared. T. because the wrist joint consists of many bones, then a dislocation can arise with the participation of any of them. For these featuresdistinguish several types of dislocation of the wrist joint:

• Dislocation of scaphoid bone;
• Dislocation of the semilunar bone;
• Periloonal dislocation of the wrist - when the semilunar bone remains in place, and all other wrist bones below the semilunar dislocate in the back of the hand;

These options are the most common types of wrist dislocation. The remaining bones in its composition are less vulnerable and very rarely beat out of the joint. Determining the type of wrist dislocation is a fairly important part of diagnosing this problem,

this determines the treatment. But visually it is not always possible to evaluate and reveal which bone was dislocated. In this case, X-ray comes to the rescue.

The X-ray is performed in two, and sometimes even in three projections, in order to completely cover all the bones and determine the degree of dislocation.

Besides,dislocations are classified by the degree of displacement. When there is a complete divergence of the joint bones, the dislocation is called complete. When the bone surfaces continue to touch - incomplete, or subluxation.

First aid to the victim

If after a trauma there is a suspicion of dislocation of the wrist joint, then the first action to help the victim should be an ambulance call, or an independent transfer of the patient to the emergency room. Before you go to the hospital, with a strong pain syndrome, you can drink anesthetic, and the damaged joint should be immobilized as much as possible.

To do this, put a straight solid object on the back of the hand and tie the injured arm to it with an elastic bandage.

If swelling swelling is noticeable, then the affected joint should be applied cold.

All further actions should be performed by a qualified specialist traumatologist, in a hospital.

If for any reason you can not seek medical help, then you can try to fix the dislocation yourself. How to do it?

1. It is obligatory to give the patient an anesthetic drug and wait until he acts;
2. Plant the patient and bend the arm at the elbow at a right angle;
3. Pull the first three fingers of the brush until a characteristic click, meaning that the bone is in place;
4. After restoring the joint, the hand should be bent to 40˚ and apply a bandage from the wrist to the elbow.

But such measures can be used only in the most extreme cases, since.

without experience in trauma, there is a high risk of mistakes in the performance of these actions, and this can only aggravate the situation.

In addition, it is not uncommon for cases when a bone fracture occurs together with a dislocation, and at home it is very difficult to identify and then irreparable complications can occur.

It is always necessary to make every possible attempt to obtain quality and qualified medical care for the victims.

Treatment of wrist dislocation

After entering the traumatology station, the victim is examined, a hand is examined and sent to a radiograph for an accurate diagnosis.

Direction of fresh dislocations of the wrist joint is performed by a traumatologist with the use of anesthesia, local or conduction anesthesia.

It depends on the type of dislocation and the degree of its severity.

To reinforce the bones, the injured person's arm is bent at the elbow joint at an angle of 90 °. The assistant doctor keeps her in the lower part of her shoulder. The doctor pulls the forearm along the axis, and after stretching the joint puts pressure on the area of ​​protrusion of the bone.

After the joint is set, the wrist is bent at an angle of 40 °, andpatient impose a plaster bandage, which starts from the fingers of the hand to the elbow. Additionally, a repeated X-ray photograph may be required, which will make sure that the joint has risen correctly.

After 2 weeks of fixation, the brush is released and left in the neutral position, but again immobilized for a period of two weeks. If a repeated examination of the brush after correction diagnoses the instability in the joint, then a special fixation with Kirschner knitting needles is performed.

But such measures are relevant if the dislocation of the wrist is fresh.

If the patient has a long trauma, for more than 3 weeks, or the dislocation was previously incorrectly set, then immediate surgical treatment is applied.

When for any reason a closed dislocation of the joint dislocation can not be done or if the dislocation is old, a special distraction apparatus is installed on the hand.

The postoperative fixation period can be from 1 to 3 months, depending on the severity and nature of the dislocation.

After removing the gypsum fixation, the injured person is given the procedures for rehabilitation.

Rehabilitation and possible complications

After removing the gypsum, the patient is given a course of rehabilitation, which usually takes a long time.

It includes several important points:

• Fizoterapiya;
• Massage;
• Physiotherapy.

Such rehabilitation measures allow not only to quickly restore the motor activity of the hand, but also normalize the work of the ligamentous apparatus, which is also damaged by dislocation and prolonged immobilization of the hand.

Detailed advice on the implementation of each of these points should be given by the doctor, after the removal of the cast.

For rehabilitation to pass quickly and successfully, it is very important to comply with all the prescriptions of the attending physician.

If you do not pay enough attention to this period, then some complications can develop, which can disrupt the functionality of the hand for life.

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For example, stiffness of joints in the wrist joint, deformation and numbness of the hand or stagnant edema.

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Such phenomena require medical treatment, and sometimes, to eliminate such complications, surgery may even be required. Therefore, it is necessary to understand the importance of a proper period of rehabilitation, since otherwise it is simply impossible to return to a full life.

Now you know what to do with a dislocated hand and how to help the victim.

A source: https://1travmpunkt.com/vyvihi/ruk/luchezapyastnogo-sustava.html

Dislocation of the hand: symptoms and help

The classical concept of dislocation involves the result of the displacement of the farther part of the articular joints relative to the central joint (in the spine, on the contrary). The joints of the hand are constantly subjected to a high load during work, lifting of the gravity, so they are most often injured.

A special case is a dislocation of the hand. Man is used to using his hands to protect. Falling, he reflexively substitutes the brush, because of what the dislocations of this zone occur most often with domestic and sports injuries, falling into the ice.

On the arm may suffer with injury any joints: clavicle, shoulder, elbow with subluxation of the head from the radius, brush, finger phalanx.

The causes and mechanism of dislocation formation

Traumatologists do not argue about the classification of dislocations. It reflects the mechanism of injury, its nature, features of pathology.

Dislocations on the upper limb, as in other places, it is common to divide into congenital and received during life.

Congenital arises in connection with a weak ligamentous apparatus of the joint, metabolic changes in bone tissue with congenital insufficiency, hereditary diseases.

Acquired, in turn, is divided into:

• pathological - appear against a background of serious diseases with destruction of bones, inflammation of the joint bag (rheumatoid polyarthritis, bacterial or purulent arthritis, specific lesions in tuberculosis, psoriasis, tumors), with neurological pathology, typically gradual development and manifestation of symptoms when the load is increased;
• traumatic - are more common among young active people.

Men are treated for dislocations 5 times more often than women

The mechanism of dislocation formation is associated with exceeding the physiological capabilities of the joint in terms of the volume of movements. There is always a force that is disproportionate to the anatomical structure and functions of the osseous joint. This pathology can be combined with:

• external or intraarticular fracture (fracture);
• damage to the capsule;
• rupture of tendons and nerve trunks;
• bleeding due to impaired vascular integrity.

In relation to the mutual arrangement of articular endings, all dislocations are divided into:

• incomplete (subluxation) - if the displaced segment of the articular bone surface remains within the total area of ​​contact;
• complete - the peripheral bone completely exits its articulated end from the articulation.

Why it is important to know the time of injury

Practical value for the possibilities and choice of the method of treatment has the prescription of the origin of the trauma. Doctors-trauma specialists distinguish dislocations:

• fresh (up to three days);
• stale (2 to 3 weeks);
• obsolete (more than 3 weeks);
• The usual (repeated 3 times or more).

The more time passed after the injury, the more the surrounding muscles contract. The doctor is more difficult to correct the dislocation.

Tactics of treatment with a recent dislocation - urgent adjustment under anesthesia, the muscles are quite relaxed.

If the patient has appealed after a long time, there will be no attempts of correction, since the divorced ends Articular surfaces can be held not only by the muscles, but also by scar tissue, only the operative treatment.

Clinical symptoms of pathology in the defeat of the hand depend on the specific joint. We will consider them in connection with the most widespread mechanism of a trauma and prospective volume of the help.

Dislocation of clavicle

Dislocations of the clavicle account for 10-15% of the same pathology (third in frequency). The most traumatic place is the acromial end. The sternoclavicular joint is less often damaged.

Trauma can be:

• straight - a blow to the collarbone, it rests against the rib, a lever is created, with which the acromial end dislocates;
• indirect - the person falls on the shoulder, the elbow, while the force in the direction of the action coincides with the axis of the clavicle.

Usually there is a displacement of the acromial end upward, and the sternal forward (the squamous localization is extremely rare).

Symptoms are very typical, and it is not difficult to diagnose. The injured person has a pain in the place of injury.

During the examination, the doctor determines the apparent deformity, swelling of the tissues, possibly, hematoma. When palpation, the displaced end of the clavicle is found.

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If the hand is pressed against the body, then the symptom of the "key" is noted: a slight depression on the end causes the clavicle to become trapped inside.

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X-ray examination of the patient is carried out in a standing position. This allows you to strengthen the displacement against the background of the hanging hand. In prone position, it becomes less significant.

The only treatment is the correction under local novocaine anesthesia.

The acromial end is adjusted in the tight arm position. The sternal articulation is deduced at the maximum dilution of the shoulders to the sides and back (before the connection of the blades).

The next stage is the creation of temporary immobility for the restoration of muscular support and ligaments.

More article:Rehabilitation after a dislocation of the shoulder joint

To do this, use:

• corset gypsum dressing with shoulder retraction at an angle of 90 degrees using a standard or specially made of gypsum pelota (curved tire, supporting the required angle and connected with corset);
• in neglected cases, with a strong contraction of the muscles and a pronounced displacement, a planned operation is performed, where the needle is inserted through the acromial process under general anesthesia, and the ligamentous apparatus is strengthened.

Wearing a dressing is shown for a month, then massage, physiotherapy and hand development using exercise therapy are prescribed.

Dislocations of the shoulder joint

Dislocations of the shoulder are most common in injuries. With all its variety of movements, the joint is poorly protected: a thin capsule, relatively soft ligaments.

The mechanism of occurrence is more often associated with an indirect effect in the fall, the struggle. The shoulder end can be displaced in any direction, opposite to the application of force.

The head of the humerus leaves:

• forward under the collarbone, if the victim fell on a retracted, fully extended arm;
• back under the corpuscles of the scapula, if the arm is additionally rotated;
• down into the armpit, if the injury occurred against the backdrop of a sharp shoulder tap.

On displacement of the shoulder end of the joint, dislocations are distinguished:

• subclavian (anteroposterior),
• front,
• axillary,
• Back (the rarest due to strong muscles on the back surface).

Clinical signs are visible on the characteristic position of the shoulder (the victim supports the arm withdrawn to the side and back). Deformation in front and lower dislocations does not cause doubts in diagnosis. Deflation of the deltoid muscle, edema or bruising, smoothing subclavian fossa, is determined.

Be sure to conduct an x-ray to exclude possible fractures.

One way to reinforce the head of the humerus

You can treat fresh dislocations by restoring under anesthesia.

Traumatologists should repeat the reverse mechanism of the injury mechanism, so that the head of the shoulder is in its place. The choice of the method of correction depends on the degree of muscle contraction, the age of the patient, the traumatologist's skills, the type of dislocation.

The methods of Koher, Hippocrates, Mott, and Janelidze are most often used.

Fixation of the hand is the same as when the collarbone is dislocated. Term of wearing gypsum up to 7 weeks. Premature termination leads to a stretching of the capsule and habitual dislocation. A too long term contributes to the formation of contracture, difficulties in restoring the function.

What are the dislocations of the forearm

Dislocations of the forearm joints are in second place behind shoulder dislocations. Distinguish the following subspecies:

• posterior or anterior dislocations of both bones of the peripheral part of the joint;
• only the head of the adult radius;
• subluxations of the head of the radial bone in childhood;
• fracture.

Most often, traumatologists meet with posterolateral displacement of both bones of the forearm. They are combined with detachments of the epicondyle of the humerus, a fracture of the coronoid process.

Formed by falling on the maximally extended elongated arm. In this case, the elbow process wedges into the humerus, creates a lever for the displacement and rupture of the capsule.

Anterior dislocations are provoked by a fall on the arm bent at the elbow.

Symptoms are typical:

• elbow swollen and deformed;
• the victim "carries" the affected arm in a bent position;
• when viewed, the tip of the elbow is not visible;
• the hand deviates to the outside;
• movements in the elbow are impossible, any attempts are very painful;
• in the case of a posterior dislocation, the ulnar nerve is damaged, there is numbness of the arm, neurologic manifestations.

The correction is carried out under anesthesia with complete relaxation of the muscles.

Fixation of the hand is carried out with the help of the back gypsum langet at an angle in the elbow fold of 80 degrees. Gypsum is applied from the shoulder to the metacarpophalangeal articulations.

Since contractures in the elbow joint are formed quickly, complete immobility is observed up to 12 days, then development begins.

Massage and thermal procedures are recommended no earlier than a month after the injury. They can accelerate unwanted scarring processes.

Typical appearance with elbow dislocation

Children's subluxation of the head of the radius

The dislocation of the hand in the child has its anatomical features. The fact is that in childhood the following occurs:

• the head of the radius in shape more resembles a triangle than the roundness;
• bone tissue is underdeveloped;
• ligament and capsule elbow have increased elasticity.

Typical mechanism of injury - the mother holds the baby by the hand and sharply pulls for itself, less often the subluxation occurs when falling on an elongated and unfolded arm inside.

Immediately after the trauma, the child cries from pain and presses his bent elbow toward him. X-ray symptoms are not present, therefore the doctor acts on the reaction of the baby: the forearm is gently pushed aside and turns with the palm of the hand outward. Pain immediately disappears, which indicates correct correction.

Mummy is recommended to take care of the weak hand of the baby.

How dislocations appear in the hand

The anatomical structure of the hand includes many small articular surfaces. Dislocations of the hand are more often associated with a fall, a blow of the palm with the adoption of a reflex protective deflected position.

The most common dislocations:

• semilunar bone,
• metacarpals,
• finger phalanx.

In the second row of the wrist bones, lesions occur much less frequently (periloonal and wedge-like dislocations).

For the development of dislocation of the semilunar bone, a mechanism of its compression between the radial and adjacent bones is necessary.

This causes a rupture of the ligaments and a turn of the bone in the palmar side under the flexor tendon of the fingers.

Use of standard tires for fixation after repositioning of the thumb

X-ray manifestations are observed in the lateral projection of the wrist.

The correction is made with a tight wrist. Immediately superimposed plaster lingeta first for a week, then it is removed, the brush is aligned with the axis of the forearm with a new longure for another 3 weeks.

The old dislocation operates with the imposition of Ilizarov's apparatus through adjacent bones.

Periloonal dislocation occurs when supported on the palmar surface. Torn ligaments on both sides of the wrist.

The skin above the wrist is edematous, any movements are sharply painful, deformation is visible. Disturbance of sensitivity occurs due to damage to the radial nerve.

The diagnosis is confirmed on the lateral radiograph.

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Dislocation is eliminated with a stretched brush. The back gypsum longus is needed for up to three weeks.

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At boxers at a hit traumatized heads of metacarpal bones (more often 3 and 4-I), they are displaced in the back party. Treatment is limited to planned repositioning or installation of spokes with fixation.

How do finger finger phalanges appear on the wrist

The first finger suffers more than others because of a strong overdistension, the capsule of the joint on the palmar surface is torn. Pain, swelling, typical position of the finger indicates damage. The diagnosis is confirmed radiologically.

When guided under local anesthesia, the finger is brought to a semi-bent position and fixed with a longus for 2 weeks.

If the dislocation occurred in interphalangeal joints, the direction is similar.

Dislocation in the joint of the little finger between the main and middle phalanxes, obvious deformation of the finger

How to provide first aid

Joints of the hands suffer most during physical work, sports, provided frequent falls (in football players, volleyball players, athletes). High workload of the trauma centers is usually observed in icy conditions. The danger to pedestrians is greatly increased.

Providing first aid to a traumatized person, it should be remembered that one can not try to fix the damaged joint on its own, use the "to straighten out" the damaged portion of the arm.

You can apply cold to the place of soreness, give an anesthetic drug from the medicine cabinet. For fixation, you should use scarves, scarves, plaques.

In life there are so many traumatic factors that you should always be careful about your movements. Do not wear slippery shoes in icy conditions. It is necessary to monitor the correct position of the hands when practicing sports, to learn how to fall optimally in order to reduce the damaging effect.

A source: http://MoyaSpina.ru/bolezni/vyvihi-ruki-simptomy-pomoshch