The dislocation of the elbow joint is a process in which the dislocation of the radial and ulnar bone occurs. This injury is the most common type of limb injury. This is due to the active movement of the hands and the impact of physical exertion on them. In the ICD-10 system, a dislocation of the elbow joint is assigned to the S53 code.
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Important! Human elbow has a complex device and consists of radial, ulnar and humerus. This device creates high strength and allows the forearm to move in different directions.
Classification
Depending on the complexity of the lesion, two types of elbow dislocation are distinguished:
- incomplete or subluxation( presence of partial contact between the bone surface);
- complete( absolute dissociation of the joint surface).
Depending on the direction of the displacement:
- front view;
- rear view;
- side view.
In medicine, there are dislocations of pathological, habitual and open appearance. The first kind happens due to ailments of muscles and joints. The habitual appearance is formed due to the weakening of the ligament apparatus, in which the surface of the joint is displaced under the influence of the slightest load. It is rare. With an open view, a dislocation of the ulna head occurs, disrupting the integrity of the soft tissue and exiting outward.
The ulnar joint is surrounded by ligaments, vessels and nerve endings that can be damaged when strong physical exertion is applied. There is a risk of their rupture. Fractures and dislocations are simultaneously called fractures.
Causes and symptoms
There are several causes of the damage:
- indirect injury( the site of the force action is away from the damaged joint);
- direct effect( application of force directly to the joint);
- stretching of a random character( for this reason a dislocation happens only in a child up to the age of three).
Symptoms of elbow dislocation:
- unbearable pain at the site of the dislocation or along the entire arm;
- swelling and redness;
- lack of joint mobility;
- loss of sensitivity;
- damage to the integrity of the joint capsule;
- deformation of joint forms;
- palpation of the head of the bone by the method of palpation;
- unnatural bending of the hand;
- body temperature is above normal;
- state of chill;
- numbness and tingling in the lesion site.
This symptom is a reason for urgent treatment in the hospital.
First aid
So what should I do if I get a dislocation? After receiving an injury, you need to contact a traumatologist. But to prevent complications, it is important to provide immediate primary care:
- to create immobility of the limb and apply a cold object;
- call an ambulance or take the injured person to the emergency room.
Important! During first aid during dislocation, try not to cause harm. It is forbidden to manually insert the joint and move the injured limb. How to correct the dislocation correctly, the medical specialist knows.
Diagnostic Methods
To determine the damage received, the traumatologist conducts an examination and a series of examinations. Initially, the physician draws attention to external signs:
- Checks the pulse on the injured hand and compares it with the value of the indicator on a healthy limb.
- Checks blood flow disorders by pressing on each nail plate in turn. Normally, they lighten after pressing, and after a couple of seconds the normal pink color returns.
- Checks the functioning of the nerves. To check the radial nerve it is necessary to bend the wrist in the wrist. The work of the ulnar nerve is checked by the dilution of the fingers on the sides. The medial nerve is checked using the thumb and little finger.
- Checks the skin for sensitivity.
- Detects the displaced articular head in accordance with the classification.
After the examination, instrumental diagnostics is carried out, which includes:
- radiography;
- arteriogram( x-ray of vessels on contrast) or ultrasound;
- examination by a neurologist( determination of motor ability, application of electromyography).
Based on the results of the tests, a diagnosis is made and appropriate treatment is prescribed. Dislocation of the arm in the elbow joint is subject to mandatory correction and immobilization.
Methods of treatment
After all examinations, inpatient treatment is prescribed, lasting about a week. Treatment procedures include:
- premedication( use of analgesic, anti-inflammatory and sedative drugs by intravenous or intramuscular route of administration);
- rheolocation( the method of correcting the dislocation depends on the type of dislocation and is performed under local or general anesthesia);
- microsurgical intervention in cases of violation of the integrity of the joint capsule;
- immobilization( fixing a sick elbow to prevent movement).
Treatment immediately after repositioning is the fixation of the gypsum arm from the middle of the shoulder to the hand. Such immobilization allows the repair of damaged cartilage tissue. How much to wear a plaster is determined by a doctor. Usually the duration is 5 - 7 days. It is allowed at this time to perform simple finger movements to maintain blood flow in the hand and prevent tissue necrosis.
Important! For serious injuries and injuries to nerve endings, the treatment is handled by an appropriate specialist.
The main treatment begins after the removal of gypsum and is aimed at joint development. With a long time in the cast, a blood circulation disorder may occur and partial atrophy may occur. This phenomenon is expressed in that the elbow joint does not unbend after dislocation. What to do with such a deviation and how to develop a hand after the dislocation?
Restoration of the full functionality of the elbow is carried out at the expense of a complex of activities:
- classes in therapeutic physical culture and swimming;
- massage sessions;
- regular visits to physiotherapy;
- regular use of reconstructive baths, compresses and ointments;
- maintenance of immunity.
Therapeutic physical culture
Physiotherapy is a set of exercises to restore the amplitude of the movement of the hand. Performing special twists and turns of the injured limb, classes with a stick, rolling pin, ball are mandatory restorative measures. Performing exercise is better under the supervision of a physiotherapist, and if there is no such possibility, then independently, but strictly according to his instructions. There are rules for carrying out exercise therapy during dislocation, which should be followed:
- increase the intensity of physical activity gradually;
- movements should not cause pain.
For each case, the physician selects the appropriate set of exercises with the required load and intensity.
Important! It is allowed to swim 3 or 4 weeks after the removal of gypsum. With the help of swimming, the hand is quickly restored, as water has a stimulating effect on the muscles.
Massage and physiotherapy
Massage helps to increase the flow of blood to the damaged joint. This contributes to the receipt of the necessary substances. Massage reduces inflammation and restores the joint. Electrophoresis sessions relieve pain and edema. Under the influence of heat, the joint becomes less constrained, the blood flow and lymph flow normalizes.
Application of compresses and ointments
External ointments and compresses saturate articular tissue with important trace elements through the skin. Drugs of local effects are almost not absorbed into the bloodstream and rarely give an adverse reaction. With the help of ointments can remove pain, reduce puffiness, prevent the formation of an inflammatory process and accelerate recovery. There are several types:
- anesthetic and anti-inflammatory( "Ibuprofen", "Voltaren", "Diclofenac", "Naiz");
- warming action( "Capsicum", "Finalgon", "Apizartron");
- combined( "Allantoin").
When hematomas and bruises are prescribed, "Heparin", "Troxevasin", "Troxerutin".
Thanks to traditional medicine, tissues are restored. Compresses are applied that are made on the basis of hot milk, alcohol propolis, onion or wormwood.
Treatment of dislocation in children
When the child complains of severe pain and discomfort in his hand, parents should immediately inspect the limb. If there are symptoms of dislocation of the elbow joint in children, you should immediately seek help from a doctor. Treatment at home is not permissible. The adult should immobilize the injured hand of the child, and place the package with a cold filling on the damage site. Older children are allowed to take an analgesic drug.
Before directing the dislocation, the doctor determines the type of damage. After the placement of the joint, X-rays are taken to its place, which verifies the contact of the elbow joint surfaces with each other. With complex damage, surgery is performed with further overlapping of the tires. The final stage is the rehabilitation period.
Possible complications and prognosis of
Negative consequences and complications after dislocation can be avoided if timely medical care is received. The prognosis is favorable in the absence of damage to large vessels and nerves. The most common consequences of dislocation of the elbow joint include a decrease in its mobility and osteoarthrosis. With the proper conduct of treatment and rehabilitation in the near future, the patient will return to the old way of life, and the hand will recover to normal state.