Fractures of the diaphysis of the forearm

The fractures are divided into isolated fractures radial and ulnar bones and fractures of both bones.

intraosseous metallocenes fractures of forearm bones
Fig. 17. Intraosseous metallocenes fractures of forearm bones

Treatment of diaphyseal fractures is complex and consists in reduction of bone fragments, immobilization plaster cast from the base of the toes to the top third of a shoulder (arm is bent at the elbow at 90 degrees), laying on a wide gauze scarf. Periods of immobilization, depending on the nature and localization of the fracture. For example, if an isolated fracture of the elbow or the radial bone - approximately 4 weeks; fractured elbow bones with the dislocation of the radial head bone-4-6 weeks; in fractures of the two bones of the forearm, 8-9 weeks. With the dramatic shifts of diaphysis forearm bones applies surgery - intraosseous metal or osteosynthesis (Fig. 17) with the subsequent fixation limbs plaster cast or apparatus, A. Ilizarov.
On the 2nd day after the imposition of the cast (conservative or operative treatment) is assigned therapeutic physical training - 4-6 times a day. In the first period against the background of General developmental and breathing exercises are applied exercises for fingers and shoulder dosage 6-10 times; exercises in static voltage immobilized muscles and imaginary movements in the elbow joint.
In the II period (as instructed by the doctor) plaster bandage is removed during physiotherapy sessions or not. When it is removed only in the classroom (bone spur has not matured), flexion and extension in the elbow joint is performed by fixing the fracture site good hand or the hand of the instructor. After immobilization great attention is paid to the restoration of supination. Apply the same exercises, as in intra-articular fractures of the elbow joint, and exercises for wrist joint, reducing the mobility of it. Furthermore, additional classes therapeutic exercises in the manual trays or in therapeutic swimming pool.
III the period of training. It provides full load on the injured arm stops, vises, exercises with printed ball, dumbbells and other Sports training are appointed by physician individually, but not earlier than 4 months after breaking a bone (radial or elbow) and 6 months after breaking two bones.
Therapeutic physical training in the so-called epiphyseal fractures in a typical location (the lower end of the bones of the forearm) is assigned to the 2nd day after reposition with the imposition of a plaster splint from the metacarpophalangeal joints up to the upper third of the forearm (the brush in the position of the small of dorsiflexion-within 10 degrees). Immobilization of fractures without displacement lasts 4-5 weeks, fractures with offset (and in some cases with re-reposition)-6-8 weeks.
In the first period are all kinds of exercises for fingers, shoulder flexion and extension in the elbow joint. Pronation and supination contraindicated, as it may cause the displacement of bone fragments. In the II period, therapeutic exercises conducted in 5 initial positions: the arm is bent at the elbow angle of 30 degrees and elbow rests on the table; the forearm and hand lay on the table; the forearm is on the table, brush hanging; palm sick hand rests on the palm healthy hands. Exercises are performed with objects friendly with a healthy hand. Exercises in the bath with water temperature 36-38 degrees warmer water causes swelling) are held 2 times a day. Although the function of a limb is restored through 1.5-3 months after the fracture, the hand becomes fully working after 6-8 months. You cannot wear this hand of gravity, making stops, vises, turn the key in the door, as all this leads to the painful syndrome, swelling of the limbs and traumatic rising neuritis. In all ages of the exercise should not cause pain. So III period, therapeutic exercises at this turning point there is little, i.e., he comes in 6-8 months after the injury in the home.