Dislocation of the forearm: causes, symptoms, diagnosis, treatment

ICD-10 code

S53. Dislocation, sprain and damage to the capsular-ligament apparatus of the elbow joint.

Epidemiology of forearm dislocation

Dislocations of the forearm make up 18-27% of all dislocations.

[1], [2], [3], [4]

Dislocation of both forearm bones posteriorly

ICD-10 code

S53.1. Dislocation of the elbow joint, unspecified.

Epidemiology

The dislocation of both forearm bones posteriorly accounts for about 90% of all dislocations in the elbow joint. The dislocation of both forearm bones posteriorly is the result of an indirect mechanism of injury - a fall on an elongated arm with a reabbling in the elbow joint.

[5], [6], [7]

Symptoms of forearm dislocation

The victim is concerned about pain and impaired function in the elbow joint, which followed the trauma.

Classification of dislocation of the forearm

In the elbow joint, simultaneous dislocation of both bones is possible, as well as isolated dislocation of the radial and ulnar bone. Depending on this, these types of dislocations of the forearm are distinguished.

• Dislocation of both forearm bones posteriorly, anterior, outward, inside and divergent dislocation.
• Dislocation of radial bone anteriorly, posteriorly, outwards.
• Dislocation of the ulna.

Indications for hospitalization

Among all the varieties of violation of congruity of the elbow joint, the dislocation of both forearm bones posteriorly and the subluxation of the head of the radial bone in children are most often met. These two nosological units are to be treated on an outpatient basis. Other types of dislocations are rare. Their elimination is associated with general anesthesia and other difficulties, so patients should be referred for assistance in the on-duty hospital.

[8], [9], [10], [11]

Diagnosis of forearm dislocation

In the history - the corresponding injury. The joint is swollen, deformed. On the back surface, at some distance from the shoulder under the skin, the elbow process extends. The triangle and the Güter line are broken. The forearm is shortened. Active and passive movements in the elbow joint are absent. An attempt to execute them causes severe pain. Mark a positive symptom of springing resistance.

Laboratory and instrumental research

On radiographs made in two projections, the dissociation of the articulating surfaces of the shoulder and forearm is revealed.

To clarify the diagnosis should check the motor function and skin sensitivity in the zone of innervation of the ulnar, radial and median nerves.

[12], [13], [14], [15]

Treatment of forearm dislocation

Redirection of the forearm is performed under general or local anesthesia. The arm is removed and slightly unbent at the elbow joint. The surgeon covers the shoulder of the injured person in the lower third with both hands so that the thumbs lie on the outstretched elbow process.

The assistant holds the brush. They make traction along the axis of the limb, and the surgeon with his thumbs moves the elbow and the radius of the radius to the front, while pulling the shoulder backwards and using it as a fulcrum. If the forearm is inserted, there are free passive movements.

It is necessary to recognize as wrong the technique of adjusting the posterior dislocation of the forearm on the bent elbow joint to a 90 ° angle, since a fracture of the coronary process may occur.

The limb is fixed with a posterior gypsum lanceata from the upper third of the shoulder to the heads of metacarpal bones. X-ray control is mandatory. The period of immobilization is 5-10 days. Then they are prescribed rehabilitation treatment: exercise therapy, physiotherapy, hydrotherapy. In the early stages of treatment should not be appointed elbow joint massage, mechanotherapy, forced passive movements, as they become rough irritants and strengthen the ossification of periarticular tissues.

Estimated period of incapacity for work

Workability is restored in 6-8 weeks.

[16], [17]