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Fracture of the radius in a typical place: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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ICD-10 code
S52.5. Fracture of the lower end of the radius.
[What causes a fracture of the radius in a typical place?
Extensor fracture (collisional fracture fracture) is the result of an indirect trauma, a fall on the arm, unraveled in the wrist joint, although it is possible with direct violence. Displacement of fragments in extensor fracture is typical: the central fragment shifts to the palmar side, the peripheral fragment to the rear and ray. Between the fragments an angle is formed, which is open to the rear.
Flexion fracture (flexion, Smith's fracture) occurs when it falls onto a wrist bent in the wrist joint, less often from a direct mechanism of action. Under the action of the mechanism of injury and muscle contraction, the peripheral fragment is displaced to the palmar and radial sides, the central part to the rear. Between the fragments formed an angle, open in the palm side.
Symptoms of fracture of the radius in a typical place
The patient is troubled by pain and impaired function of the wrist joint.
Diagnosis of fracture of the radius in a typical place
Anamnesis
In the history - an indication of an appropriate injury.
Examination and physical examination
The distal part of the forearm is bayonet-like deformed, punctured. Palpation is sharply painful, reveals displaced bone fragments. Positive symptom of the axial load. Movement in the wrist joint is limited due to pain.
Laboratory and instrumental research
The radiograph confirms the diagnosis.
Treatment of a fracture of a radial bone in a typical place
Conservative treatment of a fracture of a radial bone in a typical place
Extensor fracture. After anesthesia, the fracture site with a 1% solution of procaine in an amount of 10-20 ml is performed by a closed manual reposition. The forearm is bent at an angle of 90 ° and creates a counterweight: traction for the brush along the longitudinal axis of the limb and in the ulnar side for 10-15 minutes. After relaxation of the muscles, the peripheral fragment is displaced into the palmar and ulnar sides. To eliminate the angular deformation, the brush is bent together with the distal fragment in the palmar side. This manipulation is usually performed through the edge of the table, placing a thin oilcloth pad under the arm first. In the achieved position (palmar flexion and light uvlarnogo lead) impose a back gypsum longe from the upper third of the forearm to metacarpophalangeal joints for a period of 4 weeks. Movement in the fingers of the brush is allowed from the 2nd day. UHF on the fracture area - from the 3rd day. After the elimination of immobilization, a course of rehabilitation treatment is prescribed .
Flexor fracture. Anesthetizing the place of fracture, perform a closed manual reposition. Create traction along the longitudinal axis of the limb, the peripheral fragment is placed along the central axis, i.e. Move it to the back and the elbow. To eliminate angular displacement, the peripheral fragment is unbent, and the brushes are given an extension position in the wrist joint at an angle of 30 °, creating a slight bending of the fingers of the hand, contrasting the first finger. In this position, a palmar gypsum longe from the elbow joint to the head of the metacarpal bones is applied. The terms of immobilization and rehabilitation are the same as in the case of Collis fracture.