Injury of elbow

Elbow injury is also called overload because it is formed gradually due to a constant load in repetitive movements. There is even such a thing as "the elbow of a tennis player" - an inflammatory process or damage to the tendons that connect the muscles of the forearm and the bony protrusion of the outer elbow zone. Such a trauma of the elbow can develop in the athlete engaged in rowing, badminton, bodybuilding, barbell, as well as a person who works physically - the construction industry, agricultural work.

Since the elbow is structurally complex in structure, on the one hand it is an advantage in terms of the amplitude of motion and on the other hand it is a minus in the sense of vulnerability, it is possible to injure the elbow joint both in the fall and under constant mechanical stress.

The elbow joint is a hinged joint, which includes the radial, humeral and ulnar bones. They are connected by means of ligaments, tendons and muscle tissue. Most often, the elbow injury occurs when the fall, a person tend to reflexively "expose" the elbow as a possible depreciation. A fall with an emphasis on the elbow can lead to both a dislocation and a fracture of the joint. 

Elbow injury is a disease that can develop into a serious problem if it is not diagnosed and treated in a timely manner.

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Consequences of an elbow injury

Complications and consequences of elbow injury can be quite serious, according to statistics the number of complications reaches up to 40% of all diagnosed cases.

Most often, the elbow injury is accompanied by contracture - restriction of motor activity, joint mobility due to cicatricial, fibrous formations in the tendons. "Old", untreated dislocations are much less often diagnosed, and incorrect splices are rarely detected after fractures of the medial zone of the condyle or the ulnar process. Also as complications of the ulnar injury are instability of the joint due to damaged ligaments, habitual dislocation of the head of the radius and forearm, inflammation of the distal zone of the biceps tendon.

The consequences of an elbow injury almost never lead to disability, but athletes have to say goodbye to a professional career, and all other people simply suffer from mobility limitations of the elbow, which significantly worsens both health status and quality of life.

It is believed that any injury to the elbow is inevitably accompanied by some degree of contracture, so the actual contractura can act as a symptom, rather than a separate nosology. Post-traumatic stiffness leads to damage to the collateral ligament, often without damage to the bone. Contracture is most often diagnosed as arthrogenic, as it breaks congruence - adequacy and consistency, of the joint parts. If an elbow injury is accompanied by burns, then necrotic tissue processes and fascia join the arthrogenic complications.

Consequences of an elbow injury - contractures are divided into three categories: 

1. Pre-contra stage is accompanied by painful sensations, trophic changes in tissues and cartilage, especially if the elbow after injury is incorrectly fixed. This stage of contracture is considered to be curable, reversible. 
2. If the first stage is not identified as complicated, contracture continues to develop, four weeks after the trauma, abnormal morphological changes begin to occur in the surrounding tissues. The pain is aggravated by the tension of the formed adhesions in the synovium. This stage is characterized by the formation of young fibrous-scar tissue. 
3. The stage when, in connection with the continuing rigidity, the young scar tissue is transformed into a coarser, fibrous tissue. It begins scarring, tightening, a scar is formed.

In addition to contracture, the consequences of an elbow injury can also be in the form of ossification, when specific cells - osteoblasts and bone growths are formed at the site of the damage. The degree of severity of ossification depends on the severity of the injury, most often ossicas develop with trauma accompanied by dislocation of the forearm.

Ossification as a consequence of an elbow injury goes through the following stages in its development: 

1. Latent, latent period, which begins with the moment of injury and lasts two to three weeks. Ossicas on the x-ray are not visible. 
2. Osisifits begin to calcify, the x-ray shows unformed, poorly visible formations. 
3. Ossification begins to be structured and transformed into a spongy bone condition. The process lasts 3-5 months. 
4. Ossicles are formed and clearly visible on X-rays.

Ossification promotes overheating with physiotherapeutic procedures, too zealous or premature massage, non-observance of the period of immobilization of the joint.

The consequences of an elbow injury can also be expressed in dystrophic changes in muscles (myodystrophy), thromboembolism.

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Treatment of elbow injury

Ideally, treatment for elbow injury should start from the first day after getting injured. The earlier the treatment process begins, the less the risk of various complications.

How to treat an elbow injury?

If the injury looks like a bruise, immediately apply ice to the damaged area, a cold compress. To avoid complications, you should consult a surgeon and take an X-ray to avoid fracture. Next, the joint is fixed for at least one week to ensure maximum peace. Rubbing and massages can be done only after two or three days, the first day shows only the cold and fixation. For grinding, fixing the bandage for a while, remove and rub the ointment with careful circular motions. As symptomatic external agents are suitable ointments and gels, which include non-steroidal anti-inflammatory drugs-diclofenac, ibuprofen, imide. Starting from the third day, the elbow can be rubbed with warming ointments containing essential oils. Elbow joint development is permissible only after 2.5-3 weeks and is carried out in the form of performing gentle circular motions. Also physiotherapeutic warming up, swimming is also effective. The period of full recovery depends on the severity of the injury, but usually a similar elbow injury occurs a month later.

How to treat an elbow dislocation?

If the displacement of the bone structure of the forearm is diagnosed, the ligaments are also likely to be damaged. This is expressed not only in the pain symptom, but also in the absence of sensitivity of the hand, limiting its mobility. Sometimes the nerve conduction is disturbed so much that the pulse can not be felt on the wrist. First aid is ice and fixation, then you should immediately consult a doctor. It will be guided under local anesthesia, and fixing the elbow, forearm with a langete or orthosis. Conservative medical treatment consists of pain medications for the first three days, the appointment of chondroprotectors that improve the recovery of cartilaginous tissue. Immobilization of the joint lasts not less than three weeks, then a course of massage and restorative physical therapy is conducted. The complex of exercises consists of flexion-extensor and rotational movements, helping to restore the amplitude and activity of the elbow. 

How to treat a fracture of the elbow?

As a rule, a fracture occurs inside the joint, most often such a trauma is treated conservatively and only in extreme cases, when the fracture is accompanied by hemarthrosis and the formation of intraarticular cysts, an operation is shown. Fracture can be of the following types: 

• Injury of the lower epiphysis of the shoulder.
• Fracture in the area of the head elevation. 
• Fracture of the upper epiphyses of the forearm. 
• Combined fracture.

In addition, the fracture can be single or offset. The usual fracture is subject to immobilization at a classical angle of 90 degrees. If there is a bias, it is compared manually, often under local anesthesia, less frequent repositioning and fixation with the help of spokes. On the elbow, the fixing linget is applied for at least one month. During the process of bone and cartilage fusion, the appointment of non-steroidal anti-inflammatory drugs, chondroprotectors, and vitamin therapy is indicated. When the fixation is removed, a long restorative therapeutic exercise is shown, helping to reduce the risk of complications in the form of contracture. Therapeutic gymnastics should be performed daily for 4-5 approaches. Massage in fractures is contraindicated, it is replaced by complex physiotherapy procedures.