Supracondylar fractures of the humerus. Fracture of the epicondyle of the humerus Displaced fracture of the medial epicondyle of the humerus

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Reasons. Uncoordinated fall with support on an extended arm with a tendency to hyperextend. In this case, there arises extensor fracture: the peripheral fragment moves posteriorly and outward, the central fragment moves anteriorly and inwardly. An uncoordinated fall on the elbow with the forearm sharply bent leads to flexion a fracture in which the peripheral fragment is displaced anteriorly and outward, and the central fragment is displaced posteriorly and inwardly.

There are extra-articular fractures (type A), incomplete intra-articular (type B) and complete intra-articular (type C) (see UKP AO/ASIF).

Signs. Deformation of the elbow joint and the lower third of the shoulder, the arm is bent at the elbow joint, the anteroposterior size of the lower third of the shoulder is increased, the olecranon is displaced posteriorly and upward, and there is a recess on the skin above it. A hard protrusion (the upper end of the peripheral or lower end of the central fragment of the humerus) is palpated in front above the elbow bend. Movement in the elbow joint is painful. The symptoms of V. O. Marx (violation of the perpendicularity of the intersection of the shoulder axis with the line connecting the epicondyles of the shoulder) and Guter (violation of the isosceles triangle formed by the epicondyles of the humerus and the olecranon process) are positive (Fig. 1). Pathological mobility and crepitus of fragments are determined.

Rice. 1. V. O. Marx’s sign: a - normal; b - with a supracondylar fracture of the humerus

These fractures should be differentiated from forearm dislocations. Control of peripheral circulation and innervation is mandatory (risk of damage to the brachial artery and peripheral nerves!). The final nature of the damage is determined by radiographs.

Treatment. First aid is transport immobilization of the limb with a splint or scarf, administration of analgesics. For extra-articular fractures, after anesthesia, the fragments are repositioned (Fig. 2) by strong traction along the axis of the shoulder (for 5-6 minutes) and additional pressure on the distal fragment: for extension fractures anteriorly and inwardly, for flexion fractures - posteriorly and inwardly ( the forearm should be in a pronated position). After reposition, the limb is fixed with a posterior plaster splint (from the metacarpophalangeal joints to the healthy shoulder girdle), the limb is bent at the elbow joint up to 70° for extension fractures or up to 110° for flexion fractures. The arm is placed on an abduction splint for 6-8 weeks, after which movements are limited with a removable splint for 3-4 weeks. If reposition is unsuccessful (x-ray control!), then the question of surgical treatment is raised. If there are contraindications to surgery, skeletal traction is applied to the olecranon process for 3-4 weeks, then the limb is immobilized with a splint for up to 8 weeks. from the moment of injury.

Rice. 2. Reposition of fragments in supracondylar fractures of the humerus: a - with flexion fractures; b - for extension fractures

Rehabilitation - 4-6 weeks.

Working capacity is restored after 2 1/2 — 3 months

The use of external fixation devices has significantly increased the possibilities of closed reduction of fragments and rehabilitation of victims (Fig. 3). Strong fixation is provided by external osteosynthesis; it allows you to begin early movements - on the 4-6th day after surgery, which ensures the prevention of contractures. Fixation is carried out with lag screws, reconstructive and semi-tubular plates (Fig. 4). After the operation, a plaster splint is applied to the limb bent at a right angle at the elbow joint for a period of 2 weeks.

Rice. 3.

Rice. 4. Internal osteosynthesis of the distal humerus using screws, compression and reconstruction plates

For a type B fracture without displacement of the fragments, a plaster splint is applied to the posterior surface of the limb in a position of flexion at the elbow joint at an angle of 90-100°. The forearm is in an average physiological position.

The period of immobilization is 3-4 weeks, then functional treatment is carried out (4-6 weeks).

Working capacity is restored after 2-2 1/2 months.

When fragments are displaced, skeletal traction is applied to the olecranon process on an abduction splint. After eliminating the displacement along the length, the fragments are compressed and a U-shaped splint is applied along the outer and inner surfaces of the shoulder through the elbow joint, without removing traction. The latter is stopped after 4-5 weeks, immobilization - 8-10 weeks, rehabilitation - 5-7 weeks. Working capacity is restored after 2 1/2 -3 months. The use of external fixation devices reduces the time required to restore working capacity by 1-1 1/2 months.

Open reduction of fragments is indicated in cases of impaired blood circulation and innervation of the limb.

Fractures of the humeral condyle in adolescents are observed when falling on the abducted hand. The lateral part of the condyle is most often damaged.

Signs: hemorrhages and swelling in the elbow joint; movement and palpation are painful. Huther's triangle is broken. The diagnosis is confirmed by X-ray examination.

Treatment. If there is no displacement of the fragments, the limb is immobilized with a splint for 3-4 weeks. in a position of flexion at the elbow joint up to 90°.

Rehabilitation - 2-4 weeks.

When the lateral fragment of the condyle is displaced, after anesthesia, traction is performed along the axis of the shoulder and the forearm is deviated inward. The traumatologist sets it by applying pressure to the fragment. When repositioning the medial fragment, the forearm is deviated outward. A control radiograph is taken in a plaster splint. If closed reduction fails, then surgical treatment is resorted to, fixing the fragments with a knitting needle or screw. The limb is fixed with a posterior plaster splint for 2-3 weeks, then exercise therapy is performed. The metal retainer is removed after 5-6 weeks.

Rehabilitation is accelerated with the use of external fixation devices.

Fractures of the medial epicondyle of the humerus

Reasons: fall onto an outstretched arm with outward deviation of the forearm, dislocation of the forearm (the torn epicondyle can become pinched in the joint during reduction of the dislocation).

Signs: local swelling, pain on palpation, limited joint function, violation of the isosceles of Huter's triangle, radiography allows you to clarify the diagnosis.

Treatment. The same as for a condyle fracture.

Fracture of the head of the humeral condyle

Reasons: falling on an outstretched arm, while the head of the radial bone moves upward and injures the condyle of the shoulder.

Signs. Swelling, hematoma in the area of ​​the external epicondyle, limitation of movements. A large fragment can be felt in the area of ​​the ulnar fossa. In diagnosis, radiography in two projections is crucial.

Treatment. The elbow joint is hyperextended and stretched with varus adduction of the forearm. The traumatologist sets the fragment by pressing it with two thumbs downwards and backwards. The forearm is then flexed to 90° and the limb is immobilized in a posterior plaster splint for 4–6 weeks. Control radiography is required.

Rehabilitation - 4-6 weeks.

Working capacity is restored after 3-4 months.

Surgical treatment is indicated for unresolved displacement, when small fragments blocking the joint are torn off. A large fragment is fixed with a knitting needle or lag screws for 4-6 weeks. Loose small fragments are removed.

During the period of restoration of the function of the elbow joint, local thermal procedures and active massage are contraindicated (they contribute to the formation of calcifications that limit mobility). Gymnastics, mechanotherapy, sodium chloride or thiosulfate electrophoresis, and underwater massage are indicated.

Complications: Volkmann's ischemic contracture, arthrogenic contracture, paresis and paralysis of the forearm muscles.

Traumatology and orthopedics. N. V. Kornilov

Most often found in children and adolescents aged 7 to 17 years. Avulsion of the internal epicondyle occurs with significant abduction of the forearm and excessive extension at the elbow joint. In this case, the internal collateral ligament, which at one end is attached to the epicondyle, sharply tenses. Since this ligament is very strong, it does not rupture, but is torn away from its attachment along with a piece of the epicondyle in adults or the entire epicondyle in children. A fracture of the epicondyle can also occur due to direct trauma - a direct blow to the back surface of the elbow joint.

The epicondyles have independent ossification nuclei, which appear at different times: in the external epicondyle at the 12-13th year of life, in the internal at the 5-6th year. Fusion of both epicondyles with the metaphysis of the humerus occurs at 17-18 years of age, so many believe that before this age, every epicondyle fracture is an epiphysiolysis.

Epicondyle fracture- this is, as a rule, an extra-articular injury (the articular capsule is attached distal to the epicondyle), however, in some cases, with excessive abduction of the forearm, a transverse tear of the articular capsule occurs and dislocation or subluxation of the forearm occurs outward, which can straighten on its own. In this case, due to the traction of the muscles attached to the epicondyle (flexor digitorum superficialis, flexor carpi ulnaris, flexor carpi radialis, palmaris longus muscle, etc.), it moves downward and can become pinched between the articular surfaces of the humerus and ulna. Injury can also occur due to inept reduction of a dislocated forearm.

When separated from the internal epicondyle determine the characteristic signs: sharp pain on palpation of the fracture area, hemarthrosis, hematoma and swelling, which are somewhat less pronounced than with other fractures in this area. In the first hours, when the swelling is small, you can palpate the torn epicondyle. Movements in the joint are possible and not very painful. When the epicondyle is pinched, movements are sharply limited and painful, passive movements are sharply painful, and when trying to perform full extension of the forearm or increase the abduction of the forearm, cranugia. An x-ray of the elbow joint, taken in two projections, allows us to clarify the nature of the fracture (Fig. 28). Sometimes, for comparison, it is necessary to resort to x-rays of the intact elbow joint. When examining the victim, it is necessary to check the motor and sensory conductivity of the ulnar nerve, which is located in the groove running along the posterior surface of the epicondyle, as a result of which it is often injured.

Rice. 28. Fractures of the internal epicondyle.

Treatment of internal epicondyle fractures depends on the nature of the displacement of the fragment. For non-displaced fractures, when only a narrow gap is visible on the radiograph, you can limit yourself to applying a posterior plaster cast in children for no more than 1 week, and in adults for 2-21/2 weeks. The splint should be deep enough; it is applied when the forearm is bent at the elbow joint at a right angle. After the specified period, the splint is removed and functional treatment begins. The function of the elbow joint is restored in children after 2-21/2, and in adults after 4 weeks after injury.

When the epicondyle is displaced reposition is necessary. As with other fractures in the elbow joint, local anesthesia should not be used, since the administration of novocaine further infiltrates the already swollen tissue, which makes comparison of fragments difficult. It is most advisable to use general anesthesia. Reduction of the epicondyle is best done in an X-ray room. After anesthesia is given, they begin to compare the fragments. When the epicondyle is displaced downward, it is necessary to bend the arm at the elbow joint to a right angle and give the hand palmar flexion. In this position, the muscles attached to the internal epicondyle relax. This allows you to press your thumb on the torn epicondyle to move it upward and put it in place. When the correct position of the epicondyle is confirmed by x-ray, the arm is fixed in this position using a posterior plaster splint.

When the epicondyle is displaced downward and at an angle open upward or downward, the epicondyle is adjusted as follows. If there is an angle open upward, the arm is bent at the elbow to a right angle, the thumb of one hand moves the fragment upward, and the thumb of the other hand presses the epicondyle to the humerus. When the epicondyle is displaced at an angle open downwards, the forearm is first given a valgus position, then it is bent at the elbow joint to a right angle and the epicondyle is pressed against the humerus. The position of the epicondyle is checked radiographically, after which a posterior plaster splint is applied from the upper third of the shoulder to the metacarpophalangeal joints.

The duration of fixation with a plaster splint is slightly longer than for non-displaced fractures. In children, plaster immobilization lasts 12-14 days, in adults - from 3 to 4 weeks. After removing the plaster cast, begin active movements in the elbow joint. Typically, mobility in the elbow joint is completely restored in children by the 3-5th week, in adults - by the 5th-6th.

For chronic epicondyle fractures, when more than a week has passed since the injury, patients should be sent to the hospital for surgical reduction and fixation of the torn epicondyle. The operation consists of: that a small incision is made and the epicondyle is sutured or fixed with a knitting needle.

In cases of pinched epicondyle in the elbow joint between the articular ends of the ulna and humerus, you can try to remove the pinched epicondyle in a bloodless way. To do this, the forearm is sharply valgused; the muscles attached to the torn epicondyle become tense, and it can come out of the joint. If these actions succeed in removing the epicondyle from the joint, further treatment is carried out as described above. If the pinching of the condyle remains or the patient seeks help 7-10 days after the injury, when it is impossible to remove the epicondyle from the joint, then the patients are sent to the hospital for surgical treatment.

N. G. Damier (1960) for such cases developed a method for extracting the strangulated epicondyle closed, without surgical intervention. Under X-ray control, a single-toothed sharp hook is inserted through the skin of the anterior inner surface of the elbow, hooked onto a fragment or a ligament attached to it, and pulled inwards; in this case, the fragment is easily removed from the joint space. After removing the hook, bend the arm at the elbow joint to a right angle, move the fragment upward with your finger and press it to the humerus. Further treatment is the same as for non-strangulated epicondyle fractures.

Dubrov Ya.G. Outpatient traumatology, 1986

More often in children and adolescents. Pain at the site of injury, swelling, bruising. On palpation - pain, sometimes a mobile bone fragment, crepitus. Violation of the external landmarks of the joint. Guter's line is disrupted due to displacement of the epicondyle. Movement in the elbow joint is moderately limited due to pain. There is a pronounced limitation of rotational movements of the forearm and flexion of the hand in case of injury to the internal epicondyle, and extension of the hand in case of a fracture of the external epicondyle.

HELP:

Vein catheterization. Morphine 10 mg/ml – 1 ml or Fentanyl 50 mcg/ml – 2 ml i.v. Sodium chloride 0.9% -500 ml IV drip

Cold on the injured area (ice or cryopacks).

Immobilization (stair splint).
Tactics. Hospitalization. If you refuse hospitalization - an asset in the health care facility.
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FOREARM

S52.1. Fracture of the upper end of the radius.
RADIAL HEAD FRACTURE
An external examination reveals swelling along the anterior outer surface of the articulation. Pressing on the head of the radius is painful. A positive symptom of axial load is noted. Movements in the elbow joint are severely limited, especially rotation and extension.
OLENARY FRACTURE
Pain and dysfunction of the elbow joint. The contours of the joint are smoothed due to edema and hemarthrosis. On palpation, sharp pain is noted in the fracture zone; if the fragments are displaced, a slit-like recess is detected, running transversely to the length of the bone. The triangle and the Potter line are broken. Movement in the elbow joint is limited due to pain. In displaced fractures, active extension primarily suffers, as the triceps brachii muscle is activated.
S52.2. Fracture of the body [diaphysis] of the ulna.
S52.3. Fracture of the body [diaphysis] of the radius.
S52.4. Combined fracture of the diaphysis of the ulna and radius.
S52.0. Fracture of the upper end of the ulna.
S53.0. Dislocation of the radial head.
S52.5. Fracture of the lower end of the radius.

Montage fracture: fracture of the ulna in the upper third with dislocation of the radial head.
Pain in the area of ​​the fracture and the elbow joint, which is deformed due to swelling and protruding posterior or anterior head of the radial bone, limitation of functions due to pain, shortening of the forearm.
Galeazzi fracture: fracture of the radius in the lower third with dislocation of the head of the ulna.
Extensor type. Flexible type.
Pain and dysfunction of the wrist joint, angular deformation of the radius, pain on palpation. The head of the ulna extends outward and toward the dorsal or palmar side and is movable. Her movements are painful.
"Luch" in a typical place
Extension fracture(Collis extension fracture) A fall on an arm that is extended at the wrist joint, although it is also possible with direct violence. Typical displacement: the central fragment is displaced to the palmar side, the peripheral fragment - to the dorsal and radial side. An angle open to the rear is formed between the fragments.
Flexion fracture(flexion, Smith's fracture) occurs when falling on a hand bent at the wrist joint, less often - from a direct mechanism of impact. The peripheral fragment is displaced to the palmar and radial sides, the central one - to the dorsal side. An angle open to the palmar side is formed between the fragments.
FRACTURES OF THE WRIST AND HAND
Lunate fracture
S62.1. Fracture of other wrist bone(s).
A fracture of the lunate bone occurs as a result of a fall on the hand, which is abducted to the ulnar side. Complaints of pain and limited movement in the wrist joint. A swelling is detected on the dorsal surface of the middle of the wrist. Axial load on the III-IV fingers, palpation of the lunate bone area and dorsal extension of the hand are painful. Movement in the wrist joint is limited due to pain.
Scaphoid pearl
S62.0. Fracture of the scaphoid bone.
A fracture usually occurs when falling on an outstretched arm, with emphasis on the hand. Clinical manifestations are quite scarce and are most often regarded as a bruise of the wrist joint. Complaints of pain in the wrist joint, limitation of its functions. On examination, there is swelling on the radial side of the joint in the “anatomical snuffbox” area. Axial load on the first finger causes pain at the point of the scaphoid bone. Movements in the wrist joint are limited and painful, especially when the hand deviates to the radial and dorsal sides.
S62.2. Fracture of the first metacarpal bone.
Complaints of pain at the fracture site, limited hand function. The radial side of the wrist joint is deformed due to the protruding first metacarpal bone and edema. The contours of the “anatomical snuffbox” are smoothed. Palpation of the first carpometacarpal joint and axial load on the first finger are painful. The adduction, abduction and opposition of the first finger are sharply limited.
Fracture of the metacarpal bones.
S62.3. Fracture of the other metacarpal bone.
Significant swelling of the back of the hand, bluish coloration due to bruising. When the hand is clenched into a fist, the convexity of the head of the metacarpal bone disappears when its body is fractured. Palpation of a broken bone is painful; sometimes displaced fragments can be felt (in the form of steps). A positive symptom of axial loading is when pressure on the head of the metacarpal bone or on the main phalanx of the finger along the long axis causes pain at the site of the suspected fracture. Movements in the joints of the hand are limited, and the grasping function is severely impaired.

FRACTURED FINGERS
S62.5. Fracture of the thumb.
S62.6. Fracture of another finger.
S62.7. Multiple finger fractures.

HELP:

Ketorolac(Ketorol) 3% -1 ml IM or

Tramadol(Tramal) 2 ml i.v.

Cold applied to the injury site (ice or cryopacks)

Immobilization(disposable or foldable splints)
Tactics

Delivery to the trauma center - fracture of the “ray” in a typical place, the bones of the wrist, hand.

Hospitalization – fracture of the forearm bones.

If you refuse hospitalization - an asset in a health care facility.

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Injuries to the elbow joint make up a small proportion of all musculoskeletal injuries in athletes, but regardless of this, injuries to the elbow joint pose a serious danger, as they lead to serious consequences. As is known, this joint is characterized by great sensitivity to various types of injuries, due to the developed network of blood vessels and nerve plexuses. In sports such as weightlifting, tennis, fencing, wrestling, acrobatics, a large functional load is placed on the elbow joint, and therefore requires literacy and accuracy in the athlete’s exercises.
Exceeding the normal range of motion in a joint, unless it is for a long period of time, does not often lead to major damage. But as a result of repeated microtraumas, scar tissue forms at the site of damage, which leads to dangerous consequences.

Anatomy of the elbow joint

The elbow joint is formed by three bones: 1) humerus; 2) radial; 3) elbow. It is a complex joint in its structure, since there are 3 different joints located in one capsule:

1. The humerus-ulna is formed by the trochlea; the humerus is a trochlear notch of the ulna. According to the anatomical structure, it is a trochlear joint, its surface is helical in shape.
2. The humeroradialis is formed by the head of the condyle of the humerus and the articular fossa of the radius. Its shape is spherical.
3. Radioulnar - formed between the articular surface of the head of the radius and the radial notch of the ulna. Its shape is cylindrical.

The elbow joint is strengthened on the sides by ligaments called collateral. The humerus has 2 epicondyles, they are located on the sides of the bone: medial and lateral. The epicondyle is a protrusion that is present on the surface of the condyle; it does not participate in the formation of joints, but only serves as a place for attachment of ligaments and muscles. The flexor muscles of the hand and fingers, as well as the ligaments of the elbow joint, are attached to the lateral and medial epicondyles.

What muscles originate from the medial epicondyle?

1. Pronator teres – it is attached to the body of the radius. Involved in pronating the forearm, that is, it rotates it inward so that the palm turns down.
2. Flexor carpi radialis – descends to the base of the palm and is involved in flexing the wrist.
3. Palmaris longus muscle - goes inside, comes from the flexor radialis, goes to the palm, and is involved in flexing the hand.
4. Flexor carpi ulnaris – descends along the inner part of the forearm, attached to the bones of the palm. Involved in bending the hand and moving it.

Now that we know which muscles originate from the medial epicondyle and where they are attached, it will be easier to understand the symptoms of medial epicondylitis.

Reasons for development

Damage to the above muscles can be a direct result of blunt trauma or a consequence of sudden muscle tension. Medically, medial epicondylitis is known as golfer's elbow. Since it is among athletes involved in golf, baseball, swimming, weightlifting, and arm wrestling that these muscle groups are most often injured. Because these sports require significant strength efforts in the forearm area. It should be noted that medial epicondylitis is less common than lateral epicondylitis. The reason for this is the anatomical structure. On the medial epicondyle, the muscle attachment surface is larger than on the lateral epicondyle, so it bears less load.

Why and how does injury develop? The rupture occurs in the belly of the muscle, or more often at the junction of the muscle with the tendon, as a result of excessive repeated rotational or flexion forces.

Symptoms

Characteristic of medial epicondylitis is pain over the medial epicondyle, which stretches down along the muscles. The pain increases with movement and decreases with rest. It is also aggravated by flexing the wrist joint against resistance. Most often, movement in the elbow joint is not limited. Grip strength decreases.

Diagnostics

For diagnosis, X-ray examination in two projections, ultrasound and various tests are used. X-rays show thickening in the area of ​​the epicondyles. Ultrasound shows areas of tendon inflammation and swelling or scarring of the muscles.

Treatment

Medial epicondylitis is mainly treated with conservative methods. These include cryotherapy (cold treatment), ultrasound therapy, and therapeutic physical exercises. Cold therapy is indicated during the acute period, as it relieves pain, reduces hemorrhages and has an anti-inflammatory effect. Ultrasound treatment is used to stimulate cellular turnover, thereby reducing swelling and increasing the elasticity of the tendons.

If no positive results are observed during treatment with the above methods, or the depth of the lesion is visible to the eye at the first visit to the doctor, then the doctor prescribes therapy with local blockades. Local blockade is the introduction of analgesic or anti-inflammatory drugs into the cavity where there is a lesion. The manipulation is performed as follows: first, the place where the injection will be made is anesthetized with novocaine, then the point of attachment of the tendon to the epicondyle is found and the medicine is injected. With this method of treatment, it is advisable to administer steroidal anti-inflammatory drugs, as they reduce inflammation, relieve pain and reduce tissue swelling.

But you need to know that these drugs also have side effects during treatment, so steroid drugs are administered a maximum of 3 times with an interval of 1 week. If there is no effect from conservative therapy, they proceed to surgical treatment.

In some cases, tendon inflammation becomes chronic. Then the patient should avoid overloading the forearm. Athletes are advised to change their hitting technique. Increasing muscle and tendon strength helps prevent relapses of the disease. Swimming, running, cycling help maintain good physical shape. For prevention, before performing exercises, you should thoroughly stretch and warm up your muscles.

Pain in the elbow joint: causes and treatment

• Causes of elbow pain
• How to diagnose and treat?
• Prevention

Human hands can be very strong and resilient, but they are also subject to the most powerful, intense and prolonged impacts during physical labor. This is especially true for the elbow joint. Sooner or later, this leads to the fact that the elbow begins to signal us about impending problems through pain. The obvious course of action to eliminate the causes of pain in the elbow joint is treatment, recovery and further prevention. Let's figure out what causes pain in the elbow joint, and what the doctor will most likely prescribe for us as treatment.

Why does my elbow joint hurt?

There may be many reasons why the elbow joint bothers you, but the most common ones are the following: epicondylitis, referred pain from the cervical spine, arthritis, arthrosis. Let's consider each of the listed reasons in more detail.

Epicondylitis

The disease is more traumatic in nature than pathological. Occurs when there is too intense impact on the joint, which damages the tendons. This can be either a sharp impact or a smooth but long-lasting one. For people engaged in heavy physical labor, the question of why their elbows hurt does not arise, but the same symptoms can occur after a short, but “unusual” load.

With epicondylitis, pain manifests itself mainly with rotational movements or stress on the joint. No pain is observed at rest or with everyday movements.

Referred pain

With referred pain emanating from the cervicothoracic spine, the elbow joint does not change its external appearance (as in the case of epicondylitis), but the nature of the pain changes. In this case, the pain bothers you even at rest; often the patient even wakes up at night from severe pain in the elbow joint.

Arthrosis

With arthrosis, as a rule, there is no too intense pain in the elbow. And they are felt only when you try to bend or straighten your arm as much as possible. But as for physical indicators, the situation here is different. Movements in the elbow are often accompanied by a crunching sound, stiffness is observed, the arm may not fully straighten, and over time the bone begins to deform.

Arthritis

Pain in the elbow joint due to arthritis is inflammatory in nature, and therefore they are most often quite severe. The pain bothers me not only when moving, but also at rest. The affected area swells and redness is observed.

In each of the listed cases, if the elbow joint hurts, treatment will be absolutely necessary, since the disease will not go away on its own. How to identify a disease and where to start fighting the disease? This is exactly what we will talk about next.

How to diagnose and treat?

If you experience severe pain, the causes of which are not entirely obvious to you, you should immediately consult a doctor. There may be one source of pain, but the nature of the disease is very different, even infectious. In addition to pain, swelling and stiffness during flexion/extension may be observed.

First, the doctor will visually examine your elbow and order an x-ray. In most cases, treatment will be prescribed on its basis, but it is not a fact that the diagnosis will end there.

It is quite possible that you will need a blood test, urine test, and even fluorography. The fact is that such pain can be a consequence of infectious processes, in particular even tuberculosis. An infectious disease causes inflammation of the periarticular bursa. This state of affairs may require surgical intervention, sometimes extremely immediately. This is one of the reasons why you should not hesitate to visit a doctor. If the cause of the pain is still an infection, but surgery is not necessary, you will be prescribed a course of antibiotic therapy.

In less critical cases, problems arise due to various arthritis, arthrosis, epicondylitis, and, of course, injuries. Moreover, injuries may also not be entirely obvious, because an elbow injury is not necessarily a dislocation or fracture. In any of the listed cases of illness, your treatment will be handled by a traumatologist and rheumatologist.

If during treatment you still experience pain in the elbow joint, you need to deal with it somehow. For this purpose, the doctor will prescribe you tablets, injections or ointments, or even all together, depending on the specific case.

After the acute inflammation has been relieved, you will be prescribed various physiotherapeutic procedures, massage and physical therapy.

Prevention

If the disease has already overtaken you, then the choice is small - you need to start treating the pain in the elbow joint, or rather the reasons that caused it. But if the worst has not yet come to the worst, you have a chance to postpone the inevitable processes of aging, and perhaps even avoid debilitating pain in the elbow joints altogether.

Try to avoid excessive exercise, but don't overdo it. Moderate physical activity keeps muscles toned, and they, in turn, largely determine the condition of the joint. A balanced diet and avoidance of excess weight is extremely important. And don’t be lazy to carry out preventive examinations with your doctor more often.

Supracondylar fractures of the femur have features that distinguish them from diaphyseal fractures: these fractures relatively rarely give complete displacement of the fragments, and are often knocked together; Extremely high force is required to completely dislodge the fragment.

Malunited supracondylar femoral fractures reduce limb function much more than malunited diaphyseal femoral fractures. Prevention of complications lies in proper treatment of the fracture. An obligatory component is sanatorium treatment; mud is especially useful. Treatment in the Saki sanatorium is carried out using mud; this is one of the best health resorts in the post-Soviet space, where you can successfully combine relaxation and recovery.

There are three types of supracondylar femoral fractures:

• no offset;
• with displacement of fragments at the fracture site;
• with displacement of fragments at the fracture site and simultaneously with posterior deviation of the peripheral fragment (as if bending at the knee occurs).

Symptoms and diagnosis

Supracondylar fractures of the femur have the same symptoms as diaphyseal fractures: deformation of the limb, expressed in curvature, swelling in the lower third of the thigh, in the knee area. An effusion (hemarthrosis) is often detected in the knee joint. Feeling the fracture area is sharply painful, the function of the knee joint is completely impaired. When examining an injured limb, special attention should be paid to the condition of peripheral vessels and nerves in view of the possibility of their compression and damage during supracondylar fractures. X-ray examination clarifies the diagnosis.

In the mechanism of displacement of bone fragments during a fracture of the epicondyles, the main role is played by the action of external force. If during an injury with a supracondylar fracture of the femur there is no displacement, then it usually does not occur in the future, since the strength of the muscles acting on the fragments is insufficient to remove them from contact. If, at the time of injury, the fragments are displaced, then elastic retraction of the muscles turns this displacement into a permanent one.

Treatment fractures of the epicondyles, naturally, surgically. But no less important is sanatorium-resort treatment after.

The article was prepared and edited by: surgeon

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