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Hand bone Fractures are divided into fractures of the wrist, hand and phalanges. Among fractures of the wrist occur most frequently damage to the navicular bone. Treatment of fractures of the navicular bone is carried out by immobilization with a plaster bandage which is applied from the rear of heads of metacarpal bones to the elbow joint in dorsiflexion and slight ulnar bringing brush. Often the fractures of the navicular bone even after a very long period of immobilization are fused, and therefore apply metallocenes followed by fixing the brush to the rear plaster splint for a period of 1.5-2 months.
Among fractures of metacarpal bones the greatest attention deserves perelomova bases of the first metacarpal (Bennett fracture) in the context of extreme value for the function of the first finger. Treatment this damage carried out with a plaster bandage from the distal articulation of the first finger (in the position of abduction, of openenly and light bending) to the elbow joint for a period of 4-5 weeks.
When fractures of II-IV metacarpal bones and phalanges without bias impose a plaster of Paris splint is placed for 2-3 weeks on the Palmar surface of the hand from the border of middle and lower thirds of the forearm to finger tip. The other fingers are not amenable to immobilization. Physiotherapy sessions begin from the first days of immobilization.
In immob ilization period, the patient performs active movement in the elbow and shoulder joints in full, alternately and simultaneously travmirovanija and healthy upper limb. Shows the movement of each phalanx free from the immobilization of the finger, are performed in isolation of each finger, while fixing (with the help of a practitioner or self-help) proximal phalanx; isometric muscle tension in the forearm and shoulder, ideomotor movement. Special exercises carried out against the background of General developmental and breathing exercises. During this period, patients should also engage in occupational therapy, performing labor manipulation unharmed fingers.
In postmobilization period to prevent stiffness in the joints and strengthen the muscles of the hand and forearm, perform special moves all the joints of the fingers: flexion and extension of all fingers with, and then independently, the juxtaposition of each finger, flexion and extension of each phalanx of finger, grip small items with your fingers. Recommended water exercises and movements associated with household self-service. Special exercises to promote the restoration of function of damaged fingers, combined with movements in the other joints of the fingers and the fingers of a healthy hand.
In the recovery period of physiotherapy aimed at eliminating the residual restricted mobility in the joints of the damaged finger, the restoration of strength, endurance, speed, accurate coordination of movements by a brush and fingers, and also to adapt the limbs to physical stress, taking into account household and business needs. To this end, in classes include exercises with weights, resistance, isometric hand and forearm, block installation, with gymnastic items.
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