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Dislocations at the elbow joint by frequency ranked second. There are dislocations of both bones of the forearm backward, forward, outward, inward, consumable luxation; the dislocation of one of the radius forwards, backwards, and outwards; dislocation of the ulna one. The most common posterior dislocation of both bones of the forearm and a dislocation of the radius forward one. Damage to the ligamentous apparatus is often accompanied by isolation of small sections of bone tissue that leads to internal bleeding from the cancellous bone with the formation of hematoma. Develops sudden swelling of the elbow joint and forearm. All this creates conditions for sustainable limited mobility in the joint due to reflex muscle tension and arising in the future, scar-adhesive process. Therefore, to protect joints from developing contractures it is essential to brief immobilization and early rehabilitation, which were conducted in the initial stages of unstable contractions.
After reduction of the dislocation is bent back at an acute angle, the rear elbow is immobilized with a plaster splint for 7 days, and then prescribe physical therapy, combined with heat treatments. After reduction of anterior dislocation of the forearm extends to the obtuse angle, fixed rear plaster splint with the forearm spinaroonie for 10-12 days. The length of the periods of absolute and relative immobilization depends on the method of treatment and nature of damage. In uncomplicated dislocations of the forearm bones and the conservative treatment period of absolute immobilization lasts 3-4 days, relative - 14-15 days.
physiotherapy Sessions are carried out in accordance with the same principles as fractures of the elbow joint. The method of rehabilitation treatment build, based on the state of the biceps muscle of shoulder, spasm of which should be performed exercises for relaxation. Contraindicated redresse to perform passive exercises, you-click the pain and microtrauma of the structures of the elbow joint, to carry the weight of her arm for extension of the elbow joint. This leads to protective toning the biceps muscle of the shoulder and fixation of contractures. During the day it is recommended to provide the injured limb elevated position, helps improve blood and lymph flow, reduce inflammation in the affected location. In addition, conduct a Suction massage of the shoulder girdle and proximal shoulder. Massage the elbow joint, especially within 1.5-2 months after the injury, contraindicated due to tendency to develop Ossifying process in the periarticular tissues under the influence of mechanical irritation. A significant role is played by the movement in the elbow and wrist joints, performed in warm water. Need to make sure that when you exercise in water was immersed the whole hand to the upper third of the shoulder creates a more uniform thermal and hydrostatic action and allows you to freely perform movements of the elbow and wrist joints and the finger joints. In the early days the duration of physiotherapy sessions conducted 2-3 times a day, 10-15 min, then 20-30 min.
Estimated a set of special exercises with dislocation of the elbow in the second period
1. I. p. - Sitting on a chair, hands on the table. Flexion and extension of fingers. 8-12 times.
2. I. p. - The same, under the forearm summed up the sliding surface. Sliding your forearm to bend and straighten the arm at the elbow joint movement only forward (away from you). 5-6 times.
3. I. p. is The same, a shoulder on the table, forearm pointed up and brush healthy hand to support the forearm damaged. Flexion and extension of the forearm. 6-8 times.
4. I. p. is The same, hands on the table. Supination and pronation of the forearm, trying to touch the table with his palm and dorsal surface of the hand. 8-10 times.
5. P. I. - The same. Alternate pressing each finger on the table surface, 4-5 times each finger, 2-3 p.
6. I. p. - Sitting on a chair, arms on the table, forearm facing up. At the expense of 1-4 and rotational motion in the wrist joint clockwise; 5-8 - in a counterclockwise direction; perform with the highest possible amplitude, but without pain. 1-2 times.
7. I. p. - Sitting across a chair, the shoulder is damaged hands on the back of the chair, forearm hanging down. Oscillatory pendulum movement with flexion and extension at the elbow joint, the amplitude is small, without pain and discomfort. 10-12 times.
8. P. I. - The same. On a 1 - to expand outward forearm, at the expense of 2 - to deploy inside of the forearm; can be performed with the object (a small ball in his hand). 10-12 times.
9. I. p. - Sitting on a chair, hands on the table. At the expense of 1-4 - compress fingers in a fist, holding them in this position for 3-4 seconds, at the expense of 5-8 - relax the muscles of the hand, forearm. 3-4 times.
10. P. I. - The same. To breed and to connect the fingers without bending and not straightening it. 6-8 times.
11. I. p. is The same, the elbow of the damaged arm on the table surface. On a 1 - extension of the forearm (before the first light of pain), on the score 2-10 to contain in the maximum extended position. 6-8 times.
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