Foreign bodies of the hand. Diagnosis and removal of foreign bodies of the hand.
Fractures of the metacarpal bones. Diagnosis and treatment of fractures
Dislocation of the phalanx of the finger. First aid for a sprained finger. Treatment of dislocated fingers.
What is an open and closed extensor tendon injury? Symptoms of tendon damage. How to treat tendon damage? Extensor tendon suture. First aid for tendon damage.
Damage to the flexor tendons. Symptoms of tendon damage. Suture of the flexor tendons. First aid for tendon damage.
What to do if your finger is broken? Diagnosis of finger fractures. Conservative and surgical treatment of finger fractures.
The section discusses the main hand injuries associated with damage to the extensor tendons, flexor tendons, as well as fractures of the phalanx of the finger. Moisov A.A., an orthopedic surgeon who conducts consultations at the Medline and Moscow Doctor clinics, talks in detail about the features of such injuries and the consequences they can lead to in the absence of surgical or conservative treatment.
The tendons are located close to the upper subcutaneous layers and therefore, even with minor injuries, there is a danger of their damage, as a result of which mobility decreases or disappears, and the anatomical position of the fingers is deformed. Sometimes tendon damage occurs not from injuries from glass, a knife and a saw, but, for example, as a result of a rupture from heavy load (sports injury or from sudden heavy lifting) or as a consequence of rheumatoid arthritis, such internal (closed) injuries may go unnoticed, and in As a result, the finger does not bend, becomes numb and deformed. Tendons cannot heal on their own; their ends must be brought into contact at the site of the rupture, that is, sewn together. Only a surgeon can do this.
When contacting a specialist doctor, the victim receives qualified advice, primary wound treatment is done and a decision is made on further treatment. Surgical operations (“tendon suture”) on the tendons are performed in the outpatient clinic under local anesthesia, then a plastic splint is used for mandatory postoperative immobilization.
Fractures of the fingers, which seem like minor injuries to many, can also lead to serious consequences. Fractures of the nail or main phalanx cause very serious limitations in the work of the hand, pain during exercise, and decreased grip functions.
Finger bone fractures can be:
The nature of the fracture is determined by a specialist using radiography. The doctor may prescribe conservative treatment for hand injuries using fixation with a plaster splint or a polymer bandage, splinting with an adjacent finger). If displacement of fragments and damaged bones cannot be corrected conservatively, osteosynthesis surgery using fixation with metal structures (plates, knitting needles, screws) is used. Sometimes millimeter titanium wires are inserted through the skin.
Injuries to the distal lower extremity are a common type of injury. Most often, the big toe and little toe are hit. In this case, the mechanisms and result of the damage can be very different from soft tissue bruises to a fracture of the phalanx of the finger. And you shouldn’t assume that if your toes contain miniature tubular bones, then injuring them won’t bring much trouble.
The causes of injury can be both everyday circumstances - hitting the corner or edge of a table, chair, bed, bulky objects falling on the foot, as well as playing sports, road accidents and other circumstances. There is a concept of pathological bone fracture, when a violation of the anatomical structure occurs against the background of discharge and restructuring of bone tissue. Diseases such as osteoporosis, osteomyelitis, hyperparathyroidism, tuberculosis, tumors can become a prerequisite for the onset of a fracture.
A toe fracture can be differentiated by the following features:
With an open fracture, damage to the skin occurs and there is a wound into which bone fragments can survive. If there is communication with the external environment, the risk of infection and the development of complications during the process of tissue healing and bone fusion automatically increases.
A closed fracture is also accompanied by mechanical damage to soft tissues and damage to small blood and lymphatic vessels.
A displaced fracture causes additional damage to surrounding soft tissue structures. Pinching and compression of neurovascular bundles and muscles is possible. And without stable fixation, the fracture heals with deformation and shortening of the bone length.
A marginal fracture most often occurs when running or receiving a strong blow. A fracture becomes comminuted when the bone is fragmented, which is more often observed with an open injury.
When a toe is injured, it is important to conduct a clinical and radiological diagnosis. Clinical signs of a toe fracture:
The anatomical features and physio-functional conditions of the first toe - it is large in size and consists of 2 phalanges, and is subject to greater load during walking - lead to a number of features in the clinical course of the fracture.
Patients experience sharp, severe pain that makes it difficult to stand on their feet. The swelling spreads to adjacent toes or the entire foot, there is local cyanotic skin in the area of injury (fracture), due to the formation of a hematoma.
In addition to clinical symptoms, a differential criterion in favor of a toe fracture is radiographs of the foot taken in 2 standard projections.
The fact of the presence of an injury and/or the appearance of the above clinical symptoms is a reason to seek medical help from a doctor and conduct an X-ray examination of the injured foot.
Depending on the nature of the fracture, treatment tactics may vary:
Treatment of a fracture with plaster immobilization is a conservative method.
For fractures of 2-5 fingers, a plantar plaster splint is applied. In the absence of displacement and the closed nature of the fracture, immobilization continues for up to 2 - 2.5 weeks. With this treatment method, restoration of ability to work occurs within 2 weeks. In case of a fracture of the big toe, a plaster cast is applied from the tips of the fingers to the level of the knee joint, with the immobilization period extended to 4 weeks. In case of fractures of the phalanges of the toes and the presence of displacement of the fragments, the duration of disability on average is up to 3-4 weeks.
Signs of fusion include the appearance of bone callus in the area of the “former” fracture radiographically and the disappearance of signs of pathological mobility and crepitus during clinical examination.
If it is impossible to eliminate the fracture conservatively and in the event of destabilization of the fracture in a plaster cast, open reduction with a fragment is performed with simultaneous fixation of the associated fracture with metal structures (Kirschner wires).
You can get a fracture of the phalanx of your toe even at home. For example, if you hit a threshold, bed or chair. Most often in practice, a fracture of the phalanx of the thumb occurs. A fracture can occur not only from a strong blow, but also from a simple twisting of the leg.
Leg injuries are often suffered by people who suffer from diseases such as osteoporosis, osteomyelitis and others. The fracture can be open or closed, with or without displacement, as well as incomplete and complete, and maybe combined. A fracture of the toe phalanx can occur in several places.
Signs of a fracture of the phalanx of the fingers may vary. For example, if fractures occur simultaneously on 3-4 fingers, then the injury may not be detected, since the dysfunction of the finger may go unnoticed. But if you break your big toe, you will immediately feel a sharp pain and you won’t even be able to step on your foot; the big toe will immediately swell.
The swelling can spread to neighboring toes, and the entire foot can also swell. This happens because this finger experiences a lot of stress when we walk. The leg may turn blue and swell. To make sure there is a fracture, you must take an x-ray, because even a specialist during an examination will not be able to reliably determine whether the leg has broken or the patient has simply received a minor injury.
Further treatment of the injury will depend on the nature of the fracture. If the fracture is open, then in addition to applying a plaster, the patient is prescribed a course of antibiotics. If the fracture occurs on 2-4 toes, then plaster is often not applied, and the leg is simply secured with a splint, with which the patient walks for about 4-7 weeks.
During treatment of a fracture, it is advisable to wear special orthopedic shoes, which will relieve pain when walking. If the big toe is broken, a cast is placed on the foot, with which the patient walks for four to seven weeks.
If an intra-articular fracture occurs, then an operation is performed in which the joint is secured with special knitting needles, and after that special devices are applied. After medical intervention, complete recovery occurs within 2 months. In order for the patient to recover faster and return to a normal lifestyle, you need to undergo a special course of physiotherapy, and you also need to follow all the doctor’s recommendations.
At the first symptoms of a fracture, you need to provide first aid and call an ambulance. If no one can provide first aid, then you need to contact a specialist as quickly as possible. Often, when 2-3 fingers are broken at the same time and the natural functions of the leg are preserved, people think that they just hurt their leg.
In this case, they apply ice and can return to work the next day. Subsequently, such self-medication may cause the bones to heal incorrectly or the fracture may have complications. You should not self-medicate, but rather consult a specialist, take an x-ray and get a doctor’s prescription.