Broken Toe Symptoms and What to Do About It – Cleveland Clinic

Maybe it happened while stumbling around your house barefoot in the dark. Maybe it was while running barefoot up a flight of stairs. But we’ve all done it: stubbed a toe hard. In those first few moments of blinding pain, you might wonder if you’ve broken your toe.

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For most of us, thankfully, the pain subsides and things get back to normal fairly quickly. But if pain persists and you suspect a broken toe, resist the temptation to tape up your toe, take a bunch of pain relievers and ignore it. There’s good reason to see a physician immediately if you suspect a broken toe, says sports and medical orthopaedist Dominic King, DO.

“Any time you think you may have broken a toe, even though it may seem like a very simple problem, you should be evaluated by a medical professional,” Dr. King says.

Why? Your toe bone may have been pulled out of proper alignment or pushed into an incorrect angle, and if so, it’s important to get this corrected, Dr. King says. Even if it’s a simple fracture, your toe could heal improperly, which can cause problems down the road, such as arthritis.

Help your toe heal right

Your doctor will likely use an X-ray to determine if your toe is broken and what treatment is needed.

If the break is a simple fracture, in which the parts of your bone are still lined up properly, your doctor will probably put you in a walking boot for about three weeks, Dr. King says. The walking boot keeps your toes immobile so the bones can knit back together in alignment.

If your toe bone is at an incorrect angle, your doctor may numb the toe and then straighten it immediately. Afterward, you may be required to wear a walking boot.

If you have significant displacement or your toe is dislocated, you might need surgery to realign the bone.

Should I just tape it?

Taping a suspected broken toe can help alleviate pain if the break is simple and the bones are aligned. However, this won’t help the break to heal correctly, so it’s important to see a doctor, Dr. King says. If you had a bad break, taping your toes could actually make things worse, he says.

One way to know whether your toe is broken is if you can put weight on the foot. If you can walk on it without pain or limping, it probably is not broken. If so, try icing the injury and taking an over-the-counter anti-inflammatory medication, Dr. King says. However, if severe pain or swelling persists, see a doctor.

Also, observe your injured toe carefully, Dr. King says. If it has a deep cut or wound, your bone might be exposed to air and so should be evaluated by a physician. Other clues to a broken toe include swelling, discoloration and bruising.

If your toe is at a different angle than the toe on the other side — and it wasn’t before your injury — seek medical help right away, Dr. King says.

Broken toe – Symptoms and causes

Overview

A broken toe is a common injury that’s most frequently caused by dropping something on your foot or stubbing your toe.

Usually, you can treat a broken toe by taping it to a neighboring toe. But if the fracture is severe — particularly if it involves your big toe — you may need a cast or even surgery to ensure proper healing.

Most broken toes heal well, usually within four to six weeks. Sometimes, a broken toe may become infected or increase the risk of osteoarthritis in that toe in the future.

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Symptoms

Signs and symptoms of a broken toe include:

• Pain
• Swelling
• Discoloration

When to see a doctor

Consult a doctor if the pain, swelling and discoloration continue for more than a few days or if the injury interferes with walking or wearing shoes.

Causes

A broken toe typically happens when you drop something heavy on your foot or you stub your toe against something hard.

Complications

Complications may include:

• Infection. If the skin is cut near your injured toe, you are at higher risk of developing an infection in the bone.
• Osteoarthritis. This wear-and-tear type of arthritis is more likely to occur when the fracture extends into one of the toe joints.

Nov. 03, 2020

Show references

1. Eiff MP, et al. Toe fractures. In: Fracture Management for Primary Care. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2018. https://www.clinicalkey.com. Accessed Aug. 22, 2017.
2. Buttaravoli P, et al. Toe fracture (broken toe). In: Minor Emergencies. 3rd ed. Philadelphia, Pa.: Mosby Elsevier; 2012. https://www.clinicalkey.com. Accessed Aug. 22, 2017.
3. Gravlee JR, et al. Toe fractures in adults. https://www.uptodate.com/contents/search. Accessed Aug. 22, 2017.
4. Azar FM, et al. Fractures and dislocations of the foot. In: Campbell’s Operative Orthopaedics. 13th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Aug. 22, 2017.

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Toe Fracture in Children – What You Need to Know

1. CareNotes
2. Toe Fracture in Children

This material must not be used for commercial purposes, or in any hospital or medical facility. Failure to comply may result in legal action.

WHAT YOU NEED TO KNOW:

What is a toe fracture?

A toe fracture is a break in a bone in your child’s toe.

What are the signs and symptoms of a toe fracture?

• Pain, redness, swelling, or bruising
• Not being able to bend or move the toe
• Not being able to walk or put weight on the toe
• Toe is bent at an angle that is not normal

How is a toe fracture diagnosed?

Your child’s healthcare provider will examine your child and ask about the injury. Your child may also need any of the following:

• An x-ray may show a toe fracture.
• A MRI may show a stress fracture or ligament damage. Your child may be given contrast liquid to help an injury show up better in pictures. Tell a healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell a healthcare provider if your child has any metal in or on his or her body.

How is a toe fracture treated?

• Buddy tape, an elastic bandage, or a splint may be used to support your child’s toe in its correct position. Buddy tape means the fractured toe and the toe next to it are taped together.
• A support device such as a cane, crutches, walking boot, or hard-soled shoe may be needed. These help protect your child’s broken toe and limit movement so it can heal.
  
• Medicines may be given to prevent or treat pain or a bacterial infection.
• Closed reduction is used to move your child’s bones back into place without surgery.
• Surgery may be needed for a more severe break. Wires, pins, or other hardware may be used to keep the bone in place while it heals.

How can I help manage my child’s symptoms?

• Help your child rest so the toe can heal. He or she can return to normal activities as directed.
• Apply ice on your child’s toe for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
• Elevate your child’s toe above the level of the heart as often as you can. This will help decrease swelling and pain. Prop your child’s toe on pillows or blankets to keep it elevated comfortably.
  

When should I seek immediate care?

• Your child has severe pain in his or her toe.
• Your child’s toe is cold or numb.

When should I call my child’s doctor?

• Your child has a fever.
• Your child’s pain does not go away, even after treatment.
• Your child’s toe continues to hurt even after it has healed.
• You have questions or concerns about your child’s condition or care.

Care Agreement

You have the right to help plan your child’s care. Learn about your child’s health condition and how it may be treated. Discuss treatment options with your child’s healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Learn more about Toe Fracture in Children

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Phalangeal Fracture | Country Foot Care

Like the old song says, “There must be fifty ways to…” – break your toe! Stubbing it on the bedpost, kicking a ball, tripping on a root, falling down the stairs, landing hard while dancing, dropping a barbell on it – any one of these can harm the bones (phalanges) in your toes and cause a phalangeal fracture. Our toes are a complex set of bones, ligaments, tendons and muscles, and they are used for so many of our movements that harming them almost seems inevitable. A broken toe may be hardly noticeable, or it could really leave you hobbling, depending on how severe the break is.

Is My Toe Broken?

Sometimes it is hard to tell the difference between a bruise, a sprain, and a break. Pain, swelling, bruising and stiffness might be present with all three, but if it hurts to put even a little weight on it, or the toe has an odd bump or looks a funny shape, it is more likely to be broken. Complications from a broken toe could be immediate (like difficulty putting on shoes or walking, or pooled blood under a toenail) or they could develop over time (like the bones not healing properly or arthritis forming in them).

Quick Action for a Fracture

Here’s what to do if you’ve injured your toe. First, take pressure off the toe and rest it. Next, ice and elevate it to reduce swelling and pain. If the skin is pierced and the bone is showing through, it is a medical emergency. You will want to have the experts at Country Foot Care on Long Island take a look at it right away. The same is true if the toe feels numb or cold, if there is drainage or bleeding in the area, or if the skin color is blue or gray. Third, if it seems a minor injury, keep off it and watch for a day or so to see if it starts to improve. If not, come and see us so we can determine the extent of the injury or fracture.

How We Treat Toe Fractures

A simple fracture may need only rest and time to heal. If necessary, we may buddy tape it to its neighboring toe to keep it stable, or use a splint until it heals. For more serious breaks, the toe may have to be put back into position and a cast applied. In some cases, the bones are so damaged that only surgery will enable them to heal correctly without causing long term problems.  A toe fracture can take 6 weeks to heal, and we may want to check it during that time to make sure all is going well.

Country Foot Care has offices in New York, which offer state-of-the-art foot care in a boutique setting. Call us at 516-741-FEET (3338) and let us pamper you and put you on the road to recovery! Visit our online contact page to request an appointment today.

How do I Treat a Fractured Pinky Toe? (with pictures)

If you suspect that you have a fractured pinky toe, the first step in treatment is to have it evaluated by a doctor. Often this kind of fracture is simple and can be treated with minimal, non-invasive interventions such as anti-inflammatory medications, icing the area, and “buddy taping” the toe. In some cases, the fracture can be more complicated and may need to be set or even require surgery. Even if the fractured toe has been examined by a doctor, you may need to get a second opinion if treatment doesn’t help. There could be undetected issues preventing proper healing.

Most often when a fractured pinky toe occurs, it results from a severe blow or trauma such as stubbing the toe very hard or dropping something heavy on it. This kind of broken toe is called a traumatic fracture and can occur in any of the several bones that comprise the pinky, or more than one. If you think you your pinky toe is broken, the first step is to have the injury checked out by a medical professional. It’s important to have the toe examined to determine what kind of break has occurred. Often the doctor will recommend typical home care, but depending on the fracture additional treatment may be needed.

The most common recommendations for the treatment of a fractured pinky toe involve simple remedies that can be implemented at home. Fractured toes usually develop swelling and colorful bruising so frequent applications of ice, in addition to keeping the foot elevated, are usually advised to minimize these symptoms. Another important element of treatment is anti-inflammatory medications, which will reduce swelling and relieve some of the pain. Broken bones need support and minimization of movement while healing; as a result, patients are advised to wear supportive, rigid shoes. It is also often recommended to “buddy tape” the fractured toe to the one next to it by wrapping tape around both of them. This allows the neighboring digit to act as a splint, thereby providing support and reducing movement.

In certain instances, a fractured pinky toe may need additional treatment. Sometimes a complex fracture can occur, and the pieces of bone do not line up, one rotates, or there is significant separation. In these cases, the bone may need to be realigned, or set, so that it can heal properly, or may even require surgery to insert pins to reconnect the pieces. If the toe was examined at the time of injury but doesn’t seem to be healing, get a second opinion with X-rays. The bone may not be reconnecting, or knitting, on its own, and medication or surgery may be required for a complete recovery.

Can you run on a broken toe? Sprained toe? Can I exercise at all?

These were the words I found myself Googling Monday morning…can you run with a broken toe?

Things started off so well, it was the perfect active recovery Monday with a nice little outdoor yoga workout and even a photo that caught the light in a way to show how seriously ZEN I was feeling.

I mean Instgram happy. Body happy. Mind happy. What more can you ask for on a Monday?

Coming home the frentic energy that is my creative mind began and I was bouncing from computer to kitchen to make my green smoothie, when SHWACK.

I nailed the chair with my toe and let loose an expletive {which science has proven to help with pain} then I went back to work because seriously, who hasn’t stubbed their toe.

About an hour later I jumped up from my desk, then promptly pulled my foot up because it hurt…and was purple…and swollen. Now that was unlike any stubbed toe I’d ever seen and by the time David came home we were both convinced it was a broken toe.

Those of you who follow me on Facebook saw this frantic message {priorities right?!}

Lucky for me, I have amazing readers and those with experience started to hop in with the following basic tips:

1. It’s going to hurt, so run to your pain tolerance
2. Tape your toes for support

Lacing tips, inflammation fighters and other tips for running with foot pain #runchat Click To Tweet

How to Run with a Sprained or Broken Toe??

By day 6, I was able to put on a shoe and I’m convinced it’s not a break…maybe there was a hairline fracture or even more likely I’ve now learned a toe sprain, eh maybe it was just one of the most ridiculous toe stubs ever. I’m not about to pay a doctor to tell me since there were no bones protruding or toes going in the wrong direction. (how very runner of me).

Days 1-5 by no means could I put on a shoe and walking on hard surfaces wasn’t too comfortable. However, I found on the carpet I had pretty free range to move around, so I did DailyBurn, T25, Pilates, Yoga, whatever struck my fancy. I had been on a seriously good roll with training and I wasn’t happy at the interruption, so I made it work.

Per usual, my pain is your gain because I learned a lot from this that I’ve been able to share with the athletes I coach.

Step 1: Combat Inflammation

Step one I knew was to do everything I could to combat inflammation and get the swelling down. This was my process for how to heal a broken toe!

• First few days I did take ibuprofen which I never do.
• Iced a few times (now knowing the new science I would NOT have done this)
• Took more potent Turmeric, again to keep fighting inflammation
• CBD oil at night – more inflammation fighting
• Avoided all shoes and socks for at least 5 days
• Applied a blended essential oil twice daily << I swear this had the biggest impact. I have never had a bruise look better so quickly or swelling drop so fast. More on essential oils for runners.
• Did Cryotherapy on Day 5 {again based on the new science would have skipped this UNLESS I needed to run that day because of say a race}

Day 6 – We have lift off!

I could put on a shoe, BUT had to make a couple adjustments for it to be bearable and I think these are key! A broken pinky toe might need more time because even with the different lacing, you’ll find more pressure on the toe.

See below for what made a run bearable.

Step 2: Taping for Toe Pain Relief

For me taping the toes together hurt worse because of the increased pressure. But if you want to know how to tape a broken toe, it’s pretty straightforward:

• gently pull it next to another toe
• put a small piece of gauze or a cotton ball between the two
• using sports tape
• lightly wrap tape around both toes so they are now joined together
• this is called buddy taping

Step 3: Shoelacing Techniques for Pain Relief

Instead, I found wearing Injinji Toe Socks provided additional padding and space between my toes which felt tremendously better.

Second I felt much better on a treadmill. Outside any little angle of the ground requires your toes to work harder to keep you balanced and after a mile or two I felt my toe beginning to scream.

Possibly most important was relacing the shoe to reduce pressure around the toes. I couldn’t leave the shoe on until I’d made this change. There are a lot of great lacing techniques out there which can make an average shoe your favorite shoe, so don’t feel like you need to keep it exactly as it comes out of the box!

1. Here you start by threading up through the first hole on the bottom with a ladder to the next hole. This pulls up the toe box, which can create additional space and prevent it from pushing down on the toes.

2. Lace as normal and then at the top, utilize ALL the available holes. Usually there are two holes on the top of the shoe and we only take advantage of the front one, but you want to prevent any heel slippage as that could allow your foot to move forward crushing the toes {HINT could be why you lose toenails!}.

3. Instead — lace through the first hole to the back hole creating a little loop through which you will thread the opposite lace before tying the shoe.

CAN YOU RUN ON A BROKEN TOE?

Back to the original question of whether or not you can, or more accurately should, run on a broken toe.

What if it’s just a sprain and not a break, does that make it better or worse? In a weird twist, sometimes a sprain can take longer to heal..so I’m going to go back to what I said to start…be your own best judge of pain and if you’re making things worse.

Clearly I’m not a doctor and I’m not even sure my particular toe was broken, so the above techniques are what got me back in to my running shoes after about a week and then slowly feeling comfortable putting more pressure on it with more miles.

I have talked with a couple PT’s and the consensus is this:

If it’s crooked or pain spreading up the foot or pain that wouldn’t stop, go see a doctor. You likely need to identify where it broke because that could make a difference and you don’t want to run making things worse.

Try taking 2-3 weeks off for swelling and pain to subside. Or like me, keep testing it until you decide you can run without severe pain and evaluate your toe post run. If the bruising returns, you may have torn a tendon rather than broken it and need more time off {plus a doctor!}.

Your big toe is likely going to be a bigger problem than my small toe. If you’re altering your gait STOP. This is going to lead to a host of other injuries.

Don’t try to mask the pain with drugs and run. If it hurts, stop…again you don’t want to make things worse or prolong healing. Additionally, running and using NSAIDs leads to a host of other issues like harming your liver!

Seriously if it hurts, stop…there will be those who have it happen prior to a race and the truth is yes you could probably force yourself to tolerate the pain, but you will likely also change your gait creating pain in other areas and prolonging the healing of your toe. You certainly aren’t going to  PR, so put it in perspective… one race or months on the side lines?

What if it is broken?

If you are indeed sidelined, the good news is you can still exercise with a broken toe. It’s time to get focused on your upper body work, core work and you might even find swimming doesn’t aggravate it.

A broken toe healing time is usually around 6 weeks, which means your job during that time is to do all the things that are going to help you come back strong. You absolutely get to wallow in the frustration for a few days, that’s step 1 of getting over an injury.

Test out the buddy taping that was recommended to me, maybe it will work for you! You simply get some Rocktape and without pressure tape it to the toe next to it. See if that feels better, gives you more support.

Have you ever broken a toe?

Have you ever tried lacing your shoes different?

Other ways to connect with Amanda
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What to Know About a Broken Toe

What does a broken toe look like?

When you look down at your foot, your toe will appear bruised and swollen. The toe might even look crooked. The toenail may appear discolored. This is due to blood accumulating under the nail (aka subungual hematoma).

On x-ray, there will be an obvious fracture line. The fractured bone might be in two parts, or in multiple parts. The fracture might even extend into a joint. The bone that has been fractured may appear well aligned, or it may be displaced by several millimeters.

Can a broken toe get infected? 

Yes! If your skin was cut during the time of injury, or the nail was damaged, then bacteria can enter the toe and cause an infection. If your skin is cut at the time of injury, it is important to wash the wound well with soap and water. Avoid hydrogen peroxide. I also highly recommend going to an urgent care or foot doctor immediately for a proper washout, and to evaluate the severity of the fracture. 

Will a broken toe itch?  

As the broken toe is healing, it might start to itch. This is due to your body releasing histamines to the area during the inflammatory phase of healing. Just think of this as a signal that your body is in the process of remodeling your broken toe.

How to heal a broken toe faster?

See a foot specialist immediately! It’s best to get your broken toe evaluated as soon as you can to determine the severity of the fracture. If the fracture is displaced by several millimeters, it should be reduced and then taped in the proper anatomical position. Occasionally, a severely displaced fracture might even require surgery.

The foot specialist can also evaluate the toenail as well as any cuts that might have occurred when the toe was injured. Preemptive measures can then be taken to make sure the toenail is cared for properly, and avoid potential toe infection.

Expect your toe to take at least 6 weeks to be fully healed.

Why buddy tape a broken toe?

Buddy taping is essential for healing a toe fracture. Taping helps to stabilize the two ends of the fracture so that the bone can heal without excessive movement. Think of buddy taping as a cast that you would wear on your broken arm or leg.

It’s always best to tape the 2^nd, 3^rd, and 4^th toes together for stability. For example, if you break your 4^th toe, then tape it to the 3^rd toe, rather than the 5^th toe. The 1^st and 5^th toes are attached to other bones that have more motion than the bones attached to the 2^nd, 3^rd, and 4^th toes. Excessive motion can impede healing of the 2^nd or 4^th toes if they were to be buddy taped to the 1^st or 5^th toes.

What shoes for a broken toe?

Stiff soled shoes are recommended. This can include supportive sandals, or enclosed shoes. Avoid shoes with narrow toe boxes, and high heals. These types of shoes will not accommodate for swelling, and could displace the fracture even further.

Why is my broken toe still swollen?

Whenever you have a fracture in your foot, your body will increase blood flow to the area to help with healing. When the extra blood gets congested, it increases pressure in the capillaries (tiny blood vessels), which causes fluid to leak into the surrounding tissues. This results in the swollen appearance of your toe. The swelling will continue to be present until the fracture is healed. This may taken 2-3 months.

Fracture of the little finger without displacement and fixation bandage

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Malysheva
Olga Dmitrievna

Operating otorhinolaryngologist

Shaforostova
Ekaterina Vasilievna

Dentist-orthodontist

Tolsteneva
Alexandra Igorevna

Neurologist, pediatric neurologist

Margieva
Diana Anatolyevna

Pediatric urologist-andrologist, surgeon

Tsibikov
Ilya Vladimirovich

Traumatologist-orthopedist

Krivorotko
Mikhail Sergeevich

Traumatologist-orthopedist

Kibizova
Laura Georgievna

Ophthalmologist

Shcherbakova
Elena Mikhailovna

Children’s ophthalmologist

Endoscopy

Mardachev
Oleg Alexandrovich

Endoscopist

Khaidurova
Tatiana Konstantinovna

Endoscopist

Center for Traumatology and Orthopedics

ENT (otorhinolaryngology)

Boklin
Andrey Kuzmich

Otorhinolaryngologist

Varenkova
Olga Vladimirovna

Otorhinolaryngologist

Markovskaya
Natalya Gennadievna

Otorhinolaryngologist

Kharina
Daria Vsevolodovna

Otorhinolaryngologist, phoniatrist

Miroshnichenko
Andrey Petrovich

Operating otorhinolaryngologist,

Korshunova
Natalya Alexandrovna

Otorhinolaryngologist

Malysheva
Olga Dmitrievna

Operating otorhinolaryngologist

Jafarova
Maryam Zaurovna

Operating otorhinolaryngologist

Gastroenterology

Komissarenko
Irina Arsenievna

Gastroenterologist, therapist, cardiologist

Mukhamedzhanova
Elvira Ravilovna

Gastroenterologist

Urology-Andrology

Dolzhenok
Andrey Nikolaevich

Urologist-andrologist

Boluchevsky
Dmitry Nikolaevich

Urologist-andrologist, pediatric urologist-andrologist

Margieva
Diana Anatolyevna

Pediatric urologist-andrologist, surgeon

Shamov
Denis Alekseevich

Urologist – andrologist

Fedorov
Sergei Gennadievich

Urologist-andrologist, ultrasound doctor

Sharunov
Vyacheslav Viktorovich

Urologist – andrologist

Dentistry. Therapy

Orlova
Elizaveta Sergeevna

Dentist therapist, pediatric dentist

Babkina
Ekaterina Sergeevna

Dentist therapist

Sizova
Elizaveta Igorevna

Dentist therapist

Surgery

Trofimova
Olga Viktorovna

Surgeon

Tumanov
Andrey Borisovich

Surgeon

Cypress
Vladislav Borisovich

Surgeon

Terekhin
Alexey Alekseevich

Surgeon

Psychotherapy

Poddo
Galina Nikolaevna

Psychotherapist (leading specialist)

Ophthalmology

Mironkova
Elena Alexandrovna

Ophthalmologist

Parshunina
Olga Alekseevna

Ophthalmologist, retinologist. laser surgeon

Vereshchagin
Lev Vladislavovich

Ophthalmologist

Kibizova
Laura Georgievna

Ophthalmologist

Shcherbakova
Elena Mikhailovna

Children’s ophthalmologist

Center of dizziness and imbalance

Paukova
Marina Vladimirovna

Audiologist-otorhinolaryngologist

Zamergrad
Maxim Valerievich

Neurologist, Consultant at the Vertigo and Balance Center

Koltysheva
Ekaterina Borisovna

Functional diagnostics doctor

Melnikov
Oleg Anatolyevich

Otoneurologist, Head of the Center for Vertigo and Balance Disorders

Ivanova
Tatiana Andreevna

Neurologist

Traumatology and orthopedics

Stepanov
Andrey Borisovich

Traumatologist-orthopedist

Gerasimov
Denis Olegovich

Traumatologist-orthopedic surgeon, leading specialist

Tsibikov
Ilya Vladimirovich

Traumatologist-orthopedist

Krivorotko
Mikhail Sergeevich

Traumatologist-orthopedist

Nikolaev
Anton Valerievich

Traumatologist-orthopedist

Zagorodny
Nikolay Vasilievich

Traumatologist-orthopedist

Schneider
Lev Sergeevich

Traumatologist-orthopedist

MRI Ingenia 3. 0T

Kivasev
Stanislav Alexandrovich

Radiologist, Deputy Director for Radiation Diagnostics

Nechaev
Valentin Alexandrovich

Radiologist

Basarboliev
Alexey Viktorovich

Radiologist

Tikhonova
Valeria Sergeevna

Radiologist

Mukhin
Andrey Andreevich

Radiologist

Krysanova
Alexandra Vladimirovna

Radiologist

Vasilyeva
Yulia Nikolaevna

Radiologist

Schultz
Evgeniy Igorevich

Radiologist

Zvezdina
Daria Maksimovna

Radiologist

Computed tomography

Kivasev
Stanislav Alexandrovich

Radiologist, Deputy Director for Radiation Diagnostics

Nechaev
Valentin Alexandrovich

Radiologist

Basarboliev
Alexey Viktorovich

Radiologist

Tikhonova
Valeria Sergeevna

Radiologist

Mukhin
Andrey Andreevich

Radiologist

Krysanova
Alexandra Vladimirovna

Radiologist

Vasilyeva
Yulia Nikolaevna

Radiologist

Schultz
Evgeniy Igorevich

Radiologist

Zvezdina
Daria Maksimovna

Radiologist

Mammography

Kivasev
Stanislav Alexandrovich

Radiologist, Deputy Director for Radiation Diagnostics

Krysanova
Alexandra Vladimirovna

Radiologist

Basakov
Kirill Sergeevich

Surgeon-mammologist, ultrasound doctor, radiologist

Murtazalieva
Aina Abdulaevna

Mammologist-oncologist, radiologist, ultrasound doctor

Densitometry

Kivasev
Stanislav Alexandrovich

Radiologist, Deputy Director for Radiation Diagnostics

Nechaev
Valentin Alexandrovich

Radiologist

Basarboliev
Alexey Viktorovich

Radiologist

Tikhonova
Valeria Sergeevna

Radiologist

Mukhin
Andrey Andreevich

Radiologist

Zvezdina
Daria Maksimovna

Radiologist

Nephrology

Markina
Elena Alexandrovna

Nephrologist, Head of the Nephrology Center

Nephrology Center

Pediatric dentistry

Orlova
Elizaveta Sergeevna

Dentist therapist, pediatric dentist

Dentistry. Surgery

Kulish
Alexander Alexandrovich

Dentist-surgeon, implantologist

Dentistry.Orthopedics

Bogoslovsky
Vladimir Alexandrovich

Dentist-orthopedist

Zakharchenko
Alexander Valerievich

Dentist-orthopedist

COVID-19 Diagnostics

Mammology

Basakov
Kirill Sergeevich

Surgeon-mammologist, ultrasound doctor, radiologist

Murtazalieva
Aina Abdulaevna

Mammologist-oncologist, radiologist, ultrasound doctor

Zapirov
Gadzhimurad Magomedovich

Mammologist-surgeon, oncologist, radiologist

Online doctor consultation from 1490 ₽

Paukova
Marina Vladimirovna

Audiologist-otorhinolaryngologist

Varenkova
Olga Vladimirovna

Otorhinolaryngologist

Kardanova
Olga Dmitrievna

Cardiologist, therapist (leading specialist)

Markovskaya
Natalya Gennadievna

Otorhinolaryngologist

Shashkova
Tatiana Valerievna

Therapist, cardiologist, physiciandiagnostics

Poddo
Galina Nikolaevna

Psychotherapist (leading specialist)

Komissarenko
Irina Arsenievna

Gastroenterologist, therapist, cardiologist

Ivanova
Tatiana Andreevna

Neurologist

Markina
Elena Alexandrovna

Nephrologist, Head of the Nephrology Center

Bakhteeva
Irina Vladimirovna

Endocrinologist

Strok
Irina Viktorovna

Pediatrician, neonatologist

Korshunova
Natalya Alexandrovna

Otorhinolaryngologist

Petruk
Maxim Nikolaevich

Proctologist

Malysheva
Olga Dmitrievna

Operating otorhinolaryngologist

Tumanov
Andrey Borisovich

Surgeon

Gerasimov
Denis Olegovich

Traumatologist-orthopedic surgeon, leading specialist

Tolsteneva
Alexandra Igorevna

Neurologist, pediatric neurologist

Tsibikov
Ilya Vladimirovich

Traumatologist-orthopedist

Deposit system

Home help service

Slashcheva
Olga Mikhailovna

therapist

Korshunova
Natalya Alexandrovna

Otorhinolaryngologist

Akhkyamova
Maria Albertovna

Medical certificates

Dentistry. Implantology

Kulish
Alexander Alexandrovich

Dentist-surgeon, implantologist

MRI open type

Kivasev
Stanislav Alexandrovich

Radiologist, Deputy Director for Radiation Diagnostics

Nechaev
Valentin Alexandrovich

Radiologist

Basarboliev
Alexey Viktorovich

Radiologist

Tikhonova
Valeria Sergeevna

Radiologist

Mukhin
Andrey Andreevich

Radiologist

Krysanova
Alexandra Vladimirovna

Radiologist

Vasilyeva
Yulia Nikolaevna

Radiologist

Schultz
Evgeniy Igorevich

Radiologist

Zvezdina
Daria Maksimovna

Radiologist

Mammology Center

Dentistry. Orthodontics

Shaforostova
Ekaterina Vasilievna

Dentist-orthodontist

Rheumatology

Ushakova
Maria Anatolievna

Rheumatologist

Starovoitova
Maya Nikolaevna

Rheumatologist

Vaccination against COVID-19

Algology Center

90,000 Polyurethane splints in traumatology: a modern alternative to plaster

The classic way to treat fractures is to apply a plaster cast. It helps to fix the damaged bone and provide it with peace, in other words, create optimal conditions for correct and fastest fusion. Plaster of Paris is a time-tested, reliable and effective way to treat fractures. But it has some disadvantages that cause inconvenience to both patients and doctors:

• Plaster cast is very uncomfortable to wash. Each visit to the shower turns into a real quest. You need to carefully wrap the splint with cellophane and constantly make sure that no water gets under it.
• Gypsum is a rather heavy material. If it had to be applied to the hand or forearm, it is not so bad. It is much more difficult for patients with leg fractures.
• Gypsum tends to crumble. Because of this, it irritates the skin and causes itching. And scratching under the bandage will not work.
• Rigid immobilization not only helps, but also harms. In the human body there is a rule: “what does not work – atrophies.” If you wear a splint for a long time, inactive muscles weaken, mobility in the joint is impaired. Bone tissue weakens without stress – osteoporosis develops in it.
• If the plaster cast constantly exerts strong pressure on the skin, blood circulation is impaired. Because of this, bedsores can appear, and nerve function is impaired. Circular “deaf” bandages are especially bad in this respect. After the fracture, edema develops, the tissues are squeezed inside the plaster case.
• Plaster does not transmit X-rays very well, so it is often difficult to control how well a fracture heals.

For a long time, all these shortcomings had to be put up with. There is nothing to be done: the fracture needs to be treated, and there were no alternatives to the good old plaster splints. Currently, alternatives have appeared and are already widely used in traumatology. Modern doctors are increasingly using polymer, or, as it is also called, plastic gypsum. This technology is also used by traumatologists at the SOVA clinic.

What is a polymer bandage made of and how does it work?

Actually, there is no gypsum as such in “plastic plaster”. It is a “gauze” made of polymer or fiberglass impregnated with polyurethane resin. Blanks are produced in the form of bandages or sheets.

When a patient with a fracture or dislocation is admitted to the trauma department, the doctor, if necessary, performs reposition (restores the natural position of fragments or dislocated ends of the bones), and then applies a polyurethane bandage. As a rule, in order for it to activate and subsequently acquire final hardness, it must be soaked in water.Some materials are activated when heated to 60–100 ° C.

Many types of such bandages can be remodeled and turned into removable orthoses.

What are the advantages of polyurethane splints?

Polymer materials are devoid of many of the drawbacks due to which traumatologists and their patients do not like plaster so much:

• They are not afraid of water. You can wash without removing the splint and without protecting it from getting wet. Some materials dry themselves after water procedures, others need to be dried with a hairdryer for some time.
• Polymer does not crumble or irritate the skin.
• Good X-ray permeability greatly facilitates monitoring of the healing process.
• The polyurethane splint has a cellular structure and allows the skin to breathe.
• The blanks stretch well in different directions, which makes it possible to perfectly shape the dressing in accordance with the contours of the body.
• Unlike plaster, many polyurethane dressings are not rigid, they are resiliently elastic.This helps to avoid problems with poor circulation and muscle weakening.
• Polymer is on average 4–5 times lighter than gypsum.

Is everything that good?

No. Polyurethane splints have their drawbacks, and they can not always be used. Doctors in our clinic are sure to tell patients about this.

First of all, you need to understand that such material is more expensive than classic gypsum. The procedure, of course, does not cost space money, but there is a difference in price. In government clinics, you will most likely not be given such a bandage for free. If you do not want to experience discomfort from wearing a plaster cast, you should go to a private clinic.

Polyurethane splints are more difficult to remove. They cannot be cut with scissors; this requires a special file. Some fasteners have convenient zippers, but the cost will be even higher.

Flexible polymer fixation dressings may not always be used. For serious fractures, when the risk of displacement of the fragments is high, rigid fixation is needed.The doctor decides this question in each case individually.

Another disadvantage is that polyurethane splints differ in their properties from classic plaster. You need to work with them correctly. Since the material has appeared on the market relatively recently, not all doctors and nurses have the appropriate skills. We still need to look for a clinic that knows how to work with “plastic plaster”. One of these clinics is SOVA.

Our trauma center has everything you need to provide qualified assistance in case of bone fractures and other injuries.Our experienced doctors apply ordinary plaster of Paris and polyurethane splints, carry out primary surgical treatment of wounds, and reposition of fragments. We use modern technologies to ensure that our patients heal as quickly and fully as possible.

Plaster of paris versus conventional – innovations in traumatology

Doctors also have complaints about traditional plaster. Classic gypsum material almost does not transmit X-rays, the image is indistinct.It is difficult for a specialist to assess how well the bones grow together under the bandage.

In addition, when wearing plaster for a long time on the damaged area, blood circulation is often impaired. Tendons, joints, and muscles are virtually non-functional, which can lead to lameness or reduced joint mobility after the cast is removed.

Alternative to conventional plaster

However, the fracture site must first of all be fixed and immobilized, that is, immobilized. In trauma centers and hospitals, they offer classic plaster in the old fashioned way, in the absence of other alternatives. In the medical center “Medassist” doctors use materials of a new generation – polymer immobilizing bandages, they are also called “plastic plaster”.

Plastic gypsum is a bandage impregnated with a special polymer compound.

Plastic plaster is used not only in case of a broken arm or leg. With its help, feet, elbows, knees, dislocated shoulder or ankle are fixed, and also used for stretching muscles or ligaments.

However, in order to apply or remove polymer plaster, the doctor must have special knowledge, tools and materials. Medical center “Medassisst” is one of the few in the city where doctors can apply modern orthopedic dressings made of plastic.

Advantages of artificial plaster

Unlike classic plaster, plastic plaster weighs several times less and does not interfere with movement. At the same time, the material is very durable, which guarantees the correct healing of broken bones.

Modern plaster made of plastic is not afraid of water, you can safely swim with it both in the bathtub and in the sea, and in case of contamination, simply wipe it with a damp cloth.

The porous structure of the material allows oxygen to pass freely, so that the patient does not experience itching, irritation or other skin reactions. In addition, polymer fixatives are non-toxic and hypoallergenic.

Due to the elastic material, the gypsum adheres tightly to the site of injury, and at the same time allows you to simulate any shape with complex fractures.

During the X-ray, the plastic plaster does not need to be removed, it does not trap the X-rays. The doctor can see all the details in the image, which means there will be no difficulties in assessing the bone fusion.

Plaster made of plastic looks neat even after long wearing, and the patient feels it like a regular bandage and does not feel discomfort like wearing a regular plaster.

Such a retainer is removed using a special saw and, due to the smooth texture, does not injure the skin and hair.This compares favorably with the classic plaster, which, when worn for a long time, almost grows together with the skin.

What are the types of artificial plaster?

There are several types of polymer gypsum. The most famous are scotchkast, softcast and turbocast.

Scotchkast – polymer gypsum, strong and rigid, due to which it reliably immobilizes the fracture. The lightest of all artificial bandages. A special lining stocking is put under it so as not to injure the skin.Scotchkast comes in different colors, which will appeal to children and lovers of bright colors.

Softcast allows you to create dressings of varying rigidity. After hardening, the material remains semi-rigid, which allows maintaining muscle mobility in the damaged area. At the same time, the material is flexible, but not stretchable, which helps to maintain its original shape. It is used not only for fractures, but also for sprains of the limbs.

Turbocast is the most famous polymer gypsum made from thermoplastic.It makes it possible to give the dressing any shape, which makes it indispensable for the most complex fractures, including in children and adolescents. The special design allows the patient to independently remove and put on the bandage (with the permission of the doctor).

Consult a doctor

Each type of polymer gypsum is indicated for certain injuries and fractures. Only the attending physician can determine which one is right for you.

Plastic bandage does not cancel visits to the doctor and does not accelerate the fusion of broken bones, but it allows you to make the treatment as comfortable as possible.

In the medical center “Medassist” the doctor-traumatologist-orthopedist Sokolenko Natalya Vladimirovna (link to the doctor) will help to determine the type of polymer gypsum that suits you.

You can find out more detailed information or make an appointment by phone. +7 (4712) 46-03-03.

Published on April 17, 2020.

Medicine (gift instruction)

In your set:

1. Plaster bandage 1 m

2. Bandage dressing

3. A piece of synthetic cotton for dressing 20 cm

4. Plastic cup, 125 ml with medical plaster

5. Disposable apron

6. Wooden skewer

7. Wooden trowel

You may also need:

1. Oilcloth

2. Water container (bowl, plastic container)

3. Scissors

With this set you can complete several tasks.

GYPSUM LANGET ON THE WRIST

Measure the required length needed to fix the wrist: from the first phalanges of the fingers to the middle of the forearm (20-25 cm).

Cut the plaster bandage into pieces of the desired length.

Gently soak the plaster bandage in water, count to three and remove. Squeeze out a little and spread on a flat surface.

Smooth the bandage so that there are no wrinkles. Each fold can lead to poor circulation or simply cause inconvenience.

In the same way, put the remaining pieces on the first bandage, each time carefully smoothing a new layer.

After the bandage is prepared, gently place it on the outside of your hand and press down until the bandage takes the shape of your hand.

It is recommended to place cotton pads under the edges of the plaster to prevent chafing.

Wait until the plaster hardens, on average it takes 10-15 minutes.

Fix the splint with a regular bandage.

GYPSUM BANDAGE OWN HANDS

We suggest that you try to make a plaster cast as you did before.

For this:

Cut the bandage into pieces of the desired length (20-25 cm).

Mix gypsum with water in a ratio of 1: 1

Stir the mixture thoroughly until smooth with a wooden skewer

Soak the prepared piece of bandage in the resulting plaster solution

Smooth the bandage on a flat surface so that there are no folds.

In the same way, put the remaining pieces on the first bandage, each time carefully smoothing a new layer.

Lay 6-7 layers in this way.

Then proceed in the same way as described in the first instruction (points 6-9).

FINGER LANGUAGE

Plaster bandage is not always at hand. Often, an improvised splint made from scrap materials is used to fix the injured limb. The main thing is that it should be something solid and even.

We suggest that you try to fix your index finger with a wooden spatula.To do this:

Place the spatula under the index finger on the inside of the palm.

Using a bandage, wrap the spatula to your finger.

Turn the bandage around your wrist several times so that the bandage stays on your hand and does not fall off.

Stenosing ligamentitis: description of the disease, causes, symptoms, cost of treatment in Moscow

Stenosing ligamentitis is a serious hand dysfunction in which a malfunction occurs in its tendon-ligament apparatus. Self-diagnosis is unacceptable, because the sounded disease is often confused with acute arthritis, osteomyelitis, pathological dislocation and even sepsis. The diagnosis of stenosing ligamentitis is made on the basis of an X-ray of the hand (if necessary) and after analyzing the existing clinical picture.

The pathogenesis of dysfunction of the tendon-ligamentous apparatus of the hand causes controversy between specialists, because no one can yet voice the exact details of the formation of pathology.

The most justified interpretation of it is based on the analysis of the energetic work of the fingers during the day. They carry out their activities due to the smooth functioning of the tendons. In the canal, consisting of connective tissue, they slide in order for the finger to move in different directions.

With a provoking factor in the form of inflammation, the tendon becomes more voluminous. Its new dimensions are not designed for the dimensions of the canal, therefore the usual path of the terminal structure of the striated muscles may deviate. With the formation of significant edema, even such a modified route cannot be performed. It should be remembered that the formation of inflammation begins initially in the ligamentous zone, and then spreads to the tendon area.

Dysfunction of the fingers with stenosing ligamentitis has the following digital indicators of the number of patients for each of them:

large – 25%;

index – 3%;

medium – 20%;

unnamed – 44%;

little finger – 8%.

There is no age limit for this disease. During the formation of the body, problems usually arise with the thumb. However, specialists do not diagnose a baby under 2 years old. The disease may go away on its own as it grows older, but in some cases it develops into a more serious form of ligamentitis. Parents are better off initially to insure themselves and at the first alarming symptoms visit an orthopedist with the child.

The disease can be combined with some pathologies, significantly worsening the general condition of the patient:

one. Epicondylitis We are talking about inflammatory and degenerative transformations of the elbow joint.

2. Arthrosis. If it causes damage to the small joints of the hand, then its tandem with stenosing ligamentitis is dangerous.

3. Shoulder-scapular periarthritis. The lesion is fixed in the same area as in epicondylitis, but covers the periarticular soft tissues.

Why is stenosing ligamentitis

formed?

The reasons that the finger begins to click can be different in their pathogenesis:

one.Selected field of professional activity. This disease is often the result of repetitive finger movements in one direction. As a result, a kind of tendon blocking effect occurs. People who fall into the “risk group” of this ailment are milkmaids (with the exception of milking machine operators), hairdressers, manicurists and pedicurists, bricklayers, musicians, seamstresses, etc.).

2. Hereditary factor. It is impossible to call it the main reason for the development of stenosing ligamentitis. However, individual cases of inherited predisposition to the disease have been recorded.

3. Congenital defect. We are talking about the abnormal structure of the tendon-ligamentous apparatus of the hand, which can only be corrected by surgery.

4. Injury. After a bruise or sprain on the arm, stenosing ligamentitis may develop without further examination by a doctor.

5. Chronic diseases. The symptoms of the disease are sometimes difficult to recognize in time against the background of existing pathologies in the form of arthritis or rheumatism.The disease can also develop due to diabetes mellitus, atherosclerosis and thyroid dysfunction.

6. Physiological and age-related changes. This factor especially concerns pregnant women and women with the onset of menopause, in whom, due to hormonal changes, water is retained in the synovial membrane.

7. Systemic autoimmune changes. Stenosing ligamentitis can be provoked by scleroderma, lupus erythematosus, polymyositis, Sharp, Weber-Christian and Sjogren syndromes.

Varieties of pathology

The classification of the disease is based on the fact which ligaments were affected:

1. Nott’s disease. The primary signs of the onset of pathology are painful clicking of the finger when it moves back and forth. Secondary symptoms of the disease are already becoming a serious problem, in which the hand, with the existing deformed joint, begins to function with difficulty.

2. De Quervain’s disease.Stenosing vanginitis is a problem with the abductor muscle that swells. As a result, it leads to the effect of friction of the inflamed tendons on the bone-fibrous canals. The pathological process provokes significant pain at the base of the movable limb of the hand.

3. Syndrome of the carpal (carpal) canal (tunnel syndrome). In this area, the median nerve is sometimes compressed, which is responsible for the sensing and motor skills of the hand.

Stages of development of the disease

Depending on many factors, three degrees of pathology progression are distinguished:

one. Initial stage. The disease at the start of its development does not bring significant discomfort. At most, the victim feels a slight painful sensation in the area of ​​the finger, which quickly subside. At the same time, he begins to be alarmed by a characteristic weak click, heard after moving his finger.

2. Middle stage. With further compaction of the tendons, unpleasant symptoms cannot be dispensed with. The phase has come when the affected finger hardly changes its position, and the tubercle that appears in the problem area hurts when pressed.

3. Late stage. If the alarming symptoms of the first two stages of the development of stenosing ligamentitis are ignored, the finger cannot take its original position without additional help. The only way out of the situation is surgery.

Diagnosis of the disease

Specialists who treat the hand for this kind of dysfunction are an orthopedist and traumatologist. To make a diagnosis, multidimensional diagnostics are not required. It is enough for the doctor to examine the patient’s hand and gently palpate it.

Such manipulations are necessary to detect the area of ​​inflammation, which feels like a seal to the touch. If there are no assumptions about the presence of degenerative-dystrophic changes in the joints, then the specialist directs the patient for an x-ray.

To confirm the development of a pathological process in the body, the need to pass some laboratory tests is not excluded. Usually, the doctor needs to analyze a general blood test, which, with elevated leukocytes and ROE, will confirm the presence of inflammation in a person.

Gymnastics for fingers and hands

It is carried out for preventive purposes and at the first stage of the development of the disease. The set of exercises, each of which must be performed for 45 seconds, is as follows:

1. Put your elbows on a flat surface and begin to shake slightly with your hands.

2. Fold your palms in a prayer appeal and (if you do not spread your hands), in turn, press them against each other.

3.Remaining in the starting position, begin to spread the wrists back and forth.

4. Repeat exercise # 1 with your elbows off the table.

5. Repeat exercise No. 2 with a greater force of the healthy palm on the patient. In case of severe spasm, stop movement immediately.

6. Remaining in the starting position, with the wrists stationary, begin to spread the fingers apart.

7. Play imaginary instruments (pipe, piano, guitar).

For the sake of safety, the problematic brush must be continued to be fixed and the following specialist recommendations must be followed:

1. Change of occupation. At the second stage, stenosing ligamentitis treatment implies a long-term (up to 2 months). For this reason, given the opportunity, it is better to say goodbye to monotonous manual work for a while or forever. People who earn their living by hard physical labor should also think about changing their profession.

2. Removal of the tumor. At this stage, the wrist can already become very swollen with a serious inflammatory process. To eliminate it, hormone-based drugs are used, the leader of which is Hydrocortisone. The drug is injected directly into the lesion: in de Quervain’s disease – under the dorsal ligament, tunnel syndrome – into the carpal tunnel, Nott’s disease – under the annular ligament.

3. Pain relief. It is produced with the help of novocaine blockade, when the injection is made directly into the problem area.

Electrophoresis. With stenosing ligamentitis, you will have to undergo 10 sessions of exposure to the problem area with electrical impulses. Electrophoresis is performed using lidase dissolved in novocaine. After such a procedure, the patient feels significant relief if he was previously worried about pain.

Phonophoresis. Aloe-based gel (to relieve inflammation) or hydrocortisone (to eliminate pain, swelling) is applied to the skin in the affected area. Further, an ultrasound sensor is launched, which will help the active substance to penetrate into the affected area of ​​the hand as deep as possible.The duration of the session is 23 – 30 minutes. The advantages of the procedure are the ability to produce a safe micromassage with a noticeable result after two or three visits to a specialist.

Paraffin therapy. Usually this method is used in cosmetology, but in the case of a tumor with stenosing ligamentitis, it will also come in handy. You can also use it at home. In a water bath, high quality paraffin crushed into crumbs should be melted. At the bottom of a wide plate, you need to spread tracing paper, on which you then need to pour the liquid paraffin mass.Soon it will be covered with a crust, which means that the compress is ready. After wrapping it with a warm cloth, lie down and wait until the paraffin has cooled.

Mud therapy. The most effective treatment for stenosing ligamentitis is peloidophonophoresis. This method combines the application of healing mud under the influence of ultrasound. The time of the procedure is 5 minutes, if necessary, go through 10 sessions.

Hand deformations

Congenital and acquired deformities of the hand

DEFORMATION OF THE HAND

The following pathological conditions leading to dysfunction of the hand and severe disability can cause deformities of the hand:

1.Congenital

• Missing toe
• Additional toe
• Syndactyly (fusion of fingers)
• Primary muscle contracture, eg multiple arthrogryposis, congenital (rare)

2. Acquired

• bones of the hand, etc.)
• Burns (cicatricial contractures).
• Dupuytren’s contracture
• Rheumatoid arthritis
• Volkmann’s ischemic contracture
• Spinal cord injury (poliomyelitis, syringomyelia)
• Brachial plexus injuries
• Peripheral nerve damage
• Peripheral nerve damage

diagnosed at the birth of a baby.Multiple congenital arthrogryposis is often associated with other neurological disorders; a combination accompanied by severe deformities of the limb.

Dupuytren’s contracture

Dupuytren’s contracture is a fairly common disease of the hand. Most often, the process involves the ring finger and / or the little finger. Dupuytren’s contracture is formed by “wrinkling”, contraction of the palmar fascia as a result of excessive development of connective tissue.Such a pathological process leads to the impossibility of extending one or two fingers. In this case, thickenings (nodules) or thick short cords are often formed in the thickness of the palmar fascia, going towards the ring finger. In advanced cases, fibrotic changes form in the joints of the involved fingers, which leads to stiffness of the fingers. Often, Dupuytren’s contracture develops simultaneously on both hands.

The frequency of occurrence of Dupuytren’s contracture in men is several times higher than in women.The most common Dupuytren’s contracture occurs in middle-aged men.

At a young age, this disease is quite rare, but over the years the frequency of development of Dupuytren’s contracture increases. If the disease occurs at a young age, then, as a rule, there is a rapid progression of symptoms and a more severe course of the disease.

Causes

The exact cause of the disease is unknown. There is a clear hereditary predisposition to this disease.Smoking is an independent risk factor for the development of Dupuytren’s contracture. Alcohol abuse also increases the likelihood of developing this condition. Recent clinical studies have shown an association between an increased incidence of Dupuytren’s contracture and the presence of diabetes mellitus in a patient.

Symptoms

The disease may have an acute onset, but in most cases, severe symptoms do not appear until several years after the onset of the disease.

Normally, we can freely flex and extend our fingers. With the development of Dupuytren’s contracture, as a result of wrinkling of the palmar fascia, the ability to freely extend the fingers is impaired. As the disease progresses, stiffness appears in the joints of the involved fingers. With a severe course of Dupuytren’s contracture, the development of complete immobility of one or two fingers may be noted, that is, the development of ankylosis. In some patients, connective tissue nodes in the thickness of the palmar fascia are characterized by significant pain.In the initial stages of the disease, thickenings in the palm area in the form of dense strands or nodules are found. In the later stages of the disease, connective tissue nodules can be located in the area of ​​the fingers

Treatment

Treatment of Dupuytren’s contracture can be carried out both conservatively and surgically. The main point for choosing a treatment method is the severity of pathological changes in the palmar fascia.

TRAUMATIC DEFECTS OF BRUSH SEGMENTS

Traumatic defects of various segments of the hand result from severe mechanical injuries with primary tissue destruction, as well as after deep burns, frostbites, ischemia.

Classification.

I. Reason:
mechanical injury;
thermal injuries;
others.

II. Number of beams: isolated; plural; total.

III. Level: compensated; subcompensated; decompensated I, II, III degree.

IV. Side: left; right; both brushes.

The number of defects in brush segments is determined by the number of rays. There may be an isolated defect of one ray, which is more often observed on the 1st ray in the form of a defect in the phalanges and metacarpal bones at various levels.Multiple ray defect means complete or partial loss of two to three or four rays. A total defect is an amputation of the hand at the level of the carpal bones, when the hand as an organ loses its shape and function.

Depending on the level of the defect in the segments of the hand, three degrees of severity are distinguished, which make it possible to roughly establish the indications and choose the method of reconstruction of the stump.

Defects of the distal phalanges of the fingers refer to compensated ones that do not require restoration.

Subcompensated are defects at the level of the main phalanges of the fingers, while the indications for reconstruction are determined individually, in order to improve the function of gripping objects.

Decompensated finger defects are subdivided into three severity levels. At the first level, the defect runs along the metacarpophalangeal line. Such a stump has a significant limitation of function and is indicated for reconstruction. The second level of decompensation runs along the middle of the metacarpus.Such a brush lacks gripping functions and needs to be reconstructed. The third level of decompensation runs along the line of the wrist – this is the loss of the hand. Currently, there are no ways to reconstruct such a stump. She is subject to prosthetics.

The side of the traumatic defect of the segments of the hand is of great importance in determining the degree of compensation for the patient’s general working capacity. The adaptability to work processes and self-service in everyday life in persons with hand segment defects is very high. However, surgical reconstruction according to the indications, and in some cases by the order of the patient, increases the chances of a more complete compensation for the lost hand function.

POSTTRAUMATIC CONTRACTURES

Contracture is a limitation of the range of motion in the joint due to pathological changes in the surrounding tissues functionally associated with the joint.

Classification:

I. Due to:
1. Traumatic.
2. Fixation resulting from prolonged immobilization with plaster casts.
3. Ischemic, associated with circulatory disorders against the background of any trauma or tissue compression.
4. Others.

By localization, contractures of the hand are distributed according to the anatomical structure of the joints: contractures of the wrist joint, metacarpophalangeal, metacarpophalangeal, interphalangeal joints and are characterized by their clinical features.

In terms of prevalence, the following are noted: isolated contracture of any one joint; multiple – several joints of the hand.

By dysfunction, there are: flexion contractures with various deficits in the extension of the hand and fingers.Extension, accompanied by a large deficit in flexion of the hand and fingers; flexor-extensor, the most severe contractures with cicatricial damage to the tissues of the palmar and rear surfaces of the hand and concomitant fibrosis of the joints, tendons and muscles. As a rule, they are multiple with impaired grasping function of the hand! Abduction contractions in the position of spreading fingers and adduction – with adduction and deficiency of abduction of the fingers, limitation of interdigital and planar grips.Cicatricial degeneration of the tissues of the wrist joint is the cause of dysfunction of the hand.

Causes

Various types of damage to the hand and fingers: closed intra-articular bone fractures, joint dislocations, accompanied by hemarthrosis followed by plastic arthrosis; open, including gunshot wounds to the hand, from scalped wounds to damage to the osteoarticular apparatus, muscles, nerve tendons. Post-traumatic contractures include the most common consequences of deep, thermal and chemical burns, electrical injuries, frostbites, accompanied by an extensive scar defect of the skin and underlying tissues at various depths.

Fixation contractures are associated with prolonged immobilization of the injured hand with various, especially plaster, bandages in an antiphysiological position. In this case, contracture develops not only in the damaged joint, but also in healthy adjacent joints as a result of adhesive fibroplastic arthritis and tendinitis. The most susceptible to fixation contractures are the metacarpophalangeal and interphalangeal joints, in which quickly, after 3-4 weeks of immobilization, stiffness develops with a transition to a persistent contracture.

Ischemic contractures result from impaired peripheral blood flow in the damaged tissues of the forearm, hand and fingers. Prolonged ischemia causes dystrophy, primarily of muscles and nerves, and subsequent myogenic and neurogenic contracture. Ischemia can develop as a result of thrombosis of large arteries in the syndrome of positional compression or syndrome of prolonged crushing of the tissues of the hand. The cause of ischemia may be compression of muscles and nerves by deep subgaleal, subfascial hematoma of the middle muscle space of the forearm and palm.Compression with a circular plaster cast in fractures of the forearm, wrist and hand can also cause impaired blood flow and tissue ischemia with the formation of desmogenic contractures.

Dermatogenic contractures develop with cicatricial changes in the skin and subcutaneous tissue. In this case, the scar is not welded to the deep-lying tissues – tendons, bones. Scar tissue is mobile, tightening the skin, restricts flexion or extension of the joints.

Desmogenic contracture occurs when tendons, synovial-aponeurotic canals, muscles of the forearm and hand are involved in the scarring process.In this case, there may be a combination with dermatogenic contracture. In this case, the skin scars are fused to the tendons. As a result of muscle traction, flexion contractures of the fingers are more common. Joint mobility within the limits of the scar is preserved. A special place is occupied by neurogenic contractures of the fingers. In connection with persistent damage to the ulnar and median nerves, a “claw-like hand” develops with a deficit in extension, flexion and opposition of the fingers.

Arthrogenic contractures develop due to primary damage to the articular-ligamentous apparatus.The secondary cause of such contractures is deep dermatodesmogenic tissue lesions that keep the joint in a vicious position for a long time. In this case, wrinkling of the joint capsule, ligaments, dystrophy of the articular cartilage and, as a result, stiffness, which in the literature is called “fibrous” ankylosis, occurs. Arthrogenic contractures of the interphalangeal joints are often accompanied by subluxation of the phalanges.

Dermato-desmo-arthrogenic contractures develop after severe open fractures, gunshot injuries, deep burns as a result of cicatricial degeneration of all tissues anatomically associated with the joints of the hand and fingers.

Treatment

1. Prevention of contractures of the hand joints during the treatment of fresh injuries. Prevention of peripheral blood flow disorders, tissue edema, infectious complications as the main causes of dystrophy of all structures of the hand and the occurrence of cicatricial rigidity, stiffness and joint contractures.

2. Earlier complex conservative treatment of contractures after various hand injuries, including general and local use of medications and physiotherapeutic agents, aimed at restoring blood circulation, eliminating edema, resolving scar tissue, normalizing muscle tone and range of motion of the joints.

3. Timely, rational surgical treatment for persistent contractures with limited hand function in case of ineffectiveness of conservative rehabilitation methods.

The choice of the method of operation depends on the nature of the contracture. The leading place in the treatment of contractures is occupied by various methods of skin grafting to replace scar tissue in the hand.

Publications in mass media

Hand fractures account for 35% of all fractures.
Classification • Fracture of the wrist bones •• Fracture of the scaphoid •• Fracture of the lunate bone •• Fractures of other bones of the wrist • Fractures of the metacarpal bones • Fractures of the phalanges of the fingers.
Fracture of the scaphoid bone • Causes: fall on an outstretched arm, a direct blow to the palmar surface of the hand • Pathomorphology . The scaphoid bone breaks in the area of ​​the tubercle. Features of the blood supply cause poor healing of the fracture • Clinical picture : swelling in the anatomical snuff box, restriction of movement in the dorsal-ray direction, inability to compress the hand into a fist.To confirm the diagnosis, X-ray examination is performed in three projections: direct, lateral and oblique • Treatment: plaster cast for 6–8 weeks in the position of thumb abduction and slight dorsal extension (150–160 °). In case of poor union of the fracture, surgical treatment.

Fracture of the lunate bone • Reasons : falling on the hand laid out to the elbow • Clinical picture . Swelling in the middle of the wrist joint on the dorsum, retraction in the region of the third metacarpal bone when the hand is squeezed into a fist, soreness under axial load on the third and fourth fingers • Treatment .Plaster cast for 6-10 weeks. Surgical treatment – for false joints and aseptic necrosis.

Fracture of the metacarpal bones . The most commonly observed fracture of the base of the first finger • Pathomorphology •• Bennett’s fracture – a longitudinal fracture at the palmar-ulnar edge of the base of the first finger, while the triangular fragment is held by ligaments, the metacarpal bone is displaced in the proximal direction •• Roland’s fracture is a multi-splintered fracture of the base of the first metacarpal bone • Clinical picture: pain, deformation and edema of the metacarpal-carpal joint region, pain occurs with axial load on the finger.In case of a fracture of the first metacarpal bone, the thumb is adduced and slightly bent. • Treatment. Exact mapping of fragments, plaster cast with abduction of the thumb. In case of Roland’s fracture – arthrodesis, transosseous distance osteosynthesis.

Fracture of the phalanges of the fingers • Causes: direct and indirect trauma • Pathomorphology: displacement with the formation of an angle open to the back • Clinical picture : deformation, shortening and swelling of the finger, subcutaneous hematoma, pathological mobility, pain with axial load • Treatment: reduction, plaster cast for 4–5 weeks, exercise therapy, physiotherapy, skeletal traction on the Beller’s splint, osteosynthesis with a Kirschner wire.

ICD-10 • S62 Fracture at the level of the wrist and hand

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