Fracture 1, 2, 3, 4, 5 metacarpal bones with displacement and without: causes and treatment
Causes, treatment and recovery after a fracture of the metacarpal
Metacarpal bone is a small tubular bone of a human skeleton, which is on the brush. In their hands five pieces. Metacarpal believe and finish the expense of the little finger.
Fracture of the metacarpal – a violation of its integrity, partial or total damage obtained in the process of mechanical impact on the hand.
Careless wave of the hand and injury is provided
Very often the causes of fracture of the metacarpal bones are:
- various household injuries (falling heavy objects in his hands, a sharp pinching);
- sports (hitting the punching bag or opponent during hand-to-hand combat, excessive zeal in training);
- crime (fights and quarrels).
Also, these types of injuries are called «fracture brawler» because of the habit some people too hard, in a fit of argument, banging his hand on a solid object or hit him with a fist, expressing their anger – so it is very easy to fracture the metacarpal bones.
Varieties of fracture
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In order to determine the kind of fracture of the metacarpal bones, doctors use several types of classification. By the nature of the injury:
- Open – along with the bone damage the skin. Often a fragment of bone sticking out of it.
- Closed – the fracture is underneath the skin, its integrity is not compromised.
- Comminuted – the most dangerous fractures. Can be either open or closed. The characteristic disruption of the integrity of bone breaking away from it one or more fragments.
The amount of damage:
- single – not more than one;
- multiple – more than one fracture.
In form and direction:
Possible displacement of bones fracture of the metacarpal is:
- without displacement– broken bones, despite appearing fracture, remain in the same anatomical position;
- offset – changes the position of the bone fragments relative to each other.
The location of the injured area:
- the head (in the area of the metacarpal-planorbula movable connection of the bones);
- at the base (near the wrist);
- in the Central part of the bone.
Depending on the kind of fracture will be assigned to treatment and methods of fixing damaged brushes.
Fracture I metacarpal bone
The most common injury of this class is a fracture of the first metacarpal. This bone is involved in the juxtaposition and movements of the big toe and often the most moving.
Doctors there are two types of this injury.
Localized in the base of the bone, occurs when the injury of the triangular fragment from the elbow without changing location.
The peripheral part of the bone is curved in the radial direction, thus there is both a dislocation and a fracture. Outside are the specific deformation of the finger at the place of impact of the source of injury.
Occurs due to mechanical effects on the axis of the thumb, impact or fall of a heavy object. The patient may complain of pain in the region of injury and limiting physical activity, abduction of the thumb for the intensity of the sensations almost impossible. Attempts to probe this place is very painful.
The fracture without dislocation
The fracture without dislocation is located at a short distance from the slit of the movable connection. It is called «flexion». Is formed with a sharp flexion of the metacarpal bone towards the palm, most often due to a blow on a hard object.
Fragments change their position in the inner Palmar part. The signs are the same as those of the Bennett fracture, the difference in the definition only in establishing the fact that the carpal-metacarpal joint was not dislocated.
Such diseases are often specific to athletes, people whose profession is associated with carrying heavy loads or those who used to resolve conflicts in fights.
Trauma characterized by edema, swelling, and sometimes pathologic mobility and unpleasant crunching bones.
Injury to the II-V metacarpal bones
Injuries can be very different in nature, the line of fracture of the bone, the number of damaged areas, as bones are able to break absolutely anywhere, depending on the localization of the deforming mechanical impact.
A fracture to the fifth metacarpal bone is much rarer injuries first. This injury require immediate assistance and increased attention on the trauma, as if the bones heal incorrectly, this can significantly reduce function, and disrupt the entire hand.
Any such damage due to mechanical impact: impact, compression, crushing.
Changing the position of the bone fragments and the fracture can easily be detected by palpation, which the patient will be unbearably painful.
Hand is not able to accept the position of the fist, the grasping function is severely weakened. Can form under the skin bruising, the swelling, the finger may even seem less.
In cases where a few broken bones, the wreckage moves at an angle in the back of the palm. This situation persists due to the action of the muscles of the hand.
Diagnosis in a medical institution
In order to determine the location, nature and severity of the injury, doctors perform the following types of surveys:
- visual inspection, interviewing the patient, collect a complete medical history, identifying the causes of injury;
- obligatorily radiography in two planes;
- when multiple fracture is used by computed tomography.
The most common clinical picture in the case of such fractures is simple.
The doctor easily determines trauma symptoms and the diagnosis.
In the case of open fracture is necessary to try to stop the bleeding and call an ambulance for further hospitalization.
In a closed fracture the injured limb should be fixed with a bandage, scarf or handkerchief to minimize displacement of broken bones and immediately send the victim to the emergency room.
The fingers should be in a bent condition.
The goals and methods of therapy
The goal of treatment of fracture of the metacarpal is the complete elimination of injuries, the return of the bones of her integrity, physiological status and functioning. Any kind of treatment, regardless of the fracture, carried out under the strict supervision of a physician.
Treatment of any fracture starts with numbing solution of Procaine. If the case is simple, the wreckage and cracks a little, then conducted conservative treatment.
The surgeon presses on the back side of the brushes, shifting fingers and broken bones in a physiologically correct position, eliminating the pathological wrong angle. Then the injured hand is tightly fixed in one position using the gypsum.
After four weeks being re-regenerate in order to see how the fracture heals. If it is a fracture I the bone, superimposed plaster bandage without lining with back splint.
If the damage is complicated by the displacement of the patient sent to the hospital. At the hospital, the doctor determines what type of surgery needs to spend, whether to delete the debris.
If the fracture is not a stable position, then after reposition through the nail phalanx, the surgeon inserts a special needle for skeletal traction of the wreckage. The operation is performed under careful consideration of fluoroscopy.
In the most complicated injuries of the wrist under anesthesia and cut it open, hold the fixation (the reduction and comparison of injured parts surgically directly, giving the fingers of the hand and wrist physiological position), insert the knitting needle, the end of which is left above the surface of the skin.
Then the incision is sutured layer-by-layer method, applied thick plaster bandage.
Depending on the nature of the fracture, the flow of operation of the intensity of deformation can carry out control with the help of x-shots 1-4 times per month. If the fusion is successful, then after 3 weeks, carefully remove the needle, the plaster is allowed to shoot even after 2-3 weeks.
With an open fracture before reduction and surgery carefully clean the wound from foreign objects, dirt, small fragments of bone, if any.
In the process of finding hands in plaster the patient should be as often as possible, whenever possible, try to move your fingers to the physiological function are not much affected. Severe pain after surgery, and discomfort in the process of matching doctors can prescribe analgesics.
Complications can occur in the absence of a referral to a specialist, and if improperly performed doctor’s instructions during treatment.
If the fracture is open, possible infection and purulent abscess. The possible consequences of a closed fracture are in the wrong fusion of the bones and anatomical deformation.
How to avoid injury?
The best prevention of occurrence of injuries of the metacarpal bones is the safety precautions, safety regulations, close monitoring of the situation while dragging heavy weights, in sports and other types of physical activity.
Those involved in professional sports or heavy physical labor on the job will need to perform daily exercises for kneading muscles of the hand, to take vitamin and mineral supplements that contain calcium to strengthen bone tissue.