Dr Anil Menedal, MS – (Orthopaedics)
Dr Balwant Singh’s Hospital Inc
Broken arm is a common injury. About one in every 20 fractures involves the upper arm bone (humerus). Falling on an outstretched hand or being in a car crash or some other type of accident is usually the cause of a broken arm.
Most people know right away if their arm is broken, because there may be a snap or a loud cracking sound. The broken arm may appear deformed and be swollen, bruised, and bleeding.
A person with a broken arm usually has:
● Extreme pain at the site of the injury.
● Pain increased by any movement.
● Loss of normal use of the arm.
Diagnosis
The doctor will examine the broken arm and check for other injuries, such as nerve damage. The doctor may want to see if the patient can flex and extend the wrist and fingers. Sometimes, the doctor may use X-rays or other diagnostic imaging tools to see the bones of both the injured and uninjured arms. If the patient is a child, the long bones of the arm are probably still growing. This makes the examination for any damage to growth plates very important.
Make sure the injured person is out of the way of further harm.
● Emergency services should be sought if there is serious bleeding or if there is reason to suspect multiple broken bones or other injuries.
● Do not try to move the broken arm. This can cause further damage to blood vessels, nerves, and soft tissues.
● If a broken bone sticks out from the skin (open fracture), do not try to push
it back in.
Temporary Splints
A temporary splint can be made using wood or rolled up magazines. The joint should be immobilized above and below the site of the injury. Each end of the splint should extend far beyond the injured region and fastened using cloth, belts, or tape. Avoid any constriction of the arm with the supporting strap.
Surgical treatment
The doctor may need to move pieces of bone back into their correct positions and hold it in position by an implant. The patient will need anaesthesia. With the broken bone back in place, the doctor immobilizes the arm (fracture bracing). Most patients are fitted with a cast or splint. The doctor tells the patient how long to wear the cast or splint and removes it at the right time.
Rehabilitation
It may take from several weeks to several months for the broken arm to heal completely.
The patient’s cooperation is essential to the rehabilitation process. The patient must complete, range of motion, strengthening and other exercises prescribed by the doctor. Rehabilitation continues until the muscles, ligaments, and other soft tissues perform their functions normally.
DeQuervain’s tendonitis
It is a condition brought on by irritation or inflammation of the wrist tendons at the base of the thumb, usually caused by taking up a new, repetitive activity. New mothers are especially prone to this type of tendonitis. Pain over the thumb-side of the wrist is the main symptom. Pain and tenderness directly over the tendons on the thumb-side of the wrist is the most common finding. A test is generally performed in which the patient makes a fist with the fingers clasped over the thumb. The wrist is then bent in the direction of the little finger. This manoeuvre can be quite painful for the person with DeQuervain’s tendonitis. The goal is to relieve the pain caused by the irritation and swelling. Your doctor may recommend:
● Rest the thumb and wrist by wearing a splint.
● Oral anti-inflammatory medication such as Ibuprofen or Paracetamol.
● A cortisone-type of teroid may be injected into the tendon compartment as another treatment option.
When symptoms are severe or do not improve, surgery may be recommended. The surgery opens the compartment to make more room for the inflamed tendons. Normal use of the hand can usually be resumed once comfort and strength have returned.
Carpal tunnel syndrome
Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in thumb, index, middle, and ring fingers. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve in several ways: swelling of the lining of the flexor tendons, joint dislocations, fractures, and arthritis and keeping the wrist bent for long periods of time. Fluid retention occurs during pregnancy, which often goes away after delivery.
Thyroid conditions, rheumatoid arthritis, and diabetes also can be associated with carpal tunnel syndrome. The symptoms usually are felt during the night but also may be noticed during daily activities such as driving or reading a newspaper. Patients may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink, causing difficulty with pinch.
Symptoms may often be relieved without surgery. Identifying and treating medical conditions, changing the patterns of hand use, or keeping the wrist splinted in a straight position may help reduce pressure on the nerve. Wearing wrist splints at night may relieve the symptoms that interfere with sleep.
When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases.
