Injuries to the wrist and wrist joint: first aid

The wrist joint is formed by the ends of the ulna and radius and small bones of the wrist.Around the articular bag in a large number of ligaments are located, which allows you to make brush movements in different directions.

The human brush consists of three parts.The wrist is formed by 8 bones, which are arranged in two rows, and from them 5 metacarpals leave, which create the basis of the brush.Phalanges of fingers are attached to these metacarpal bones.In order for a person to make small movements with a brush, there are many tendons and nerves in it, it is perfectly blood-flowing.

Hand injuries are fairly common, after each there is a risk of losing the function of the hand, so before the doctor's visit, the victim can be provided with only first aid, and already qualified treatment will be appointed by specialists.

Table of Contents: Bruised Press Faulty ligaments Dislocation of wrist joint Fracture of brush Brush wounds Finger laceration of the finger: first aid Shinning Bandages

Bruised

Since the capsule of the wrist joint is not protected by muscles, its bruises are always very painful.The bruise of the hand is characterized by a rapidly developing edema, often a hematoma( subcutaneous hemorrhage) is formed.Especially bright these characteristic signs of a bruise are shown at a trauma of a fingertip - for example, at impact on it by a hammer.The bones of this part of the body are thin enough and break easily, so if you have a serious injury, you must take an X-ray and exclude( or confirm) the fracture.

After the puffiness is somewhat reduced, it is possible to perform procedures for heating the bruised place of , but only if the doctor confirms the absence of an inflammatory process.

As warming up, you can use ointments with anti-inflammatory and analgesic effect, which include Fastum-gel .Often, with a bruise under the fingernails of the injured hand, blood accumulates - it must be removed in the surgical room of the polyclinic, which will lead to a significant relief of the condition and the disappearance of dull, aching pain.

Compression

If the hand is squeezed by any heavy object, then immediately there is an extensive hemorrhage, there is damage to the muscles and skin. First aid in case of such injury is to apply a tight bandage, applying cold .The injured hand must be given an elevated position.Pressure - a trauma that will necessarily require qualified medical care!

Damage to ligaments

Trauma of the ligaments of the wrist joint is possible with a sharp movement of a large amplitude - for example, this often occurs when falling on the arm.The same statement applies to injuries of the tendons on the wrist, but in this case, there is often a detachment of small bone fragments, to which the tendons are attached.The result of this trauma is the subluxation of the joint, and blood accumulates in its cavity.

Note: ligament damage is always accompanied by sharp pain, swelling and impaired mobility in the affected joint.Often, with such a trauma, pathological movements are observed - for example, the victim can bend his finger to the side, or take him to the opposite side: this will be a characteristic sign of the detachment of the bone fragment.

First aid for such damages is to apply cold, ensure rest to the affected joint and position the hand on the hill. You should definitely seek qualified medical help.

For the fingers to move, we need tendons - on the outer surface of the extensors, on the inner flexors.

Symptoms will be different:

• If there is damage to the extensor, which is attached to the nail phalanx, it ceases to straighten and "hangs".
• If the ligament leading to the lower phalange is injured, then a double contracture is observed: the middle phalanx is bent, the nail is bent over, and the finger acquires a zigzag shape.
• If there was a double contracture, then the treatment will proceed surgically, it is impossible to restore the functioning of the brush without carrying out the operation.
• Tendons-flexors most often suffer with cut wounds of the palm.Such injuries are characterized by the inability to bend fingers, squeeze them into a fist.The victim should make attempts of such movements extremely cautiously, because there may be a divergence of the ends of the tendons, which will complicate the treatment.

The first aid for such a trauma is to immobilize the limb when a tennis ball is inserted into the injured palm, the foam sponge .It should immediately seek help from a doctor in the trauma department - such damage is treated only surgically.

Dislocation of the wrist joint

Dislocation of the wrist joint occurs, as a rule, with an unsuccessful fall on the hand.With such a trauma, the brush moves to the back side, but the displacement of the palm is extremely rare.Dislocation causes compression of vessels and neural bundles, which is manifested by acute pain, numbness of the entire hand, inability to perform any movements, swelling and blood circulation disorders.

If the brush moves to the rear, then in the wrist joint you can define the deformation in the form of a step.Palmar dislocation does not restrict movement in the hand and fingers. The first help in such a trauma is to immobilize the brush - this is done using a piece of board or plywood, any solid object.

Note: can not be dislocated by itself, in any case, as this will lead to additional injury to the joint.

If an dislocation occurs in one of the wrist bones, you can feel the bony protrusion at the top of the wrist.This condition is accompanied by a swelling of the hand and some disturbance of the movements.Often, patients with such trauma generally do not pay attention, it may lead to a significant deterioration in the movement of the hand in the future, so it is necessary to apply a tire to the injured hand and go to a medical facility.

The dislocation of the metacarpus often occurs as well - this trauma occurs when a fist falls onto a compressed fist, immediately after it the surface of the brush swells and its surface changes.The injured palm becomes shorter than the healthy one, and the fingers do not collapse into a fist.

If there is a fall on the arm with a straightened thumb, then there is a high probability that there will be dislocation in the metacarpophalangeal joint .The finger in this case is shifted to the rear of the hand, it is strongly bent, the phalange nail becomes bent, and finger movements are impossible.The first help is to fix the finger in its original position( it can not be crumpled or attempted to correct) - doctors will work on the dislocation, and the procedure of correction is carried out only under anesthesia.

Fracture of the hand

Fractures of the bones can appear both in the fall and in the impact.Symptoms of such traumas are quite classical - pain, swelling, a violation of the shape of the hand, a shortening of the finger, the lack of the ability to move the affected part of the brush.Since the symptoms of bruises and fractures are identical, you need to go to a medical institution and take an X-ray - this will help to clarify the diagnosis and conduct effective treatment activities.

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Brush wounds

Open damage can be of different character:

• piercing,
• cut,
• torn,
• chopped,
• bruised.

Wounds, usually a trauma to tendons or blood vessels, tearing off a phalanx or a whole finger are complicated.

The amount of first aid will depend on the type of wound:

• If there is an abrasion, you do not need to see a doctor.It is enough to clear the skin of contamination, gently rinse and treat the wound with iodine or a solution of brilliant green( green).
• Minor damage can be covered with a bactericidal plaster, and if necessary, apply a sterile bandage.
• If the wound is cut or chopped, then wash it in no case it is impossible!It is allowed only to gently clean the surrounding skin from contamination, treat it with any antiseptic and apply a pressure-tight sterile bandage to stop bleeding.
• For stab wounds, acute pain and minor bleeding will be characteristic.The edges of damage quickly close, and this creates optimal conditions for the development of the infectious process.In any case, in the framework of the first aid for the wound, a bandage is applied, and further specialists must work with the injured person.

If there is a bruised wound, then there may be a strong / intense bleeding.To stop it, it is necessary to apply a tourniquet just above the wound to the injured person's hand. In the summer, the tourniquet can remain in place for two hours, in the cold season - not more than one and a half hours.Be sure to attach a note with the specified time on the harness!

Detachment of the phalanx of the finger: first aid

With the detachment of the phalanx or the entire finger, the first task is to stop the bleeding with the harness. Then a sterile bandage is applied to the wound and the victim is immediately taken to a medical institution.The truncated fragment can not be washed - it is wrapped with a clean napkin( it is highly desirable to make it a sterile napkin) and placed in a plastic bag.The package with the fragment is placed in another bag with snow or cold water, and when transporting this container it is necessary to ensure that there is no compression of the tissues.

If an incomplete break has occurred, the limb must be cooled and immobilized. Then the victim is urgently transported to a medical institution - from how quickly the victim is on the operating table, the probability of restoring a severed fragment depends.

Please note: the brush's viability at a temperature of +4 degrees is maintained for 12 hours, at a higher temperature - a maximum of 6 hours.With a finger injury, these figures correspond to 16 and 8 hours.

Splinting

If an injury to the wrist and hand has occurred, the injured limb must first be immobilized.To do this, you can use either standard medical tires, or handy tools - for example, thick cardboard, boards, plywood. The brush is fixed as follows:

• , the fingers are slightly bent and a roller of fabric / foam is embedded in the palm of the hand;
• the thumb is set aside;
• brush slightly bent backwards.

The tire is bandaged to the palmar surface of the forearm from the elbow to the wrist, its end must necessarily protrude beyond the nail phalanx.It will be useful to apply cold to the already immobilized brush, and the hand must be laid on the kerchief.

If the finger is damaged, then a normal ruler can be used as a tire - it is tied / pribintovyvayut to the damaged finger.

Dressings

You can bandage the wound with a regular bandage, an adhesive plaster, or use a small-sized tubular bandage, on the packaging of which the body parts are indicated, which can be bandaged.

One finger is applied with a spiral bandage. This is done as follows:

• take a bandage 2-3 cm wide and several times wrap it around the wrist;
• then along the back of the brush lower the bandage diagonally to the nail phalanx and begin to bandage the injured finger in a spiral, rising to its base;
• if the bandage is wide, then you can twist it around the nail, which will ensure a good fastening of the bandage;
• to complete the procedure you need circular rounds on your wrist.

If all the fingers need to be re-banded, a spiral bandage is also applied.On the right hand begin bandaging with the thumb, on the left - with the little finger.After ligating one finger, make a circular tour around the wrist and return to the nail phalanx of the next finger.

In order to bandage the brush, it is necessary to lay cotton wool or gauze swabs / napkins between the fingers.Use for this bandage a wide bandage( at least 10 cm) and wrap it all at once with your fingers, then return to the wrist.Then make a circular fastening and again go down to the fingers - gradually the whole brush will be bandaged.The thumb should always be attached separately from the palm of your hand!

Note: if there is no bandage at hand, then you can use a scarf as a dressing.Of course, such a bandage will not stop arterial bleeding, but it will help to keep the hand immobilized and prevent contamination.

Injuries to the wrist and wrist joint never pass without a trace.Even a banal dislocation in the future can lead to unpleasant consequences.Therefore, after providing first aid, the victim should seek qualified medical help.

Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category