Bilateral fractures of the humerus
Traumatology / / April 29, 2016
Bilateral fractures of the humerus account for 3.5% of the number of symmetric fractures.These fractures occur when traffic injuries, falls from raised both hands weight, when falling on his back with a support on both elbows, while the impact on both elbows bent, if dropped from the rotation of a steep hill (or stairs).Every second victim observed fractures and other skeletal bones.There may be symmetrical chrezbugorkovye fractures combined with dislocation of the shoulder joint, and diaphyseal fractures at different levels.
Symptoms of fractures of the humerus
Symptom "armless patient" - the victim can not sit up unaided, sit down, turn around, something to take.So the scene is often the victim, his hands limply lying in an awkward position (as if turned inside out).Tucked under her arm the patient can not remove yourself.If the victim with the help of passers-by is possible to sit down, his shoulders helplessly lowered, hands lie motionless (without support) on the ground or on the hips in that po
First aid for fractures of the humerus
intramuscularly injected Promedolum (1 mL of 1% solution) or analgin (4 mL of a 50% solution), diphenhydramine (1 mL of 1% solution).Introducing drugs needed in hip fabric as metabolic processes in damaged tissues shoulders sharply reduced, and the presence of hematomas and hemorrhages mechanically prevents the ingress of drugs in the bloodstream.For intravenous administration, it is more expedient to use the subclavian vein or veins of the lower extremities.
Local anesthesia is performed by introducing a 0.5% solution of novocaine in hematoma area of each arm fracture (60-80 ml).
- Bilateral fractures collarbone
- Bilateral fractures blades
- Bilateral fractures of the forearm bones
- Bilateral fractures wrist
- Bilateral femoral fractures
- Bilateral fractures of the patella
- Bilateral fractures of the tibia
- Bilateral fractures of the fibula
- Bilateral fractures of the foot
- bilateral calcaneus fractures
transport immobilization is carried out by one or two ladder rails.The tire is bent in the form of a U-shaped frame, the length of the middle portion should be slightly in excess (about 5 cm) and the length of the forearm of the affected hand.Bent at the elbows (to a right angle) and put together the hands of the victim is placed in a prepared frame of the ladder tires.Bandages first record put together a forearm to the middle of the frame.Then individual bandages fix the shoulders to the side of the tire, in this case after the imposition of several rounds of bandage on each shoulder make a counter move 2-3 vosmiobraznyh travel between both shoulders across the back.The second bus-frame covering the torso and limbs at the level of the middle third of the shoulder.
possible to use the stair tire separately modeling them on the right and left hand, as in the unilateral fracture.Tires bandage joined to the upper (nadplechnoy) and lower (forearm) in the form of parts of a closed frame that is put on the victim gently, and placed on a lower portion folded along the forearm while attached trusses comfortable position (partial circumference shoulders).Bandages, first fix the forearm, then the shoulders, finishing 2-3 vosmiobraznymi immobilization bandage rounds of both shoulders through the shoulder girdle and back.
transport immobilization at fractures of the humerus symmetrical U-shaped tire-frames (a) typical or twin tires to immobilize the shoulder (B).
transport the victim with head elevated supine necessary.Immobilization of limbs is not difficult to carry out, if necessary, the mask anesthesia and intravenous infusions.When first aid is necessary to take care of the rehabilitation of the mouth and nose (excessive salivation), as well as the toilet eye (lacrimation) and persons in general, as the patient himself helpless in this regard.For the same reason, a greater control over the function of the excretory organs.
Treatment and rehabilitation
the treatment of diaphyseal fractures of bilateral shoulder is considered the method of choice intramedullary osteosynthesis, allowing easy to manage external plaster immobilization.Usually it uses a special plaster cast, which provides a strong immobilizing simultaneously both hands.When epimetafizarnyh fractures with good grip fragments appropriate to apply allocating CITO tires.To be considered promising osteosynthesis with external fixation.