The outer bone or radius of the forearm, situated on the thumb side of the fore arm, has only a free connection by ligaments to this joint, so as to enable it to turn like a spindle around the fixed ulna and thereby make it possible to turn the hand almost 180 degrees in a semicircle, palm up, palm down.
The elbow joint is bound up with very strong ligaments holding the three bones together. Fracture of the upper end of the radius is very common and often is caused by accidentally striking the elbow against a hard surface or edge.
The bone usually splits in the joint. An X-ray should be taken. There will be a swelling and discoloration on the outer side of the joint. The treatment requires an elastic cotton bandage around the joint, and holding the arm in a straight down position and not using it for about two weeks. After that, light massage and slight movement is begun.
Heat by pad or lamp is also useful. This condition usually heals in about four weeks, when light work may be attempted. Dislocation of the elbow sometimes occurs by falling on an outstretched hand and arm with the palm up.
The patient will hold the dislocated forearm slightly bent and rigid. The will of the dislocated forearm bones will be sticking out behind the elbow. In order to get the bones back into place it will require a slight straightening of the bent joint, and pulling upon the arm and forearm until the bones slip back into place.
This can be accomplished by putting the operator's knee against the bend of the elbow, while pulling the arm and fore arm. X-ray will show if the bones are in place, also if there is no fracture. After
the reduction of the dislocation, the arm is bandaged in a sharply flexed position, and suspended by strong bandage tied around the wrist and hung around the neck.
Fracture of the upper end of the ulna is usually accompanied by dislocation of the radius as well. The reduction is a more complicated procedure than the others and the arm is put into a right angle position, palm up, in splints (metal or plaster) exending from the knuckles to the middle of the upper arm.
Fracture and dislocation of the elbow, especially if they occur together, require very prompt treatment. Delay will cause bad results. Put the arm, in the position you find it, between splints or support it with a triangular sling from the neck, and get the patient to a doctor or hospital.
The veins in front of the elbow are most often used for taking specimens of blood and for injection and transfusion because these veins are of good size and convenient to get into. "Tennis forearm" or "golf forearm" is an inflammation of the tendons and muscles attached to either side of the elbow joint and follows overstrain in these competitive games.
A game played for fun and for pleasure only is not likely to cause injury, because you stop when you wish and feel like stopping, and before you become exhausted and overstrained. The treatment for such sore elbows is rest of the arm in an extended position, that is, keeping the arm straight down.
Also apply a cotton elastic bandage and use heat daily by pad, hot water bag or lamp. "Miner's elbow" is a swelling of the bursa at the tip of the elbow. It gets filled up with serum, which may turn into pus if the irritation from the occupation is continued, and the skin over the bursa is cut or scraped.
Any other occupation which involves much irritation to the point of the elbow joint will cause bursitis in this region. Treatment is rest from the particular occupation, and strapping tightly with short, adhesive plaster strips.
Don't let the adhesive plaster encircle the whole elbow, because that will cause injury by obstructing the circulation. The quickest way to get relief from an elbow bursa is to have your doctor aspirate the serum from it with a syringe.
If the skin over the bursa is red, inflamed, sore and throbbing, it has prob-ably been infected and the pus will have to be evacuated by a small incision or aspiration, as the doctor sees fit.
Continuous hot application of boric acid or Epsom salt solution compresses may be tried for a couple of days in the hope of spontaneous breaking and healing.
During the night, or when compresses are not being applied, use the following ointment:
Ichthyol 2 drams
Menthol 15 grains
Belladonna ointment and Lanolin (in equal parts to make 1 ounce)
Mix, make an ointment; direct to apply thickly to the swelling, then cover with gauze and bandage.
0 komentar:
Posting Komentar