Tumor of the bone of the nail phalanx of the toe. The nature of destruction. If fused with displacement

Nail plate. It is a tissue derivative arising from the three zones of the nail bed. Fully grows in length in 70-160 days.

nail bed. It consists of three parts: the back cover, the germinal matrix (also known as the ventral floor), and the sterile matrix (also known as the ventral nail bed). The proximal end of the nail plate originates between the dorsum and the U-shaped germinal matrix of the nail bed.

Nail fold (eponychial fold). The proximal part of the nail plate is located under the nail fold. The skin on the back of the nail fold is the nail fold (it is located on top of the back cover of the nail bed). The thin plate extending from the nail fold to the rear of the nail plate is called the eponychium. The lunula is a curved, opaque strip on the nail distal to the eponychium at the junction of the germinal and sterile matrix.

hyponychium. This is an accumulation of keratin between the distal part of the nail plate and nail bed. Due to its strong adhesion, it is resistant to infection.

blood supply. Dorsal branch of the terminal trifurcation of the digital artery.

Function

Soft tissue support of the fingertip (hyponychium)
Used as a tool (scratching, plucking, scraping, grabbing and lifting, etc.).

Damage to the nail bed

Usually occurs due to hard hit, which leads to compression and damage to the (soft tissue) nail bed between the (hard) nail phalanx and the nail plate.
It is necessary to perform radiographs in frontal and lateral projections.

Subungual hematoma

The nail bed is well supplied with blood. closed injury of the nail causes bleeding under the nail plate with the formation of a tense hematoma, with a characteristic throbbing pain.

Treatment of subungual hematoma

Closed lesions (usually hematoma, less than 25% of the visible nail bed) can be evacuated by perforating the nail plate with a hot needle or paper clip. If a rupture of the nail bed is suspected, revision is necessary.

Rupture of the nail bed

May be simple, stellate (due to blast-type trauma), or crushed (causing fragmentation of the nail bed). The nail plate can move out from under the nail fold.

Refusal of revision in the acute period after injury with these injuries leads to the development of late complications, such as deformation of the nail plate or its detachment from the nail bed.

Treatment of nail bed ruptures

Ring block with local anesthetics
Peel off the nail plate (saving for use as a splint)
Tip: use a small mucosal elevator or anatomical blunt scissors to get them between the nail plate and the nail bed, then peel off the nail plate with a thin vascular clamp.
Wash off the sterile matrix.
Carefully restore the sterile matrix (absorbable suture 6/0-7/0) using a magnifying glass.
A defect in the sterile matrix can be replaced by a split skin flap or a split nail bed graft (from an adjacent injured toe or from the first toe).
If the nail bed is torn out from under the nail crease, it should be set and sutured (if possible) or fixed in place with a splint.
Use the nail plate to splint the nail fold.
In young children, the replanted nail plate can take root and begin to grow.
If the nail plate is lost or too damaged, you can use the silicone plate or foil from the package suture material for splinting the nail fold.

Tearing of the nail bed with a fracture of the nail phalanx

In almost 50% of cases, damage to the nail bed is combined with a fracture of the nail phalanx. The presence of a tear in the nail bed makes the fracture open.

Treatment of ruptures of the nail bed with a fracture of the nail phalanx

The following are the principles for treating nail bed ruptures. Additionally:

Intraoperative administration of intravenous antibiotics and oral intake in the postoperative period.
Abundant irrigation until the fracture is repositioned.
Non-displaced fractures can be treated conservatively after flushing and restoring the nail bed. They are splinted with soft tissues.
In case of displaced fractures, thin (0.8-1 mm) pins are used for fixation, except in cases with many small fragments, then it is better to splint the bone fragments with soft tissues without pin fixation.
Tip: Pass the Kirschner wire 2-3 mm below the hyponychium to achieve precise placement in the nail phalanx.
Check the position of the pin on the radiograph in the lateral projection - it is easy to miss and not get into the nail phalanx!
Seymour fracture - epiphyseolysis of the nail phalanx with a displacement of its distal part to the rear in combination with a rupture of the nail bed. The nail also moves out from under the eponychial fold (see Chapter 5).

Violation of the growth of the nail after injury

Within 21 days after the injury, the nail stops growing in length, and its thickening appears proximal to the injury site. This causes the nail to bulge as it continues to grow. After that, the growth of the nail accelerates compared to the norm for 50 days, and then slows down for 30 days, and only after that the growth becomes normal. Reconstruction of the nail complex

Reconstruction of the nail complex is difficult and often imperfect, even in the most experienced hands. Below are possible options reconstruction. Problems often overlap, and the choice of treatment should be approached individually.

Detachment of the nail plate from the nail bed

Scarring of the underlying part of the nail bed due to lack of fusion with the nail plate.
Keratin builds up under the nail and this can be mistaken for a fungal infection.
Treatment:

Excise scars.
Suture if possible.
Replace the defect with a split nail bed graft, usually taken from the first toe.

splitting of the nail

The cause is scarring in the backcoat/germenal matrix/sterile matrix complex.
Treatment:

Excise scars and restore the sterile matrix.
Excise part of the germinal matrix and replace with a full-thickness complex germinal matrix graft from the 2nd toe with an acceptable but not perfect result.
Removal of the germinal matrix in severe cases.

Nail spicule (thorn)

Usually the remnant of the germinal matrix complex after distal amputation.
Treatment:

Raise the eponychium flap
Excise the spicule and the remainder of the germinal matrix.

Hooknail (deformity in the fork of a parrot's beak)

Occurs as a result of tension suturing of the fingertip during distal amputation or loss of bony support for the nail bed.
Treatment:

Excise scars on the fingertip
Raise the nail bed
Replace the bone defect with a bone graft (may dissolve)
Replace the soft tissue defect with a local movable flap
Microsurgical grafting of a part of the toe (difficult decision)

Absence

Congenital or post-traumatic.
Treatment:

Excise skin or nail-like scars and replace with a full-thickness skin graft
Microsurgical transplantation of the nail bed.

Most of the nerve endings pass through the fingers. Being injured, they immediately give a powerful impulse about damage directly to the brain. In fact, absolutely anyone can get a toe injury, but most often such people are fans of playing football, whether they are real athletes or just amateurs.

Toe bruises
What are the symptoms of a dislocation
What treatment will help with an injury

Toe bruises

A lot of household injuries are daily received by people, and most often it happens very unexpectedly. A dislocated toe is no exception. Finger bruising can be characterized slight damage on the leg of soft tissue - a group of muscles, skin or tendon.

However, often there is a combined injury to the finger, when a bruise of the leg occurred along with a subsequent dislocation. This usually happens when the finger is hit with a heavy object or when there is an involuntary impact on something hard enough. And how many cases when the little toe on the leg was injured due to an accidental impact on the corner of a door or bed!

This topic is very relevant, because the toes affect the balance when walking any person and an unexpected injury to any of the toes can lead to such a sad result as the loss of the ability to move. What to do in such a situation? Everyone should know how to help with a fresh injury and prevent unpleasant complications from developing.

What are the symptoms of a dislocation

There are some indicators by which you can determine whether a dislocation or other injury has really occurred:

Symptoms of frequent and minor injuries - cut, scratch, bruise. These injuries usually resolve without outside intervention.
Various nail injuries.
Direct injury to the finger. It can be understood by the growing feeling of pain and the swelling that has appeared.
Dislocation of one of the phalanges of the finger. Symptoms will appear instantly - a shift in the position of the injured finger and swelling.
Stretched ligaments of the finger. There is a pain syndrome.
Shattered bone on the finger. This injury is characterized by severe edema and shock pain syndrome.
Fracture of any toe. The finger looks deformed, in an unnatural position. Bruising and swelling are inevitable. The victim feels severe pain and stiffness of movements.

Dislocation thumb feet is more common than injuries to other toes. And this is despite such a feature as a strong muscular apparatus, which nature has awarded thumbs. This is always associated with its isolated location.

In order to accurately make sure that you have a dislocation of the finger, it is necessary to confirm the diagnosis. To do this, it is advised to conduct an x-ray.

What treatment will help with an injury

First you need to set the dislocated finger as soon as possible in order to prevent the formation of soft tissue edema. If you do this right away, then the chance of a successful reduction procedure will increase many times over, and during the healing period, the injured area will hurt less. To do this, you need to see a specialist. Below are important tips first aid for sprained toes.

If the bruised finger is held under cold water, and then apply an absorbable anesthetic, this will bring a feeling of relief and relieve pain. Then you need to apply a bandage - it can prevent swelling of the tissues surrounding the injured organ. These dressings are done within 4-5 days.
A dislocation of the little toe on the leg requires very careful handling. Here you should not be wise and it is best to turn to specialists. The only thing you can do yourself is to bandage tightly all the fingers along with the patient.
With sprains, ice applied in a timely manner is also very effective. After sufficient cooling, it is required to bandage to the rest of the toes. It is possible that this will have to be done within 2-3 weeks.
If everything is very bad and a fracture has occurred, then here one must be as careful as possible to control the bleeding. If a bone suddenly sticks out, in no case do not set it yourself. Treatment without competent medical intervention can only aggravate this situation. You can only put a tire on yourself. And see a doctor immediately!

You need to try to understand whether there is serious damage or not, and before the doctor arrives, try to provide first aid yourself. Most effective remedy It is, of course, ice. And the sooner you use it, the better for the sore finger. If it is possible to reduce the swelling, then it is possible to release tissue from pressure and nerve endings. This helps to reduce pain.

In most cases, massaging the affected finger with an ice cube is very effective. But if the patient diabetes, cold massage is categorically contraindicated, since this procedure greatly slows down blood circulation. The most important thing to remember is that in no case should the injured place be heated, since the heat will expand everything. blood vessels and will increase swelling and pressure on the affected tissue, respectively.

A photo with injuries on the finger shows what it looks like outwardly.

If the joint of any finger is dislocated, acute pain immediately appears in the area of dislocation; even the deformity of the injured finger, characteristic of such a case, may occur. The ability to move the injured finger becomes difficult or even may even disappear, and if you try to touch the sore spot, the pain will increase dramatically. It is also possible that there will be swelling.

However, one should not forget about the nails, which break and fall off when the fingers are injured. To prevent this, the nail must be fixed in its place. If in a week he has not grown into his place, then the best option- to cut it off.

When assisting a bruised toe, the leg should be placed on a raised platform to reduce blood flow to it. Try not to walk for two days. Also, do not bandage your sore finger yourself. After all, if a bruise was accompanied by such a dangerous injury as a bone fracture, you can cause irreparable harm to the patient by incorrectly applying a bandage to him. This work is best left to real professionals.

Useful articles:

At the first symptoms of a broken toe, immediate treatment is necessary.

A broken bone is a fairly serious injury that takes a long time to heal.

AT human body there are more than two hundred bones, any of which in a certain situation may not withstand the load and be damaged.

Most often at risk of fractures of the limb - as the most vulnerable part of the body.

And, in particular, the most common type of fracture is a fracture of the toe.

The structure of the finger joint and its functions

The toes are very important locomotive apparatus a person, as they, together with the foot, support the weight of the body and give it the opportunity to move, while helping to maintain balance.

Each finger on the hand and foot consists of several bones, which are called phalanges. They are interconnected by movable interphalangeal joints, which allows you to bend and unbend your fingers.

Causes of fractures of the phalanges of the fingers

In everyday life, it sometimes happens that there are fractures of the toe - when falling, severe bruising on hard objects, unsuccessful jumps from a height. Also, the cause may be the tucking of the foot, the fall of a heavy object on the leg, and similar situations impact on the foot.

A fracture is characterized by damage to the integrity of the bone, and sometimes the skin around it.

Classification

Toe fractures can be divided into the following types:

Traumatic fracture - occurs as a result of a mechanical effect on the foot, such as a bruise, compression, tucking.
Pathological - occurs as a result of some diseases that violate the strength bone tissue and making it too fragile. These diseases include osteoporosis, bone cancer, dysfunction thyroid gland, tuberculosis, tumor and others.

The second characteristic of a fracture is its type and condition:

open - when the integrity of the skin is broken and part of the broken bone can be seen through the wound;
closed - in which the integrity of soft tissues is preserved;
with displacement - as a result of the impact on the finger of the force that caused the injury, the damaged bones are displaced. In this case, there may be an infringement of the nerves, vessels or muscles located nearby.
no offset;
complete - in which the bone breaks into two or more parts;
incomplete - a crack is formed in the bone tissue;
comminuted - occurs when a bone is crushed, as a result of which the fragments fall into the wound.

The location of the fracture can be classified as:

on the nail phalanx;
on the middle phalanx;
on the main phalanx;
combined fracture - when two or more phalanges of the fingers were damaged.

Why does the thumb break most often?

The difference between the thumb and the rest is that it has two phalanges instead of three. At walking, this finger takes the brunt of the load, supporting the weight of a person, and often it is more likely to get a fracture, as it protrudes more forward.

Moreover, blueing and swelling can spread from the big toe to the entire foot and adjacent fingers, as a result of which it becomes painful to step on the foot or move it.

For the treatment of a fracture of the big toe, a plaster cast from the upper third of the leg to the toe will be required, which should be worn for about 5 to 6 weeks.

How to identify trauma

Symptoms of a broken toe are divided into absolute and relative.

Relative signs of injury only allow a preliminary conclusion about the injury. These include:

sharp pain;
swelling of the injured finger;
bleeding under the nail or skin may occur;
there is a violation of the function of the limb;
when moving in the finger is felt sharp pain.

On the thumb, the hematoma and swelling are more pronounced, while the leg swells and hurts while moving the fingers. A fracture of the II, III, IV and V fingers may be less noticeable, because there is a small load on them. The victim does not even immediately notice the injury and usually goes to the doctor only the next day, when the pain intensifies.

Absolute signs accurately indicate the presence of a fracture. Among them are the following:

pathological mobility of the finger;
unnatural position of the limb;
crunch of fragments when pressing on the affected area.

Diagnostic methods

In case of a broken toe, you need to contact a traumatologist. Based on a small survey, identification of relative and absolute signs of a fracture, as well as x-rays he can make a correct diagnosis.

Even if the finger does not hurt very much at first, it is still better to go to the hospital after getting injured, without putting it off for later.

First aid and medical procedures

What to do in case of this injury?

If you do not need to see a doctor

In principle, anyone can provide first aid. First, you need to immobilize the foot, that is, immobilize it. After removing the shoes, it is necessary to bandage the injured limb with a sterile bandage if there is a wound. This is done in order not to bring the infection there.

Then you need to find any solid object that would act as a tire, and bandage it to the foot. Just remember that when applying a bandage to the wound, the hands must be clean.

As a result of such actions, the wound will not be re-damaged by bone fragments, and the pain should decrease.

Treatment of fractures depending on their type

When treating a broken toe, you need to consider its localization:

So, with an injury to the nail phalanx of the finger, it is necessary to anesthetize it. If the distal nail phalanx is damaged, the bone is immobilized. To do this, the nail is perforated, removing accumulated blood from under it, the broken fragments are fixed with a plaster and attached to the adjacent phalanges. If the subungual hematoma is too large, then you need to remove the nail.
Fracture of the middle and main phalanx of the fingers is a fairly common occurrence, since these fingers are little protected from external influences. Their treatment is usually carried out on an outpatient basis. If the damage was without displacement, then a sticky patch is applied to the diseased area for about two weeks. Even a small fracture should not be left without immobilization, as it may not heal properly.

With multiple fractures, a plaster “shoe” is applied, which must be worn for about 2 to 3 weeks.

If a displacement occurs when a finger is damaged, traction is applied to it along the axis for a sore finger, or a Cherkes-Zade tire is applied.

If the displacement was large, then a manual reposition of bone fragments is performed until their original position is restored, after which, after about 1-2 weeks, a gypsum bandage in the form of shoes. It must be worn until the wound is completely healed. At the same time, working capacity is restored in about three to four weeks.

If you have chosen a home treatment option, then first of all you need to perform the following steps:

Apply to damaged area cold compress to reduce swelling. It is necessary to do this for 10 - 15 minutes every hour, and repeat one - two days. But at the same time, you need to observe the measure so that frostbite does not occur.
The leg on which the toe was broken should be raised above the level of the heart in order to reduce swelling and soreness.
Also, to eliminate pain, it is recommended to take ibuprofen or another pain reliever that the doctor will advise.
To immobilize a diseased finger, it is necessary to make a tourniquet using an elastic bandage, attaching the damaged area to the adjacent finger and placing a cotton pad between them for alignment. With the help of gauze, the tourniquet is fixed.

With an open fracture, the bone is repaired from fragments, the foot is immobilized, an anti-rabies vaccine is administered, and antibiotic therapy is prescribed to avoid the development of a secondary infection.

Better yet, do not hesitate to seek treatment at the hospital, where you:

An x-ray will be taken to determine the nature of the fracture. Plaster may also be applied.
If necessary, eliminate the offset (when the two edges of the finger are not in place), or curvature in which the finger is bent in the wrong direction. Once the finger is in place, the doctor will put a splint on the injured area to keep it immobile until it heals.
Sometimes your doctor may advise you to wear special, supportive shoes that are beneficial in getting rid of swelling.
If you tear your skin when you break it, you will get a tetanus shot to avoid infection.

Rehabilitation

For about six weeks after the fracture, it is necessary to take care of the injured finger, do not overexert it. This implies that long walks, and even more so sports, are contraindicated. When walking, carefully look under your feet so as not to hurt your sore toe.

The rehabilitation process includes physical procedures, massotherapy and special gymnastics and following the doctor's recommendations. In your diet you need to include foods rich in protein and calcium.

Preventive measures

To avoid finger fractures, you need:

Wear comfortable shoes with stable soles.
Reduce consumption of foods that deplete calcium from the body, which is responsible for bone strength, such as coffee, sweet soda, and alcoholic beverages.
It is recommended to consume foods containing calcium. It's not only dairy products but also beans, peas, apples, apricots, grapes, potatoes, eggs, carrots, cabbage, Rye bread and many others.
You also need to be careful in places where a heavy object can fall on your feet, or where there are many objects on the floor that are easy to hit with your foot.

From the foregoing, we can conclude that you can not neglect your health, because then it will be rather unpleasant and long to be treated.

Fracture - dangerous injury which always brings a lot of physical and psychological inconvenience. Excessive loads on the bones musculoskeletal system can easily damage most of them. Indeed, of the more than two hundred bones of the body, only less than half have a "special" strength. Also, one should not forget about the joints in which the main load is taken by connective tissue. Therefore, a fracture of the big toe is a threat from which no one is absolutely protected. Everyone needs to know the types of this damage and the methods of treatment.

Anatomical features

The foot is the most complex and most distant element of the musculoskeletal system. The peculiarity of its structure is the presence a large number joints and small bones, each of which is quite vulnerable to mechanical injury. This vulnerability is most relevant for the extreme toes due to their location - the thumb and little finger. It is they who most often undergo dislocation, fracture and, according to statistics, are considered the most traumatic part of the leg.

The foot includes twenty-four separate bones that make up its three divisions. Together they form a complex vaulted support system which helps to support vertical position body. The third section is considered the most traumatic, which includes fourteen tubular hollow bones connected by joints and muscles. They form five fingers, but their length and structural features do not allow us to talk about the special strength of each of them.

Diagnosis of a fracture of the bones and joints of the thumb is the easiest thing in comparison with other fingers. The main symptoms are a sharp pain, the inability to step on the foot, the appearance of swelling. The intensity of symptoms depends on the type of fracture. With other fingers, the manifestation of symptoms occurs in an increasing manner over time. This often misleads the patient about the true severity of the injury to the finger.

The thumb is the most susceptible to injury. It protrudes forward in relation to others, and is one of the anchor points that support the weight. standing man. It is on the finger under consideration that a significant part of the loads is accounted for.

Fracture classification

There are two categories of fractures. Medicine refers to the first traumatic fracture- "classic" version mechanical damage. Its severity, complexity of treatment and danger to the body depend on the magnitude destructive force acting on the thumb. The second category is pathological fracture, the danger and treatment of which is often significantly higher than in the first case.

Pathological fractures also form as a result of mechanical damage, but this often requires much less impact. The reason lies in the pathology, which causes a violation of the strength of the bones locally or throughout the body. It can be any spicy or chronic illness directly or indirectly affecting bone tissue.

Tuberculosis, malignant tumors, systemic diseases leading to circulatory and balance disorders nutrients in blood plasma - the list is very wide. These and similar ailments can provoke conditions when an intra-articular fracture becomes chronic condition thumb.

The specific classification of fractures according to the general state of damage distinguishes between:

Closed fracture - there is no damage to the skin, the bone is not visible. This case usually does not require surgical intervention and is fairly easy to treat.
An open fracture is the most dangerous view injury in which fragments of the damaged bone destroy soft tissues. Often accompanied by intense bleeding, displacement of bones, rupture muscle tissue, vessels. Requires immediate medical attention.
Displaced fracture - the damaged bone moves to the side, infringing on the tissues, vessels, and nerves located in it. May be open.
A non-displaced fracture is a simple form of injury accompanied by tissue swelling and pain.
Complete or incomplete fracture - the damaged bone is completely divided into two or more separate sections or a crack forms in it. A fracture of sufficiently long bones may be accompanied by the appearance of damage of each type.
Comminuted fracture- a dangerous destruction of the bone, in which it is crushed into several fragments. Recovery often requires surgery.

Each of the injuries can happen to any of the bones of the foot, but it is the big toe that most often suffers.

The classification of the fracture is the first thing you should pay attention to. To select the most effective course of treatment, it is necessary to determine the category to which the resulting limb injury belongs.

Diagnostic methods

Psychology modern man is such that everyone is sure that bad things happen to anyone but us. After a thumb injury, when examining the symptoms, many people unconsciously try to put them under those that correspond to the bruise. This is especially true after a less dangerous, but accompanied severe pain, dislocation of the phalanx of the fingers. A fracture after this, especially simple, and without displacement, it is simply impossible to diagnose on your own. It will not hurt as much as the previously received dislocation. Or if we are talking about other fingers - the victim will be misled by "delayed" development negative feelings. It is not uncommon for the pain in a broken finger to get worse as the day progresses. But a few hours after the injury, the sensations in the finger resemble an ordinary bruise or dislocation.

There are probable and absolute signs of a fracture. Probable signs only suggest the presence of such damage in the thumb. Therefore, they require diagnostic confirmation and include:

pain during palpation of the injury;
swelling of tissues at the site of injury, significantly increasing the volume of the affected area;
the appearance of a hematoma in the damaged area;
sharp pain when moving a finger.

Only an X-ray of the finger will allow, in the presence of the mentioned symptoms, to answer the question: "the patient has a fracture or a simple bruise." Also, the answer can be obtained without an X-ray over time, but a broken bone can heal incorrectly, and this is a very difficult pathology to treat.

A fracture of any of the toes is guaranteed to confirm that the patient has symptoms such as:

change appearance fingers and their adoption of an unnatural position;
complete inability to control the mobility of the injured finger;
crunch of bone fragments during palpation of the damaged area;
happening open fracture, allowing to observe the displacement and destruction of bone tissue;
severe swelling tissues, accompanied by sharp pain even with the slightest pressure.

X-ray of the damaged area this case is also necessary, because it will allow you to see the extent of the injury and establish its danger.

For displaced fractures, x-rays are needed to correctly set the displaced area. Do not try to do it yourself - without the necessary knowledge, you can only aggravate the situation by provoking tissue rupture and internal bleeding.

First aid

If you are not going to see a doctor, you must first immobilize your finger. It is worth taking off your shoes, conducting a visual inspection of the damaged area, choosing a solid object that will become an analogue of a medical splint. Fixing the finger will help avoid tissue damage from bone fragments and reduce pain. Seeing a doctor if a fracture is suspected is the best treatment option. Especially if the edema continues to increase or maintain an abnormally large volume, and the intensity of the pain only intensifies.

The choice of treatment option depends on the location and preliminary diagnosis fracture. For the thumb, there are three main varieties of it:

Damage to the distal nail phalanx. The site should be anesthetized, then the bone is immobilized. The treatment consists in fixing the broken fragments with a plaster, if necessary, the nail plate is completely removed.
Fracture of the middle and main phalanx. The vast majority of cases allow ambulatory treatment which consists in the immobilization of the damaged bone. The average recovery time is two weeks.
Complex multiple fractures. For treatment, it is required to wear a “gypsum shoe” for the time set by the attending physician.

A multiple fracture resulting in the formation of two or more bone fragments requires manual reposition of the broken sections. This task can only be completed an experienced doctor, since any careless movement can damage nearby tissues. For cases that require repositioning of bone sections, the recovery time is from two weeks to a month.

The choice of treatment for a fracture of the thumb depends on the degree and severity of its damage. The degree of danger of the injury depends on the force that affected and the vector of its application.

Self-treatment and prevention

The home treatment option includes several recommendations that are similar to healing a bruise. The only difference is the need to immobilize the injured finger, so as not to provoke a further aggravation of the situation. To relieve swelling, it is recommended to apply a cold compress for ten to fifteen minutes. To achieve the effect, the procedure should be repeated every hour for several days. You can also hold the injured leg above heart level to reduce swelling.

Prevention of fracture of the thumb is:

in the use of comfortable shoes that reliably protect all fingers;
in refusing to use foods that leach calcium from the body - this increases bone fragility;
in compliance with safety regulations.

In order to get rid of pain, you can take painkillers that the doctor will approve. To strengthen bones, it is recommended to eat foods containing calcium. These include dairy products, peas, beans, eggs, rye bread, apples, grapes and many others.

Do you know that:

American scientists conducted experiments on mice and came to the conclusion that watermelon juice prevents the development of atherosclerosis of blood vessels. One group of mice drank plain water, and the second is watermelon juice. As a result, the vessels of the second group were free from cholesterol plaques.

There are very interesting medical syndromes such as compulsive swallowing of objects. In the stomach of one patient suffering from this mania, 2500 foreign objects were found.

According to WHO studies, a daily half-hour conversation on mobile phone increases the chance of developing a brain tumor by 40%.

The human stomach copes well with foreign objects and without medical intervention. It is known that gastric juice capable of dissolving even coins.

The rarest disease is Kuru disease. Only representatives of the Fur tribe in New Guinea are ill with it. The patient is dying of laughter. It is believed that the cause of the disease is the eating of the human brain.

When lovers kiss, each of them loses 6.4 calories per minute, but in the process they exchange almost 300 different types of bacteria.

Each person has not only unique fingerprints, but also a tongue.

Our kidneys are able to purify three liters of blood in one minute.

In addition to people, only one living creature on planet Earth suffers from prostatitis - dogs. These are really our most faithful friends.

According to statistics, on Mondays the risk of back injuries increases by 25%, and the risk heart attack- by 33%. Be careful.

A person taking antidepressants will, in most cases, become depressed again. If a person coped with depression on his own, he has every chance to forget about this state forever.

Dentists have appeared relatively recently. Back in the 19th century, pulling out diseased teeth was part of the duties of an ordinary hairdresser.

With regular visits to the solarium, the chance of getting skin cancer increases by 60%.

To say even the shortest and simple words, we use 72 muscles.

The weight of the human brain is about 2% of the total body weight, but it consumes about 20% of the oxygen entering the blood. This fact makes human brain extremely susceptible to damage caused by lack of oxygen.

The phalanx of the human limbs consists of three parts: the body - the base, the proximal and distal ends, on which the nail tuberosity is located.

Each human finger consists of three phalanges, except for the thumb (it consists of two). The three phalanges of the fingers are called the main, middle and nail. The phalanges on the toes are shorter than those on the fingers. The longest of them is on the middle finger, the thickest - on the thumb.

The structure of the phalanx of the fingers: an elongated bone, in the middle part having the shape of a semi-cylinder. Its flat part is directed to the side of the palm, convex - to the back side. At the end of the phalanx are the articular surfaces.

By modifying the phalanx of the fingers, certain diseases can be diagnosed. Symptom drumsticks- this is a thickening of the terminal phalanx of the fingers and toes. With this symptom, the tips of the fingers resemble a flask, and the nails are like watch glasses. The muscle tissue that is located between the nail plate and the bone has a spongy character. Because of this, when pressing on the base of the nail, the impression of a movable plate is created.

Drum fingers are not independent disease, but only as a consequence of serious internal changes. Such pathologies include diseases of the lungs, liver, heart, gastrointestinal tract, sometimes - diffuse goiter and cystic fibrosis.

A fracture of the phalanx of the finger occurs from a direct blow or injury and is more often open. It can also be diaphyseal, periarticular or intraarticular. Fracture of the nail phalanx is usually fragmental.

The clinical picture of the fracture is characterized by pain, swelling and limited function of the finger. If there is internal displacement, then deformation is noticeable. If there is no displacement, a bruise or sprain may be diagnosed. In any case, you need to x-ray examination for a definitive diagnosis.

Treatment of a fracture of the phalanx of the fingers without displacement is carried out with plaster or an aluminum splint, which is applied when the nail phalanx is bent up to 150, the middle one - up to 600, the main one - up to 500. They wear a bandage or splint for 3 weeks. After removing the material, therapeutic exercises with physiotherapy are carried out. A month later, the working capacity of the phalanx is fully restored.

In case of displaced phalanx fractures, the fragments are compared under local anesthesia. After that, a plaster or metal splint is applied for 3-4 weeks. In case of fractures of the nail phalanges, the finger is immobilized with an adhesive plaster or a circular plaster bandage.

The phalanges of the toes often suffer from dislocations in the metatarsophalangeal and interphalangeal joints. Dislocations are directed to the rear of the foot, the sole and to the side.

This problem is diagnosed by a characteristic deformity, shortening of the finger or limiting its movement.

The greatest number of dislocations falls on the phalanx of the first finger, its distal part. In second place are dislocations of the fourth finger. The middle toes are much less commonly affected due to their location in the center of the foot. In the direction of dislocations are usually observed in the rear and side. The dislocation is reduced until edema develops. If the swelling has already formed, it is much more difficult to insert the phalanx into the joint.

Closed dislocations are reduced after local anesthesia. If it is difficult to set it in the usual way, then use the introduction of a spoke through the distal phalanx or the use of a pin. The procedure is simple and safe. Then they carry out traction for the damaged finger along the length and counter-traction (which is carried out by the assistant) for ankle joint. By pressing on the base of the phalanx displaced to the side, the dislocation is reduced.

At chronic dislocations need surgical intervention.

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A fracture is a dangerous injury that always brings a lot of physical and psychological inconvenience. Excessive loads on the bones of the musculoskeletal system can easily damage most of them. Indeed, of the more than two hundred bones of the body, only less than half have a "special" strength. Also, one should not forget about the joints, in which the connective tissue takes the main load. Therefore, a fracture of the big toe is a threat from which no one is absolutely protected. Everyone needs to know the types of this damage and the methods of treatment.

Anatomical features

Fragment of the main phalanx on the radiograph

The foot is the most complex and most distant element of the musculoskeletal system. A feature of its structure is the presence of a large number of joints and small bones, each of which is quite vulnerable to mechanical injury. This vulnerability is most relevant for the extreme toes due to their location - the thumb and little finger. It is they who most often undergo dislocation, fracture and, according to statistics, are considered the most traumatic part of the leg.

The foot includes twenty-four separate bones that make up its three divisions. Together they form a complex vaulted support system that helps maintain the upright position of the body. The third section is considered the most traumatic, which includes fourteen tubular hollow bones connected by joints and muscles. They form five fingers, but their length and structural features do not allow us to talk about the special strength of each of them.

The thumb is the most susceptible to injury. It protrudes forward in relation to others, and is one of the anchor points that support the weight of a standing person. It is on the finger under consideration that a significant part of the loads is accounted for.

Fracture classification

Structure of the foot and toes

There are two categories of fractures. The first medicine refers to a traumatic fracture - the "classic" version of mechanical damage. Its severity, complexity of treatment and danger to the body depend on the magnitude of the destructive force acting on the thumb. The second category is a pathological fracture, the danger and treatment of which is often significantly higher than in the first case.

Pathological fractures also form as a result of mechanical damage, but this often requires much less impact. The reason lies in the pathology, which causes a violation of the strength of the bones locally or throughout the body. It can be any acute or chronic disease that directly or indirectly affects bone tissue.

Tuberculosis, malignant tumors, systemic diseases leading to circulatory disorders and nutrient balance in the blood plasma - the list is very wide. These and similar ailments can provoke conditions when an intra-articular fracture becomes a chronic condition of the thumb.

The specific classification of fractures according to the general state of damage distinguishes between:

Closed fracture - there is no damage to the skin, the bone is not visible. This case usually does not require surgery and is fairly easy to treat. An open fracture is the most dangerous type of injury, in which fragments of the damaged bone destroy soft tissues. Often accompanied by intense bleeding, displacement of bones, rupture of muscle tissue, blood vessels. Requires immediate medical attention. Displaced fracture - the damaged bone moves to the side, infringing on the tissues, vessels, and nerves located in it. May be open. A non-displaced fracture is a simple form of injury accompanied by tissue swelling and pain. Complete or incomplete fracture - the damaged bone is completely divided into two or more separate sections or a crack forms in it. A fracture of sufficiently long bones may be accompanied by the appearance of damage of each type. A comminuted fracture is a dangerous destruction of a bone, in which it is crushed into several fragments. Recovery often requires surgery.

Each of the injuries can happen to any of the bones of the foot, but it is the big toe that most often suffers.

The classification of the fracture is the first thing you should pay attention to. To select the most effective course of treatment, it is necessary to determine the category to which the resulting limb injury belongs.

Diagnostic methods

Swelling of tissue at the fracture site

The psychology of modern man is such that everyone is sure that bad things happen to anyone except us. After a thumb injury, when examining the symptoms, many people unconsciously try to put them under those that correspond to the bruise. This is especially true after a less dangerous, but accompanied by severe pain, dislocation of the phalanx of the fingers. A fracture after this, especially simple, and without displacement, it is simply impossible to diagnose on your own. It will not hurt as much as the previously received dislocation. Or, if we are talking about other fingers, the victim will be misled by the “slow” development of negative sensations. It is not uncommon for the pain in a broken finger to get worse as the day progresses. But a few hours after the injury, the sensations in the finger resemble an ordinary bruise or dislocation.

There are probable and absolute signs of a fracture. Probable signs only suggest the presence of such damage in the thumb. Therefore, they require diagnostic confirmation and include:

pain during palpation of the injury; swelling of tissues at the site of injury, significantly increasing the volume of the affected area; the appearance of a hematoma in the damaged area; sharp pain when moving a finger.

A fracture of any of the toes is guaranteed to confirm that the patient has symptoms such as:

change in the appearance of the finger and its adoption of an unnatural position; complete inability to control the mobility of the injured finger; crunch of bone fragments during palpation of the damaged area; the case of an open fracture, allowing to observe the displacement and destruction of bone tissue; severe swelling of tissues, accompanied by sharp pain even with the slightest pressure.

An x-ray of the damaged area is also necessary in this case, because it will allow you to see the degree of damage and establish its danger.

For displaced fractures, x-rays are needed to correctly set the displaced area. Do not try to do it yourself - without the necessary knowledge, you can only aggravate the situation by provoking tissue rupture and internal bleeding.

First aid

Thumb fixation

The choice of treatment option depends on the location and preliminary diagnosis of the fracture. For the thumb, there are three main varieties of it:

Damage to the distal nail phalanx. The site should be anesthetized, then the bone is immobilized. The treatment consists in fixing the broken fragments with a plaster, if necessary, the nail plate is completely removed. Fracture of the middle and main phalanx. The vast majority of cases allow outpatient treatment, which consists in immobilizing the damaged bone. The average recovery time is two weeks. Complex multiple fractures. For treatment, it is required to wear a “gypsum shoe” for the time set by the attending physician.

A multiple fracture resulting in the formation of two or more bone fragments requires manual reposition of the broken sections. This task can only be performed by an experienced doctor, since any careless movement can damage nearby tissues. For cases that require repositioning of bone sections, the recovery time is from two weeks to a month.

The choice of treatment for a fracture of the thumb depends on the degree and severity of its damage. The degree of danger of the injury depends on the force that affected and the vector of its application.

Self-treatment and prevention

Cold compress to relieve swelling

Prevention of fracture of the thumb is:

in the use of comfortable shoes that reliably protect all fingers; in refusing to use foods that leach calcium from the body - this increases bone fragility; in compliance with safety regulations.

To get rid of pain, you can take painkillers that the doctor will approve. To strengthen bones, it is recommended to eat foods containing calcium. These include dairy products, peas, beans, eggs, rye bread, apples, grapes and many others.

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Valgus deformity

Inflammation

Joint treatment

Edema and tumors

Of all types of fractures, the leading place is occupied by traumatization of the big toe. Since the tubular bones of the limbs are considered the most vulnerable, external influences become main reason fracture of the main phalanx of the 1st toe.

After reading this material, you will learn how to distinguish a fracture from a bruised toe and be able to provide first aid to the victim.

One of the most common types of injuries is considered to be a marginal fracture of the big toe. It is not difficult to understand that a person has broken a bone, since the altered bone structure in this area is noticeable without special equipment.

For reference! The main symptom of a thumb fracture is excruciating pain.

Usually traumatization of the limbs is formed due to external factors. A fracture of the nail phalanx of the big toe can be associated with the following reasons:

severe injury or blow;
stumbling;
falling on a limb of a heavy object;
traumatization;
sharp bend of the foot;
sports or domestic injury;
production factors;
anatomical features;
frequent twisting of the feet.

Integrity can be provoked various problems with the musculoskeletal system. To others possible factors include:

flat feet;
the presence of injuries in the ankle;
increased fragility of bones due to lack of calcium;
bone disease;
bone tuberculosis;
disease parathyroid glands accompanied by an increase in the production of parathyroid hormone;
some types of cancer.

All of these factors reduce the strength and elasticity of bone tissue, which provokes trauma to the limbs.

Classification

Fractures of the limbs can be divided into several types and classifications. AT medical practice separate open and closed view. The first type is formed with the formation of various flaws in the skin. The danger of this configuration lies in the contact of the bones with the external environment. Unlike the open type, the closed type does not tear the outer covers.

By location A fracture of the big toe may or may not be displaced. In the first form, the bone structures are deformed and deviate from the normal posture. In the case of no displacement, the position of the bones does not change.

The nature There are several types of fracture:

without splinters;
ordinary cracks;
breaks;
one- and two-splintered;
multisplintered.

Also, with a fracture, one or more fragments may form. by the most severe case recognized as the one when the bones are severely crushed.

By localization share the following forms of damage:

fracture of the proximal phalanx of the 5th toe;
traumatization of the phalanx;
violation of integrity closer to the foot;
fracture of the nail;
injury closer to the nail plate.

According to the mechanism of education distinguish direct and indirect fracture. In the first position, defects in the bone tissue coincide with the site of the lesion. In the second type, the point of traumatization and bone defects do not converge.

Symptoms

The symptoms of a fracture of the big toe are absolute. For transformation characterized by severe and unbearable pain. Other signs of broken bone integrity include:

abnormal mobility of the limbs;
severe curvature of the phalanges;
the formation of open wounds;
the crunch of fragments;
the formation of fragmental bone wounds;
swelling in the affected area;
strong pain;
increased discomfort during movement of the phalanges or palpation of the affected area;
distribution of pain throughout the foot;
severe redness of the skin;
the formation of hematomas;
decline motor activity feet.

All of these signs can appear not only with a fracture of the thumb, but also in case of a bruise, dislocation. A thorough examination will help determine the location of the fracture and make an accurate diagnosis.

Look at the photo of the fracture.

How to recognize a fracture

When injuring fingers, it is important to be able to distinguish between a fracture and a bruise or crack. When the integrity of the bones is violated, large and open wounds. The patient can see crushed phalanges without special equipment. When driving thumb extraneous sounds appear, including a strong crunch.

The contusion is characterized by the preservation of the shape of the phalanx. The patient does not notice the unnatural curvature of the thumb and does not feel acute pain. However, limb mobility may still be reduced.

Diagnostics

If you determine the form of injury to the finger visual inspection impossible, the victim must be taken to the hospital and diagnosed. Complex laboratory research includes examination of the injured finger, palpation for problems in the phalanx, and other examinations.

For reference! With a complex type of fracture, the patient is prescribed MRI and CT.

After the initial detection of a fracture, the victim must undergo an x-ray. The obtained picture in two projections will allow to determine the nature of the damage and the complexity of the violation of the integrity of the bone structures.

If it is not possible to establish the diagnosis in this way, the patient needs to undergo a magnetic resonance or computed tomography. Such examinations will help to identify damage to soft tissues, joints and tendons.

What to do first

If a bone fracture on the thumb is suspected, the first thing to do is to calm the victim and give him any of the listed painkillers - Citramon, Tempalgin, Solpadein, Nurofen, Ibuklin, Pentalgin. Then call an ambulance.

While waiting medical team proceed with the following activities:

Lay the victim on a hard surface.
The injured part of the leg needs to be slightly raised. To do this, place your foot on any object at hand.
At closed fracture apply ice or any other cold object to the inflamed part. In order not to freeze skin change its position every five minutes.
Subcutaneous bleeding can be reduced by applying bottled water to the swelling.
At open form fracture treat the wound antiseptics local action then cover the affected area with a sterile dressing.
Try to immobilize your thumb. To do this, apply a tire from any improvised materials.
In case of severe shock, the patient may lose consciousness. At this time, it is important to watch general condition the victim. Make sure that the tongue does not sunk in the mouth, and also that the patient does not choke on vomit.

The patient must be transported on a stretcher in a supine state. The leg should be in an elevated position. In the case of self-treatment in the hospital, the patient needs to sit or reclining.

Treatment in a hospital

After applying to medical institution The patient is placed in the traumatology department, where complex treatment is provided.

Standard therapy is as follows:

For a certain amount of time, painkillers and anti-inflammatory drugs of local importance are injected into the patient. The list of drugs includes Ketorolac, Analgin, Nimesulide.
In severe fractures, narcotic analgesics are prescribed.
With a closed fracture without displacement, cold water bottles are applied to the foot three times a day. The session lasts ten to twenty minutes.
Treatment of a fracture of the big toe without plaster is possible with a closed form of trauma. In this case, the patient creates conditions for the immobility of the limbs. Immobilization reduces pain shock.
Immobility of the thumb is provided with bandages and a splint. The procedure is carried out only after the reduction of the affected area in its axis.

Successful recovery is possible only with bed rest. After eliminating the primary symptoms, the patient is allowed to move around with the help of crutches without resting on the injured leg.

Closed reduction

When the phalanx is displaced, the patient is assigned a closed reposition. The procedure is carried out as follows:

The affected part is treated with anesthetics and painkillers.
The surgeon then extends the finger and returns the phalanges to a physiological state.
If there is no effect, the procedure is repeated until full recovery movement of the joints of the thumb.

Reposition of this kind is possible only with a fracture without splinters. For accurate diagnosis The patient is given an x-ray. A picture must be taken after the procedure to control the quality of work. After that, a tire is applied to the site of the lesion.

Skeletal traction

If the closed reposition did not give the desired result, the patient should undergo skeletal traction. During the procedure, the doctor holds the bone fragment in a retracted position with the help of a nylon thread. Then plaster is applied to the affected area. The operation is performed under local anesthesia.

In this state, the victim needs to spend two weeks, after which it is necessary to take a picture of the affected part. With positive dynamics, the thumb is fixed with a splint or plaster until the soft tissues are completely healed and the bone is restored.

Such a procedure is prescribed not only in the absence of the effect of a closed reposition, but also in the case of an open fracture of the finger. Crushed phalanges are restored under the careful supervision of the surgeon.

Fragments of bones are fixed with needles, screws and plates. After that, the damaged area is treated with antiseptics and a drainage channel is created. Then a wide strip is applied, consisting of several layers of a plaster bandage. Longueta is used when applying plaster splints and to strengthen dressings.

The fracture site must be treated with antiseptics. Otherwise, there is a risk of developing bacterial infection and dangerous complications. After the tissues and bones have healed, the plaster is removed, leaving a supporting bandage.

Rehabilitation

Full recovery takes up to eight weeks. The duration of rehabilitation depends on the severity and shape of the fracture.

At this time, the patient is prescribed a course of auxiliary procedures:

massage;
general strengthening complex of exercises;
physiotherapy;
restoration of blood circulation.

Physical therapy can help speed up the healing process. In each case, the list of physiotherapy is individual, but in conservative treatment includes:

electrophoresis;
treatment with calcium salts;
magnetotherapy;
mud treatment;
amplipulse;
myostimulation;
paraffin-ozocerite applications.

Complications

Illiterate treatment for a fracture of the proximal phalanx of the 5th toe dangerous with its consequences. The main ones include:

visible deformity of the finger;
restriction of mobility;
loss of functionality;
the appearance of false joints;
complete immobility of the joint;
infectious inflammation of all constituent parts of bone tissue;
gangrene.

At untimely appeal in the hospital there is a risk of abnormal fusion, which will lead to improper bone healing. Correct such a pathology can only be surgically.

Conclusion

Remedial gymnastics, physiotherapy, massage will help to develop the big toe. It's also important to watch your diet. Include in your diet fresh vegetables and fruits, lean meats, protein food. During rehabilitation, it is useful to take dairy and sour-milk products.

Limiting heavy loads will help speed up the recovery process. Purchase comfortable orthopedic shoes.