9Mar

Fracture of the toes and their joints: signs, treatment and causes

Contents:
Reasons
  • Classification
  • Clinical picture
  • First aid
  • Diagnosis and therapy

  • Causes

    A fracture of the toe, like a fracture of the bones of another localization, occurs when a traumatic factor that exceeds the strength of bone tissue is stronger. The toes are composed of short and thin phalangeal bones, strengthened with small ligaments and muscles. In this case, the foot carries a tremendous load, keeps the weight of the body when moving and in static poses. For the formation of such a fracture, the effect of a low traumatic force is sufficient.

    Injury of phalanal bones usually occurs when heavy items fall on the foot, when you strike your finger on a hard surface, when you turn the foot, or wear too narrow shoes. In this case, they speak of a traumatic fracture, which is 95% in the statistics of injuries to the bones of the toes. Significantly less common pathological fractures. They develop due to the weakening of bone strength in various diseases( osteomyelitis, osteoporosis, tumors, tuberculosis).

    Classification

    The classification was created to identify the severity of the trauma and determine the tactics of effective treatment. First of all, they specify the localization of the defect of bone tissue. Injury of the big toe is characterized by a more severe course, a variety of clinical manifestations and peculiarities of therapy. Fracture of the 2nd - 5th finger usually proceeds easily, does not require long-term treatment, rarely leads to disruption of the foot functions.

    Injury of the first toe
    Edema and redness of the injury site

    According to the bone fragments with the external environment, the following are isolated:

    • open - a defect in the bone tissue leads to damage to the skin;
    • closed - bone fragments do not communicate with the external environment, the integrity of the skin over the site of the injury is not compromised.

    After the displacement of bone fragments, the bones are extracted:

    • with displacement - the ends of the damaged bone are displaced in different planes;
    • without bias - bone fragments remain in the physiological position.

    According to the nature of displacement fragments of bone are extracted:

    • with longitudinal divergence - occurs when a trauma of ligaments and muscles of the damaged finger;
    • with longitudinal desire - arises at preservation of integrity of the musculoskeletal device which pulls bone fragments;
    • with angular displacement - appears in the case of a bone defect in a child, bones in childhood have an elastic periosteum, while the phalanx is damaged only on one side;
    • with wedging of fragments - develops when the damaged bone edges are inserted into each other, arises when the impact is directed along the longitudinal axis of the phalanx.

    The number of fragments of damaged bone is broken by fractures:

    We also advise: Broken leg First aid with closed fracture
    • multibeam;
    • single and double-lobed;
    • without the formation of bone fragments.

    Fracture localization is characterized by fractures:

    • of the distal nail phalanx( marginal fracture);
    • of the middle phalanx;
    • main phalanx.

    Finally, due to the formation of trauma, fractures are identified:

    • traumatic,
    • pathological.

    In clinical practice, fractures of the large and ring finger of the foot, as well as the little finger, are more common. On the features of a fracture of the big toe, you can learn from this article.

    Clinical picture

    The defect of the bones of the toes has a kinetic manifestation of varying intensity, depending on the nature, severity and location of the injury. Signs of a fracture of the thumb have more pronounced symptoms due to the large size of the bones in comparison with other toes of the foot, frequent damage to the joints, features of the anatomical structure.

    Fracture of toe
    Radiography is a classic method for diagnosing
    fractures

    If the first finger of the foot is damaged, the foot marks intensive pains, the spread of the edema to the entire foot, a significant disruption of the motor and supporting function of the lower limb. In the case of a trauma of the 2nd - 5th fingers, signs of a fracture are less pronounced. As a result, victims often do not seek medical help, which subsequently causes the formation of complications.

    Symptoms of fracture are divided into relative and absolute. Relative allows you to suspect fracture, occur when the soft tissues are damaged without a bone defect, for example, with bruising, sprain, muscle tear. Absolute symptoms give complete confidence in the diagnosis, occur only with bone fracture.

    Relative signs of fracture include:

    • pain in the area of ​​trauma;
    • increased local temperature, redness of the skin, swelling of the finger;
    • cyanosis of the skin above the site of the injury due to the formation of a hemorrhage into soft tissues;
    • impaired motor function of the injured limb;
    • strengthening of the pain syndrome with a feeling of the place of injury and during the movement of the foot.

    Absolute fracture symptoms include:

    • wound formation with visualization of bone fragments;
    • detecting bone deformation when feeling the site of an injury;
    • revealing the crunch of bone fragments( crepitation);
    • shortening or deformation of the damaged finger;
    • appearance of abnormal finger mobility.

    In the event of an injury, you must contact the tram station or the trauma department of the hospital. Untimely treatment of a doctor increases the risk of complications: large bone callus, ankylosis, false joint, wrong fusion of bones, osteomyelitis, gangrene.

    First aid

    Fracture in the toe area, as well as trauma of other localization, requires the provision of pre-medical care. After the onset of injury, you must call the ambulance. A damaged leg should be given an elevated position with a pillow or roller of blankets, bedspreads, clothes. This will ensure the outflow of blood from the site of damage, reduce swelling and pain.

    To the site of the injury, you can attach a plastic bag filled with ice, which will reduce pain, reduce the size of the hematoma, and prevent swelling of soft tissues. For additional anesthesia, the victim is given drugs from the group of analgesics or non-hormonal anti-inflammatory drugs( analgin, paracetamol, nesesulide, ketones).

    Fracture of toes
    Applying a dressing for fractures without bias

    If, for whatever reason, you can not call a health team, the patient can be taken to the hospital on his own. In case of a trauma to the first toe in this case, it is necessary to impose a transport tire. It is made of two pens or pencils, wrapped in bandage or cloth. Then improvised tires are tied on the sides of the finger, which provides reliable transport immobilization and prevents the development of complications en route to the emergency station.

    Injury of the 2nd - 5th finger usually does not require the imposition of tires, it is enough to give the injured foot an elevated position and prevent motor activity. It should be remembered that it is possible to cure a fracture quickly only if you contact the doctor in a timely manner. Refusal of diagnosis and adequate therapy usually leads to the development of severe undesirable consequences, which will require prolonged treatment.

    Diagnosis and therapy

    Regardless of the detection of relative or absolute signs of fracture, the diagnosis is confirmed by an X-ray examination. Radiography is carried out in the direct and lateral projection of the foot for the diagnosis of trauma, monitoring the correct comparison of bone fragments and monitoring the adhesion of bone defects after the end of treatment. This instrumental method is considered a "gold standard" for the diagnosis of fractures.

    Gypsum dressing as "sapozhok"
    Gypsum dressing as "sapozhok"

    Therapy for a defect in the bones of the foot depends on the type of fracture, its location, and the age of the affected person. In childhood and young age, the callus is formed in the shortest possible time in 2-4 weeks. For the elderly, the fracture fusion time can be increased to 6-8 weeks. When the bone fragments are displaced, the traumatologist under local anesthesia( novocaine, lidocaine) makes a comparison( reposition) of the fragments, then proceeds to the therapeutic immobilization( immobilization) of the injured foot.

    In case of a fracture of the big toe, gypsum is used as a "boot", which is applied to the foot, ankle and lower third of the shin. With a lesion without bias, the gypsum bandage can be replaced with a special orthosis. Fracture of the 2nd - 5th finger of the foot without displacement does not require the use of gypsum. In such cases, a finger is applied to the damaged finger, which immobilizes it by attaching it to a neighboring healthy finger. To do this, put cotton wool or a soft cloth between the fingers, and then attach them to each other with an adhesive plaster.

    Special orthosis for foot
    Special orthosis for foot

    With open trauma, the wound is treated with an antiseptic solution. In the case of a defect in the phalanx of the thumb, especially with joint damage, surgery is performed. Apply intraosseous osteosynthesis - fastening of bone fragments by means of plates, screws, screws, wire. In severe cases, the extension of damaged phalanges is prescribed. Rehabilitation with complex fractures increases. The recovery period with closed injuries without bias usually does not exceed 2 to 3 weeks, and in case of an open fracture or closed trauma with a displacement of not less than 4-6 weeks.

    Fracture of fingers on the foot with timely diagnosis and treatment quickly heals and does not leave undesirable consequences. Refusal of therapy leads to the development of complications, which causes disruption of the motor activity of the lower limb and chronic pain in the area of ​​trauma.

    Toes