Anyone can get a broken toe. It is enough to hit a stone, a corner of furniture, or fall under a bicycle wheel. Limbs are always more vulnerable to injury and there is no need to exercise extreme species sports to earn damage. Most often, the big toe gets hit; a little less common is a fracture of the little toe. Each injury has its own specifics and special treatment methods.

The most common are closed fractures. In this case, integrity is maintained skin. Injury that occurs as a result of compression is often accompanied by displacement. An open comminuted fracture is difficult to restore. But much is determined by the location of the damage. In this regard, the following are highlighted:

• fracture thumb legs - often accompanied by a fracture of the sesamoid bone. Intra-articular lesions are the most difficult to treat;
• fracture index finger – implies damage to one or more phalanges of the fingers;
• middle finger fracture– the nail phalanx is most often affected, and along the fault line the fracture can be oblique, longitudinal or transverse;
• fracture ring finger – single injuries are rare; very often injuries also affect the little finger. There are also simultaneous injuries to the 1st, 2nd and 4.5th fingers;
• fracture of the little toe– one of the common injuries is a fracture of the proximal phalanx.

A non-displaced injury heals faster and does not require medical reduction. It is much more difficult in the case of significant deformations. There are several types of displacements:

• with divergence and setback;
• with lateral and angular displacement;
• with wedging of fragments.

If the middle and distal phalanx are damaged, the treatment tactics will be the same, although the damage themselves occurs in different ways. Only an impacted fracture of the toes can cause a fracture of the middle phalanx. It is quite difficult to damage it when dropped or hit.

Phalangeal fractures

A blow to the entire foot leads to injuries to the phalanges. The first two fingers are often subjected to mechanical stress, and therefore fractures of this kind occur specifically in them. Axial load on broken phalanges is impossible; the damaged finger is not able to bend. Injuries can also be open or closed, with wounds on protruding fingers occurring many times more often.

Swelling occurs at the site of injury. A blow to the big toe causes similar disorders as with an injury to the big toe, which is due to the presence of only two phalanges. Phalangeal fractures are divided into T-shaped, oblique and transverse. A direct blow to the fifth toe causes multiple injuries due to small size phalanges The affected little finger instantly swells and becomes blue.

Trauma code according to ICD 10

Everything is hidden under the S92 code. For an injury such as a fracture of the little finger, a separate code is not assigned, but for a thumb injury, code S92 is written on the card. 4. In case of a complex fracture with multiple injuries to the foot, the disease is designated by code S92.7. All fractures of any finger other than the thumb are covered by code S92.5.

Reasons

You can get a broken toe as a result of strong blow. Football players are familiar with such injuries, and even reinforced boots do not always protect the foot from injury. Most often it goes to the first finger, because it has the most large sizes. Traumatic injuries occur due to the fall of a heavy object, accidents, or feet falling under the weight. A person can trip and get a crack, but in normal conditions musculoskeletal system just happens. A minimal impact fracture occurs simply due to bone fragility. Diseases such as osteoporosis and tuberculosis lead to tissue weakening.

Damage caused by bone pathologies occurs in only 5% of cases of common fractures. As a result of this injury, the integrity of the bone group is compromised, and recovery is extremely difficult. So, when the phalanx of the little finger is damaged, they are often observed. A minor blow to another object can cause such pathologies. It is enough to step on a person’s foot to cause injury.

Symptoms

Due to a fracture of the big toe, the foot takes a forced position. This is immediately noticeable, and there are no problems with making a diagnosis. Symptoms of a fractured little toe are less pronounced. The leg may swell and turn blue both with a fracture and with a bruise.

What are the first signs of a broken toe? First of all, it is severe pain. It intensifies with tapping or palpation. Painful shock doesn't happen. Even in the case of a serious injury, pain can be tolerated. A hematoma in the area of ​​the fracture indicates rupture of blood vessels. In some cases, the leg literally turns purple. Swelling after a fracture most often occurs with severe bruising and damage to soft tissue.

If there are wounds, then we're talking about about open injury. Skin lesions often accompany symptoms of a broken or cracked big toe. Other signs of a broken toe include:

• redness and local hyperthermia;
• increase in size of the damaged finger;
• limited mobility or complete immobility.

Symptoms of a toe fracture may include shortening of the damaged toe and its pathological mobility. If a bone is crushed, the fragments may be visible to the naked eye. Signs of a pinky toe fracture include a deformed foot and possible displacement of the fifth toe. TO characteristic symptoms A fracture of the little toe should be attributed to crepitus of bones or their fragments.

First aid

Lack of adequate therapy can lead to irreversible deformities. If it is not possible to quickly deliver the victim to a doctor, then you need to provide first aid for a broken toe.

In this case, the procedure will be as follows:

• give the patient an anesthetic;
• treat the wound if there is one;
• fix the injured finger.

If the pain does not decrease, then they suggest non-narcotic analgesics. Immobilization is necessary if displacement is suspected. You can fix your toe using a bandage and splint. Usually the thumb is immobilized. It is wrapped together with a pencil or other solid object of suitable size. Fixation is not always justified. More often, the patient is simply laid down or seated, and the leg is placed on an elevation.

If the main phalanx of the 4th finger is damaged, you can fix the finger with the adjacent one. The phalanges cannot be tied tightly; a cotton pad is placed between them. Cold will help relieve pain and swelling. Apply a bag of crushed ice for 5-10 minutes, and then take a break to avoid frostbite. Cooling will help if there is a fracture of the little toe, but for this injury, first aid will be slightly different.

What to do if your little toe is broken

If the little toe is injured, the leg must be raised up and placed on a pillow in a relaxed position. This will prevent swelling and soft tissue swelling. Immobilization of the little toe is not required, but to get the victim to the hospital, the foot should be secured. Shoes are not worn, otherwise the broken bones may be dislodged.

What else can you do if you have a broken toe at home? After pain relief and anti-inflammatory therapy, all that remains is to call “ ambulance" Without accurate diagnosis difficult to undertake further actions. It is prohibited to reset the finger yourself.

Diagnostics

Minor cracks and fractures often occur without significant symptoms. It is not always possible to determine an injury by eye. In the case of a fracture of the nail phalanx of the big toe, the deformities are easily visualized. The specialist asks questions regarding the duration and causes of the injury. To clarify the diagnosis they do x-ray. The traumatologist prescribes radiography in two projections, which will allow the violation to be accurately localized. Treatment tactics also depend on the accuracy of diagnosis.

If the second and further fingers are damaged, the patient may not be aware of the fracture. Often the symptoms are similar to a banal bruise. How to determine a broken toe without x-rays? An experienced doctor will be able to understand the nature of the damage by palpation and tapping. But it is not always possible to recognize complex wounds visually. A crack can be identified using a CT scan. But this method seems redundant and unjustified in cases where the damage is obvious.

Treatment

Temporary disability due to foot injuries is small. A fracture of the little finger is a serious injury. In this case, a plaster cast is applied and the foot is immobilized.

If the broken little toes on the foot are displaced, then they are set. How to treat a fracture in case of a closed injury? Usually the method of one-stage reposition is used. Treatment for a fractured toe begins with pain relief, after which the toe is gradually pulled out, returning it to its physiological position. After reduction, the functionality of all fingers is checked. If the swelling goes away and the fingers function properly, a fixator is installed. This is usually a cast, but may be a bandage.

The timing of immobilization of the phalanges of the toes is determined by the severity of the injury. For minor injuries, a big toe orthosis can reduce the load and protect the foot from external influences.

If it is not possible to cure a fracture with one-stage closed reduction, use skeletal traction. This is an invasive restoration method that allows you to keep bone fragments in the correct position. The damaged little finger (or other finger) is pierced and a nylon thread is inserted. If the little toe is broken, it can be fixed with special pins. In adults, fusion takes several weeks, in children - less. The puncture site is treated with antiseptics, and after removing the fixator, a finger orthosis is installed.

Apply folk remedies with a fracture it makes no sense. The exception is herbal medicines with anti-edematous, anti-inflammatory and analgesic effects. But they are used for short-term treatment. Products containing gelatin - jellies and jellied meats - can speed up the fusion process.

Surgical treatment

Open reduction is inevitable if the bone is displaced or there is an open fracture with damage to cartilage tissue. The most complex is a fracture with multiple fragments. To compare fragments, knitting needles, metal wire and plates are used. Rules surgical treatment provide for subsequent plaster casting for up to 8 weeks.

Despite the surgical precision, open surgery poses many difficulties due to the specific nature of the therapy. Remains high risk infection and suppuration, there may be difficulties with anesthesia.

How long to treat and wear a cast

How to quickly heal a damaged foot and reduce the duration of treatment for fractures? Much is determined by the individual characteristics of the patient’s body and the specifics of the injuries themselves. After open reduction, the bones heal for quite a long time. Whether plaster is needed after the main treatment is determined by the traumatologist. But not a single reposition can be done without additional fixation.

You will have to wear a cast as long as the fracture of your finger heals. For cracks and minor fractures of the toes, immobilization lasts up to 3 weeks. In case of displacement, you can walk no earlier than after 4 weeks, and sometimes after 6 weeks. finger in case of an open wound, depends on the complexity of the operation. Usually, wearing a cast is prescribed for a period of 5-6 weeks. Restoration of working capacity takes up to 2 months if complications have occurred.

In case of malunion, it will be necessary reoperation. It's hard to say how long recovery will take. Typically, the period of incapacity for work is doubled.

Rehabilitation

Development of the foot after removal of the cast should be carried out under the supervision of a physician. The specialist will prescribe gymnastics, massage and select physical treatments. Rehabilitation after a thumb fracture does not take much time. Recovery takes from several weeks to a month. But this is in the absence of complications.

The patient is recommended to start exercise therapy immediately after removing the cast. One of effective exercises is fingering small objects with your toes. Such gymnastics will be especially useful if the nerves have been damaged due to injury. There should be no overexertion during training. First, train for 15-20 minutes, over time the duration of training is increased to 40-60 minutes.

Physiotherapy

Exercises after a toe fracture include squeezing and straightening all of the toes. The injured finger is not used for some time, but then it is also included in gymnastics. At the first stage, it is better to replace exercises with self-massage. Light stroking and squeezing will improve blood flow and prevent atrophy. There should be no unpleasant sensations during gymnastics. The duration of therapy is no more than 10 minutes, the duration of the course is 10-15 procedures.

You can work out your foot on your own, but before performing massage and gymnastics you should consult a doctor. If a toe fracture heals slowly, then hardware physiotherapy is prescribed. Proven effectiveness following methods treatment:

• UHF therapy – reduces pain, improves tissue trophism, stimulates metabolism and capillary circulation. One of the reliable methods of recovery after fractures;
• Magnetic therapy – accelerates regeneration, prevents the development of diseases skeletal system, reduces swelling;
• interference currents - activate trophic processes, relieve hematomas, normalize blood circulation.

Ozocerite applications have beneficial properties. They dilate blood vessels and eliminate pain after a long stay in one position. Similar action have salt baths. Baths with soda will prevent complications and... They eliminate local inflammatory reactions and reduce post-traumatic swelling.

Complications and consequences

Negative consequences arise due to lack of treatment. Many patients simply do not go to the doctor, because the injury does not bother them much. But this is at first. Over time, the deformities become irreversible and the foot does not function properly.

Complications can arise due to errors in therapy. If a fracture of the phalanx of one of the toes does not heal properly, a callus may form. This is pathological tissue at the site of fusion. Its dimensions sometimes exceed the size of the phalanx. The growth of replacement tissue is due to the weakness of the bone structure. Callus compensates for the lack of strength, but causes great inconvenience to the patient. It causes pain, interferes with walking, and complicates the selection of shoes. Besides, it's always additional source inflammation and vulnerable spot in case of injury.

If the callus has formed due to improper reposition, then repeated surgery is required. In this case, healing will take longer than usual. In the presence of a bone defect, repeated surgery is associated with the risk of developing tissue inflammation.

There are other complications of toe fractures:

• false joint – occurs due to shrapnel damage. Scattered fragments are erased and become separate elements bones. They are not connected to each other, and the space between them represents that same false joint. Due to the lack of cartilage tissue between the fragments, inflammatory process. The functionality of the finger and foot is generally reduced. If the upper phalanx is damaged, then ingrown nails are possible;
• ankylosis - occurs due to inflammation in damaged tissues. Over time, the joints ossify and lose mobility. This is one of the reasons why toes go numb. Sometimes they are completely immobilized, which leads to tissue death. To get rid of this defect, prosthetics are used;
• osteomyelitis is one of the the most dangerous complications. Occurs as a result of improper treatment open fracture. Pathogenic microorganisms enter the bone and cause inflammation. The infection enters the body through open wound. Less often – by hematogenous route. Correct initial treatment of the injury will prevent the development of osteomyelitis. If infection cannot be avoided, use powerful antibacterial therapy. IN advanced cases– depressurization of the bone;
• shortening of the bone is a consequence of improper fusion. Erroneous reduction followed by immobilization firmly fixes the fragments in incorrect position. The supporting function of the bone decreases, and pain occurs when moving. The risk of re-fracture increases sharply. Another reposition will correct the situation, but the fragility of the damaged bone still remains.

Prevention

In case of weakening of the skeletal system, it is prescribed. They are recommended to be taken for preventive purposes by all persons. old age, women during and after menopause, as well as pregnant and lactating women. From a medical point of view, the best prevention is increased caution on the street and at home. It is not difficult to avoid a fracture of the main phalanx if you look under your feet and avoid injury.

Foods enriched with calcium, magnesium, and vitamin D will help strengthen bones. This group includes fermented milk products, egg yolks, nuts, chicken liver, seafood, olive oil. They also prevent diseases such as arthritis and arthrosis. At the same time, you should limit your consumption of oxalic and uric acids.

Dear readers of the 1MedHelp website, if you still have questions on this topic, we will be happy to answer them. Leave your reviews, comments, share stories of how you experienced a similar trauma and successfully dealt with the consequences! Your life experience may be useful to other readers.

Author of the article:| Orthopedic doctor Education: Diploma in General Medicine received in 2001 from the Medical Academy named after. I. M. Sechenov. In 2003, she completed postgraduate studies in the specialty “Traumatology and Orthopedics” at the City Clinical Hospital No. 29 named after. N.E. Bauman.

Legs are a common occurrence. The phalanges of the limbs are vulnerable to many external influences, and are also subject to constant pressure from a person’s weight. From the materials in this article you will learn what symptoms are accompanied by this pathology and how long it takes to treat it.

The structure of the finger joint and its main functions

Toes are an integral part musculoskeletal system in the human body. Together with the foot, they support the weight of the body, make it possible to move, while helping to maintain balance.

Each toe is made up of several small bones, which are otherwise called phalanges. They are connected to each other by movable joints, which makes it possible to bend and straighten the fingers.

Limbs are the vulnerable part human body, which is most often subject to fractures. In most cases, the thumb is affected. It differs from the others in that it has only two phalanges instead of the required three. When walking, the big toe experiences the main load. The likelihood of getting a fracture increases several times. When injured, blueness and swelling usually spread to the entire foot.

The leg quickly swells and becomes bluish. The painful discomfort that accompanies this pathology usually does not allow the victim to fully lean on the limb. Often an open fracture of the big toe is complicated due to damage to the skin and infection. In this case, the person develops obvious signs intoxication of the body.

The difference between a fracture and a bruise

With a severe bruise, the clinical picture may be the same as with a fracture. One pathology can be distinguished from another by absolute characteristics:

• unnatural foot position;
• abnormal mobility is observed in the area of ​​the fracture;
• a characteristic sound when pressed, similar to a crunch.

These signs indicate a fracture of the big toe. Symptoms of injury should alert you and be a reason to go to the hospital.

Which ones are there?

To determine the most effective scheme treatment, it is important to determine the type of injury. If the skin is damaged, when the wound and the bone itself are visible, we are talking about an open fracture. In this case, the risk of infection of the affected area increases, so medical attention is required immediately. Having imposed aseptic dressing, the victim must be immediately taken to a traumatologist.

The closed version of the injury requires repositioning of the bone, that is, returning the fragments to their anatomical place. A fracture with a displaced big toe requires the fragment to be placed in place and properly fixed. Otherwise, fusion may not occur correctly.

If surgery is required. During the operation, the doctor performs an open reposition of the fragments and performs intra-articular fixation using special wires. Mobility of the affected joint is restored approximately by the eighth week. Throughout the entire period of treatment, it is recommended to support the body with vitamin therapy.

Big toe fracture: do you need a cast?

Even in ancient times, people believed that a diseased organ needed complete rest to recover. Bone is no exception. Its main function is to create support for the muscles. In case of fractures, complete immobilization of the bone can be considered a kind of equivalent to rest. Immobilization allows you to speed up and direct the right direction the process of regeneration of the damaged area.

The patient is given bandages, which are pre-moistened in gypsum solution. When applied to a limb, they take its shape and retain it for up to full recovery. A plaster cast is usually applied not only to the injured toe, but also to the foot and part of the lower leg. High immobilization is not entirely justified, as it seriously limits the mobility of the leg. On the other hand, in order to provide rest to the toe, it is necessary to immobilize the entire foot, and this is only possible with the help of a plaster cast “boot”.

Sometimes immobilization is not required for patients diagnosed with a big toe fracture. No plaster is used for bone cracks that heal on their own. Also included in the category of exceptions are the first few days after surgical manipulations on a limb with a fractured finger, when the injury is a secondary pathology. In this case, there is a need for regular monitoring of the wound healing process. When signs of successful recovery begin to appear, a cast is immediately applied to the leg.

Rehabilitation after a fracture

For six weeks after the injury, it is necessary to protect the injured finger from stress and try not to overexert it. Long walks and sports are contraindicated.

The rehabilitation period includes physiotherapy, special gymnastics and therapeutic massage. It is recommended to diversify your diet with foods rich in protein and calcium.

Some patients complain of discomfort when wearing a cast for a long time. This condition just needs to be endured for the bones to heal properly. If you have broken your big toe, you should not get the cast wet or try to remove it yourself.

Prevention

To avoid broken toes, doctors advise wearing comfortable shoes with stable soles. You should also exclude from your diet foods that “wash out” calcium from the body. These include sweet carbonated water, coffee and alcoholic drinks. Nutrition should be as balanced as possible. Special attention It is recommended to give foods containing calcium (beans, cabbage, carrots, rye bread). In case of bone tissue pathologies, it is recommended to undergo regular examination. Such simple preventive measures can prevent fractures, significantly improve the quality of life and remain healthy.

The term " Marginal fracture“mainly concerns patients who have received injuries to the phalanx of a finger of various origins, in which its complete or partial destruction is achieved.

Species

There are several classifications of marginal fractures.

Marginal fracture of a finger

Classification by reason of occurrence:

• injury (strike, severe bruise, compression, falling a heavy object on your fingers);
• pathology (occurs with certain ailments, during the course of which fragility develops and bone density decreases).

Difference in skin trauma:

• open (with this type of fracture the skin is damaged, a wound is formed, and part of the bone is visible from it);
• closed (in this case the skin is not injured).

Fracture location:

• nail;
• average;
• combined;
• basic.

Doctors also classify fractures based on how the bone was destroyed:

• with the formation of fragments;
• a fracture in which bone fragments are displaced;
• fracture without bone displacement.

Applying a plaster cast

The main reasons for the formation of a fracture are ailments that cause the bones to become less strong. This happens if there is:

• tumors;
• hyperparathyroidism;

Also important reasons are injuries received during accidents, playing sports, at home and at work, during a strike with heavy objects.
With a marginal fracture of the finger, a thin flat fragment is separated. It is worth noting that the injury is not very serious and mainly occurs while running. This situation most concerns the big toe for the reason that it takes on most of the load and protrudes on the foot stronger than the rest.

Signs

Very often people do not know how to distinguish an ordinary bruise from a marginal fracture. To do this you need to familiarize yourself with important signs finger injuries. They can be roughly divided into:

• relative;
• absolute.

Relative

Symptoms, which are called relative, appear:

• the presence of edema;
• painful manifestations;
• development of hemorrhage under the skin and nail plate.

Absolute

If there are absolute symptoms, you can high probability suspect a fracture. These include:

• crunching of bone fragments during pressure;
• unnatural position of the phalanx of the finger;
• unnatural movements.

How severe the symptoms will be depends on where the fracture is located.

When the big toe is injured, the symptoms of fractures are more pronounced and appear more intense. If the fracture is on the second, third, fourth finger or little finger, its manifestations are not immediately noticeable. For this reason, patients are not in a hurry to see a doctor to receive first aid.

Diagnostics

Treatment

Surgery after a toe fracture with installation of a fixation plate

This type of fracture is quite painful. For this reason, when providing first aid, the patient is given an injection with an anesthetic drug. After this, the traumatologist tries to immobilize the finger as efficiently as possible for the speedy fusion of the bone. If the manipulation is performed incorrectly, bone restoration will not occur physiologically, which will lead to the need surgical intervention.

If the injury is minor, the patient is recommended to apply ice compresses to the injured area and raise the limb to an elevated position (place a pillow or a blanket rolled up under it). In this case, the doctor wants to achieve the following effects:

• an ice compress will numb the limb and reduce swelling;
• the rise promotes the outflow of blood and prevents its accumulation in the limb.

In the first few hours after injury, ice packs should be used according to the following scheme: hold for 15 minutes and break for 45 minutes. It is also necessary to use an elastic bandage for fixation. This is necessary for walking or moving your leg.

It is worth noting that it should not remain on the limb for a long time, as this can provoke the development of even greater problems. With normal recovery, the patient can return to his normal lifestyle within 1-1.5 months.

Rehabilitation

After applying a plaster cast or fixing bandage, the doctor recommends that the patient remain at rest for 1.5 months and do not strain the leg or arm, so as not to aggravate the injury. To do this you need:

• limit sudden and very active movements;
• do not play sports;
• is not on your feet for a long time;
• include in the diet maximum quantity foods that contain a lot of protein and calcium.

To speed up the rehabilitation process, you can connect:

• physiotherapeutic procedures;
• gymnastic exercises.

All of the above activities are carried out only according to the clear instructions of the attending physician.

Prevention

Although a fracture does not pose a great danger, it is still better to prevent them. To do this you need:

• be careful and not allow heavy objects to fall on your fingers;
• don't hit the cobblestones when you run;
• fill your diet with foods rich in calcium;
• reduce the use of foods in your diet that promote leaching from the body nutrients(These include coffee, soda, alcoholic drinks).

If, however, a fracture could not be avoided, take a painkiller tablet, fix the injured area and contact the nearest medical institution for help.

Moisov Adonis Alexandrovich

Orthopedic surgeon, doctor highest category

Moscow, Balaklavsky prospect, 5, metro station "Chertanovskaya"

Moscow, st. Koktebelskaya 2, bldg. 1, metro station "Dmitry Donskoy Boulevard"

Moscow, st. Berzarina 17 bldg. 2, metro station "Oktyabrskoye Pole"

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Education and professional activities

Education:

In 2009 he graduated from the Yaroslavl State Medical Academy with a degree in general medicine.

From 2009 to 2011, he completed a clinical residency in traumatology and orthopedics at the Emergency Clinical Hospital medical care them. N.V. Solovyov in Yaroslavl.

Professional activities:

From 2011 to 2012, he worked as a traumatologist-orthopedist at Emergency Hospital No. 2 in Rostov-on-Don.

Currently working in a clinic in Moscow.

Internships:

May 27 - 28, 2011 - Moscow- III International Conference “Foot and Ankle Surgery” .

2012 - training course on Foot Surgery, Paris (France). Correction of forefoot deformities, minimally invasive surgeries for plantar fasciitis (heel spurs).

February 13 -14, 2014 Moscow - II Congress of Traumatologists and Orthopedists. “Traumatology and orthopedics of the capital. Present and future."

June 26-27, 2014 - took part in V All-Russian Congress of the Society of Hand Surgeons, Kazan .

November 2014 - Advanced training "Application of arthroscopy in traumatology and orthopedics"

May 14-15, 2015 Moscow - Scientific and practical conference with international participation. "Modern traumatology, orthopedics and disaster surgeons."

2015 Moscow - Annual international conference.

May 23-24, 2016 Moscow - All-Russian Congress with international participation. .

Also at this congress he was a speaker on the topic "Minimally invasive treatment of plantar fasciitis (heel spurs)" .

June 2-3, 2016 Nizhny Novgorod - VI All-Russian Congress of the Society of Hand Surgeons .

In June 2016 Assigned. Moscow.

Scientific and practical interests: foot surgery And hand surgery.

Fracture of the phalanx of the finger

Our fingers make very fine, coordinated movements and disruption of these movements can have a huge impact on daily and professional activities. To maintain full hand function, it is important that all finger fractures are evaluated by a physician to determine appropriate treatment. If you think that a broken finger is a minor injury, then you are seriously mistaken. Without proper treatment of fractured finger hands can cause serious problems: limitation of finger flexion (contracture), pain with minor loads, decreased grip of the hand, whether it is a fracture of the nail or the main phalanx of the finger.

Anatomy of hand bones

The human hand is formed by 27 bones:

• 8 carpal bones;
• 5 metacarpal bones;
• The 14 bones that form the fingers are called phalanges. The first finger has only two phalanges: proximal and distal. Unlike the rest of the fingers, which consist of three phalanges: proximal, middle and distal.

Fractures of the metacarpal bones of the hand account for 30% of all hand fractures in adults.

Types of finger fracture

For the reason

• Traumatic fractures are damage to the finger bone due to trauma.
• Pathological fracture - a fracture of a finger in the area of ​​pathological restructuring (affected by any disease - osteoporosis, tumor, osteomyelitis, etc.) Osteoporosis is the most common cause pathological fracture.

By character

• Closed fractures (without breaking the skin)

Incomplete

Full

• Open fractures (with skin damage)

Primary open

Secondary open

Based on the presence of offset:

• Fractures without displacement of fragments
• Displaced fractures.

Signs and symptoms of a broken finger

Signs of a broken finger include:

• Pain on palpation (touch);
• swelling of the finger;
• Limitation of movements;
• Subcutaneous hemorrhage;
• Finger deformity;

Finger fractures can be accompanied by the following injuries:

Dislocation of the phalanx, tendon damage, ligament damage. This may complicate treatment.

Diagnosis and treatment of a fracture of the phalanx of the finger

If you have symptoms of a fracture of the phalanx of a finger, you should go to the emergency room at your place of residence. Where, after the examination, radiography will be performed in two projections of the damaged segment. The doctor must determine not only the location of the fracture, but also the type. The bone can be broken in several directions. A fracture of the phalanx can be transverse, in a spiral, into several fragments, or comminuted, i.e. collapse completely.

Treatment of finger fractures depends on three main factors:

• First, is the joint affected?
• Second, is it a “stable” or “unstable” fracture?
• Third, is the finger deformed?

If the fracture involves a joint (intra-articular fracture), it is important to ensure that the articular surface is not destroyed and the fragments are not separated, i.e. no offset. In this case, you can do without surgery.

Second, it is important to define a “stable” or “unstable” fracture. The stability of the fracture can be determined by radiographs. A fracture is considered unstable if the fragments are displaced, or the nature of the fracture is such that even after proper reduction (elimination of displacement), the fragments can move over time and remain in a displaced position. The anatomy will naturally be disrupted, which may affect the function of the finger and hand.

The doctor must determine whether there is shortening of the segment or whether the distal fragment is rotated (rotated relative to its axis). The fingers on the injured hand should line up and look the same as on the healthy one.

If the articular surfaces are destroyed or the fragments are displaced, if the fracture is unstable, if there is a deformity that needs correction, then surgery is necessary to restore normal anatomy hand and preservation of function after healing of a finger fracture.

Conservative treatment

When a finger is fractured without displacement, it turns out next help: the damaged segment of the hand is fixed with a plaster splint or polymer bandage, which is lighter and stronger than plaster.

Sometimes an adjacent finger is used as a splint, firmly fixing them together with a bandage. This makes it possible to work with a hand and bend your fingers without fear that bone fragments will move.

If after reposition the fragments have shifted, there is instability of the fracture, a comminuted fracture, or the deformity cannot technically be eliminated, then surgery is necessary. With the help of metal structures, fragments can be fixed in the correct position until the fracture heals completely. If the fracture is displaced, the doctor should try to correct the displacement of the fragments without surgery. This is done under local or conduction anesthesia. If the displacement is not eliminated, then there are indications for surgery. After the displacement is eliminated, the finger is fixed with a plaster splint or polymer bandage to prevent secondary displacement. Fractures of the phalanges heal in 3-4 weeks. During these three weeks, control (repeat) radiographs are taken at 10 and 21 days to ensure that there is no secondary displacement in the cast. After this, the plaster is removed and active development of the hand joints begins.

Surgical treatment

Depending on the type and severity of the fracture of the phalanx of the finger, an operation may be required - osteosynthesis (osteo - bone, synthesis - create, restore), thanks to which anatomical restoration of the damaged structures is achieved.

During the operation, open reposition of the fragments (comparison of broken parts) and fixation with metal structures occurs. And for each fracture, an appropriate metal structure or a combination of them is selected:

• Plate
• Screws
• Spoke

Pros this method: simplicity and short time manipulations, absence of an incision and, as a consequence, a postoperative scar.

Cons: one end of the pin remains above the skin so that the pin can be removed after the fracture has healed; the risk of wound infection and penetration of infection into the fracture area; long wearing plaster cast 1 month; the impossibility of starting early development of the joints of the hand, resulting in the risk of irreversible contracture (lack of movement in the joint) of the injured finger.

Osteosynthesis with plate and screws:

During the operation, access to the fracture site is performed, the fragments are compared and fixed with a plate and screws. The wound is stitched up. A sterile dressing is applied. Dressings are performed every other day. The sutures are removed on days 12-14.

The advantages of this method: full recovery anatomy of the phalanx; possibility of early development of hand joints; plaster cast is applied for only 2 weeks.

Cons: as after any operation, a small scar remains.

For deformation of fingers due to fractures in the article Dupuytren's contracture.

Don't self-medicate!

Only a doctor can determine the diagnosis and prescribe the correct treatment. If you have any questions, you can call orask a question about .

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The phalanx of 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 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 is 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 towards the side of the palm, the convex part towards the back side. At the end of the phalanx there are articular surfaces.

By modification of the phalanx of the fingers it is possible to diagnose certain diseases. The symptom of drumsticks is thickening of the terminal phalanx of the fingers and toes. With this symptom, the fingertips resemble a flask, and the nails resemble watch glasses. The muscle tissue that is located between the nail plate and the bone is spongy in nature. 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 a consequence of serious internal changes. Such pathologies include diseases of the lungs, liver, heart, gastrointestinal tract, and sometimes - diffuse goiter and cystic fibrosis.

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

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

Treatment of a fracture of the phalanx of the fingers without displacement is carried out with a plaster cast or an aluminum splint, which is applied when the nail phalanx is bent to 150, medium - up to 600, main - up to 500. The bandage or splint is worn for 3 weeks. After removing the material, carry out therapeutic exercises with physiotherapy. After a month, the working capacity of the phalanx is completely restored.

In case of displaced phalangeal fractures, comparison of the fragments is carried out under local anesthesia. After this, a plaster or metal splint is applied for 3-4 weeks. For fractures of the nail phalanges, the finger is immobilized with an adhesive plaster or a circular plaster cast.

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

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

The largest number of dislocations occurs 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 affected due to their location in the center of the foot. In direction, dislocations are usually observed to the rear and to the side. The dislocation is reduced before swelling develops. If 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 reduce using the usual method, then use the insertion of a pin through the distal phalanx or the use of a pin. The procedure is simple and safe. Then they perform lengthwise traction on the damaged finger and countertraction (which is carried out by an assistant) for ankle joint. By pressing on the base of the displaced phalanx, the dislocation is reduced.

For old dislocations, surgical intervention is required.

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

Anatomical features

A fragment of the main phalanx on a radiograph

The foot is a complex and most distant element of the musculoskeletal system. The peculiarity of its structure is the presence large quantity joints and small bones, each of which is quite vulnerable to mechanical injury. This vulnerability is most relevant for the outer toes due to their location - the big toe and little toe. They are the ones most often subject to dislocations and fractures and, according to statistics, are considered the most traumatic part of the leg.

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

Diagnosing fractures of the bones and joints of the thumb is the easiest thing compared to other fingers. The main symptoms are sharp pain, inability to step on the leg, swelling. The intensity of symptoms depends on the type of fracture. With other fingers, the onset of symptoms increases over time. This often misleads the patient about the true severity of the finger injury.

The thumb is most susceptible to injury. It protrudes forward in relation to the others, and is one of the support points that supports the weight standing man. It is the finger in question that accounts for a significant portion of the loads.

Classification of fractures

Structure of the foot and toes

There are two categories of fractures. Medicine refers to the first as a traumatic fracture - the “classic” version 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 are often significantly higher than in the first case.

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

Tuberculosis, malignant tumors, systemic diseases leading to impaired blood circulation and the balance of nutrients 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.

Type classification of fractures according to general condition damage distinguishes:

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 are destroyed soft fabrics. Often accompanied by intense bleeding, bone displacement, rupture muscle tissue, vessels. Requires immediate medical attention. Displaced fracture – the damaged bone moves to the side, pinching the tissues, vessels, and nerves located in it. May be open. Fracture without displacement – simple form damage, 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 can be accompanied by the appearance of damage of each type. A comminuted fracture is a dangerous fracture of a bone in which it is crushed into several fragments. Recovery often requires surgery.

Each injury can occur to any of the bones of the foot, but most often it is the big toe that is affected.

The classification of the fracture is the first thing you should pay attention to. Maximum to choose effective course treatment, the category to which the resulting limb injury belongs should be determined.

Diagnostic methods

Tissue swelling at the fracture site

Psychology modern man is such that everyone is sure that bad things happen to everyone except us. After a thumb injury, when studying the symptoms, many people unknowingly try to classify them as 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. After this, a fracture, especially a simple one, can be simply impossible to diagnose independently without displacement. It won't hurt as much as the previous dislocation. Or, if we are talking about other fingers, the victim will be misled by the “slow” development of negative sensations. Often the pain in a broken finger intensifies “increasingly” throughout the day. But for several hours after the injury, the sensation in the finger resembles an ordinary bruise or dislocation.

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

pain when palpating the injury; tissue swelling 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 x-rays over time, but the broken bone may not heal properly, and this is a very difficult pathology to treat.

A guaranteed fracture of any of the toes confirms that the patient has symptoms such as:

change appearance finger and its adoption of an unnatural position; complete inability to control the mobility of the injured finger; crunching of bone fragments upon palpation of the damaged area; a case of an open fracture, allowing observation of displacement and destruction of bone tissue; severe tissue swelling, accompanied by sharp pain even with the lightest pressure.

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

For cases of displaced fractures, x-rays are necessary to correctly reduce the displaced area. Don't try to do this yourself - without necessary knowledge you can only aggravate the situation by provoking tissue rupture and internal bleeding.

First aid

Thumb fixation

If you are not planning 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, and choosing a hard object that will become an analogue of a medical splint. Fixing the finger will help prevent tissue damage from bone fragments and reduce pain. See a doctor if you suspect a fracture - best option treatment. Moreover, if the swelling 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 of the fracture. For the thumb, there are three main types:

Damage to the distal nail phalanx. The area should be numbed, then the bone is immobilized. Treatment consists of 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 for outpatient treatment, which consists of immobilizing the damaged bone. The average recovery time is two weeks. Complex multiple fractures. Treatment requires wearing a “plaster shoe” for as long as prescribed by the attending physician.

Multiple fractures, which result in the formation of two or more bone fragments, require manual reduction of the broken areas. This task can only be performed by an experienced doctor, as any careless movement can damage nearby tissues. For cases that require repositioning of bone areas, the recovery period ranges from two weeks to a month.

The choice of treatment option for a thumb fracture depends on the extent and severity of the injury. The degree of danger of the injury depends on the force that was applied and the vector of its application.

Self-treatment and prevention

Cold compress to relieve swelling

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 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 the level of your heart to reduce swelling.

Prevention of a thumb fracture is:

using comfortable shoes that reliably protect all toes; in refusing to eat foods that wash calcium out of the body - this increases bone fragility; in compliance with safety regulations.

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

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