Sudeck syndrome, which is also sometimes called dystrophy, is a pathological condition that develops after injury or overexertion. upper limbs and has three stages of development. The disease was first described by the German surgeon P. Sudeck in 1900. But then it had several names at once - reflex sympathetic dystrophy and post-traumatic dystrophy of the hand.
The main cause of this condition is trauma, and most often it is a fracture of the radius or ulna. But the fracture itself, as a rule, cannot be the cause. Such a diagnosis is made when the principles of treatment were violated, for example, incorrect immobilization was performed, or the patient removed the plaster cast early and did not follow the doctors’ instructions. Also, the development of this syndrome can be caused by improperly performed rehabilitation after a hand injury or even an erroneous diagnosis, when a bruise or sprain is diagnosed instead of a fracture.
Another common reason is the prescription of hot procedures immediately after the removal of the cast, as well as an incorrectly carried out massage course and restoration of the arm using passive movements. All this can ultimately lead to the development of severe pain and the development chronic illness Zudeka, which is not so easy to overcome.
But in some cases, the cause of this condition remains unknown, although sometimes hormonal imbalances can play a role, vegetative-vascular diseases or oncology.
Manifestations
Like any other disease, Sudeck syndrome has its own symptoms, which depend on the stage of the disease, and the more advanced the disease, the more pronounced its symptoms will be.
So, for example, the initial (first) stage is characterized by such signs as:
- Redness of the skin.
- The presence of edema of the subcutaneous tissue.
- Local increase in temperature.
- Pain syndrome.
- Limitation of movement in the hand.
As it develops and in the absence of treatment, the pathology gradually moves into the second stage, the symptoms of which are even more pronounced. Here they mainly predominate:
- Blueish skin tone.
- Severe swelling of the subcutaneous tissue.
- Muscle spasm.
- Severe limitation in hand movements.
At this stage, the development of muscle atrophy begins, and at x-ray in the area of the bone you can see specific spots that indicate the beginning of the development of this process.
The disease ends in the last, third stage, which is characterized by muscle atrophy and complete absence ability to move the affected limb. In this case, the person feels severe pain, and the bones themselves gradually lose their substance and become fragile and very thin. Sudeck syndrome is especially common after a fracture. radius hands, since in most cases the patient refuses immobilization and wears only an improvised soft bandage.
Conservative therapy
Treatment of Sudeck syndrome is usually conservative, that is, without surgery. It begins with diagnosis and correct diagnosis, as well as with determining the stage of development of the pathological process. The most commonly used diagnostic method is radiography, but in more severe cases, CT or MRI may be recommended.
We must remember that the first two stages of this disease are highly treatable, since there is no chronic process here yet. This means that timely consultation with a doctor will help avoid complications.
The first thing the doctor will do is prescribe painkillers, since this disease is very severe pain syndrome, even with the slightest movement of the hand. As a rule, drugs are prescribed such as:
- Ketanov.
- I took it.
- Analgin.
At the same time, during the treatment period, the arm is kept at rest using immobilization, but even such measures do not really help cope with severe pain.
After selecting an analgesic, algoneurodystrophy in Zudak syndrome is treated with muscle relaxants, vasodilators, B vitamins, and other medications that are prescribed only by a doctor. Physiotherapeutic methods are also used in parallel, among which the most popular and frequently used are:
- Acupuncture.
- Therapeutic gymnastics.
- Massage.
However, all these methods can only be used at the recovery stage.
If the disease has entered the third stage, that is, when osteoporosis begins to develop, then the main therapy consists of taking an additional dose of calcium, magnesium and other minerals that help stop bone destruction.
Surgery
Surgical treatment of algoneurodystrophy in Zudak syndrome is used only when all conservative methods have been tried and have not brought the desired result.
As for the prognosis, in the first and second stages it is favorable, but in the third, sometimes impairment in movement may persist for life.
Prevention
The only one the right way prevention has not yet been developed. However, doctors advise people with hand injuries to take care of the limb and try to follow all the doctor’s prescriptions. At the same time, it is necessary to carry out proper rehabilitation and do this only under the supervision of a specialist.
Sudeck's syndrome - quite dangerous disease which can occur after a limb injury. In order to avoid complications, it is necessary to detect the symptoms of this syndrome in time and consult a doctor. In this article we will look at this disease in detail. In addition to describing the symptoms, we will talk about the causes of Sudeck syndrome and treatment methods. Interested? Then read this article.
Disease history
Sudeck syndrome was first introduced in 1900. Then the famous German surgeon P. Sudeck presented a clear description radiological signs(more specifically, the transparency of the bone pattern), which occurred at certain inflammatory reactions with joints and bone tissue (very rapid atrophy occurred). Thus, Sudek was able to prove that the leading role is played by disruption of local autonomic reactions. Thanks to this discovery, the world of orthopedics and traumatology has changed significantly.
The occurrence of Sudeck syndrome
As mentioned above, the main cause of the disease is limb injuries, which are accompanied by various trophic and vasomotor disorders. Quite often, the cause of Sudeck syndrome is incorrect or simply erroneous treatment of a damaged bone, banal ignorance of the basics of bone tissue rehabilitation, improper immobilization (fixing the bone in a stationary position), etc. After the immobilization process, various hot procedures can become aggravating factors, etc. called rough rehabilitation, which is carried out through passive movements and non-professional massage.
There is also a natural connection between a broken bone and the likelihood of getting Sudeck syndrome. After a fracture of the radius bone of the arm, for example, the probability of acquiring this disease is something like 60%. In addition, quite often the causative agent of Sudeck syndrome can be a disease of the spine.
Sudeck syndrome: symptoms
The development of symptoms in Sudeck syndrome occurs in three main stages:
- First stage. Initially, slight swelling and redness appears on the skin. The patient is bothered by pain in the damaged area. The hand, in turn, has limited mobility, and the skin around it is hot to the touch. Typically, most people ignore the above and consider them to be completely natural after an injury.
- Second stage. The swelling begins to increase, and the skin acquires a characteristic bluish tint. Muscle spasms appear and muscle tone increases. Muscle tissue and skin gradually atrophy. Starting from this stage, specific spots that are located near the bones can be clearly seen on x-rays.
- Third stage. Muscles and skin begin to atrophy even faster, resulting in rarefaction bone tissue. The limb completely loses its mobility, and the pain begins to increase and becomes unbearable. At this stage, the disease has already progressed to chronic form.
Diagnostics
Diagnosis of Sudeck syndrome is based on an assessment of clinical symptoms. In addition, we take into account additional procedures. An X-ray of the problem bone very clearly identifies osteoporosis of the bone and ankylosis of the joints. This makes it possible to diagnose Sudeck syndrome with one hundred percent probability. They also quite often resort to inspection with a thermal imager. It determines the temperature difference between tissues. This way they find out what stage the disease is at. In addition, the doctor may prescribe ultrasound diagnostics. It allows you to learn more about the condition of the blood vessels in the damaged area. With this information, your doctor will be able to prescribe more accurate treatment.
Sudeck syndrome: treatment
Treatment is prescribed based on completed studies. Sudeck syndrome is easily treated in the first and second stages. Treatment requires pain relief and drug therapy. The second includes taking B vitamins, vasodilators and muscle relaxants (medicines that are designed to relax muscle tissue). IN special cases Surgery may be required.
The third stage of the disease is characterized by a decrease in the size of the hand (atrophy). Atrophy irreversibly affects the tissue and joint, so even after treatment of Sudeck syndrome, hand dystrophy syndrome may appear. In this case, in addition to standard drug treatment, the patient also receives special gymnastics, therapeutic massage and special physiotherapy. All these procedures help not only to cure Sudeck syndrome, but also to carry out prevention.
However, it is worth remembering that reliable prevention of this disease simply doesn't exist. Therefore, in order to avoid exacerbation of Sudeck's syndrome, it is necessary to be careful with hand injuries. And in case of the slightest suspicion of an exacerbation, you should contact your doctor as soon as possible. Only competent and timely treatment will help to avoid relapse.
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Sudeck's syndrome is a type of neuropathic pain syndrome, a pathological condition caused by damage to soft tissue, nerves, joints or bones.
The disease is accompanied by (bone atrophy), limited mobility in the joint, impaired blood flow and associated trophic consequences.
The disease was first introduced and characterized by the German surgeon P. Sudeck in 1900.
He noted that on X-ray images with some inflammatory processes in the bones and joints, followed by atrophy, there is a transparency of the bone pattern, calling this phenomenon acute trophoneurotic atrophy.
Causes of the disease
Most common cause the development of the disease is a complication after or fracture of a limb, improper treatment or immobilization of the hand (ensuring complete rest), in case of damage to nerves or sympathetic nerve ganglia.
Poor dressing, painful manipulations, swelling, joint immobility - all this can gradually lead to the development of Sudeck syndrome.
A certain place in the formation of the borderline state is played by vegetative vascular disorders, hormonal disorders and cancer. Women over 40 years of age are most often affected, although cases of the syndrome developing in men are also common.
The reason for the appearance pathological condition also called fractures:
- – about 62%;
- lower limbs – 30%;
- humerus – 8%.
Elderly and middle-aged people are more likely to suffer from upper limb syndrome, and children - from lower limbs.
Clinical picture
Any injury is accompanied by disorders of the vasomotor mechanism and autonomic nervous system.
At proper treatment All negative manifestations gradually pass, and the healing process begins.
Otherwise, the pain intensifies at the slightest movement or touch.
There are three clinical stage Sudeck syndrome, each of which has its own symptoms:
- I – acute form . Characterized by intense burning pain, swelling of the damaged limb develops. The pain syndrome is not relieved by traditional analgesics. The temperature at the site of injury rises, the joints become stiff. Duration – up to 6 months;
- II – dystrophic stage. The temperature gradually decreases, the swelling also subsides slightly. The pain wears permanent form, but less intense. The tendons become denser and osteoporosis begins to develop.
- III – atrophic stage. The skin acquires a cyanotic color (marbled), becomes cold, and becomes very thin. Soft tissue dystrophy and osteoporosis lead to tissue atrophy. There is practically no pain during this period. The lesion gradually covers the skeletal system, which is expressed in hardening of the joints, fibrosis of the gliding apparatus of the tendons, and bone thinning. Duration – from 6 to 12 months after injury.
On late stages disease in 20% of patients develops severe muscle weakness. Patchy osteoporosis, detected in 80% of patients early stages, with a long course of the disease turns into.
Therapy methods
The disease at stages I and II of development is easy to stop and the patient can recover quite quickly.
Stage III is chronic and is characterized by tissue atrophy, which complicates the healing process.
With proper treatment, joint mobility is only partially restored.
Treatment of Sudeck syndrome in acute stage includes:
- immobilization of the limb for 12-14 days according to the doctor’s indications;
- applying cold to the affected area;
- acupuncture in combination with ultrasound of the reflex zones of the limb;
- magnetic therapy;
- interference therapy.
Drug treatment is usually conservative. The specialist prescribes vasodilators and analgesics, B vitamins, Ca antagonists, muscle relaxants, α-adrenergic blockers.
In more serious cases, professional help from a psychologist may be required. According to indications, a short course of neuroleptics and antidepressants, corticosteroids is administered.
If pathogenetic treatment does not bring results, the intensity of the pain syndrome remains, the patient is offered surgical intervention. The operation involves a sympathetic blockade: intravenous injection of regional, procaine drugs into the nerve, as well as infiltration anesthesia.
With absence allergic reactions, externally make applications based on hot pepper, use Espol and Nicoflex ointments.
In advanced cases, slow stretching of the diseased area, osteotomy of the distal metaepiphysis of the radius and other operations are indicated.
Therapy requires long-term and integrated approach. The duration of treatment depends on the stage and complexity of the disease, the age of the patient, the effectiveness of the treatment therapeutic measures and range from 6 months to a year.
Forecast
At stages I and II of the disease, in the first weeks from the development of complications, the prognosis is quite favorable.
Stage III is characterized by a more complex prognosis; as the disease progresses, it is often unfavorable, since irreversible damage has begun in the tissues.
Despite a wide arsenal of treatment measures, Sudeck syndrome remains a complex disease with an unclear pathogenetic mechanism, which makes treatment difficult.
Full recovery is possible with early contact with specialists and usually occurs 6 months after the start of therapy. In some patients, mild restrictions of movement and impairment of the working functions of the limb may persist for quite a long time.
Preventive measures
Specific preventive measures does not exist for algoneurodystrophy. Experts advise you to be more attentive to your health, not to put off visiting a doctor, and to seek help at the first sign of illness.
Only with a timely visit to the clinic there is a chance of returning to a normal lifestyle and completely restoring the function of the injured limb.
During rehabilitation, it is necessary to be careful with intense thermal procedures and avoid rough massage 
events. Exercise therapy is allowed, Spa treatment with radon baths, gravity therapy.
The development of the pathological syndrome can be interrupted at any stage, but a common outcome of the disease is fibrous ankylosis in stable decompensation, which in most cases leads to disruption of normal life activities and disability.
Full recovery occurs only with timely consultation with a specialist and compliance with all therapeutic measures, aimed at bone regeneration, pain relief and prevention of atrophy progression.
A pathology such as Sudeck's syndrome, in last years attracts more and more attention from specialists in the field of traumatology and orthopedics. This interest is primarily due to the significant increase in the frequency of this disease, as well as the high degree of disability of patients. This disorder can also be found in the medical literature under the name algodystrophy, Sudeck's disease, post-traumatic osteoporosis, reflex sympathetic dystrophy (RSD) of the limb, autonomic-irritative or neurodystrophic syndrome.
On this moment It has been proven that RSD can occur after a number of diseases and injuries of the musculoskeletal system, but most often this disorder is diagnosed in those patients who have suffered from broken arms or legs. If we look at modern statistics, we can see that Sudeck syndrome develops in 62% after a fracture of the radius of the arm, in 30% after damage to the lower extremities, and in 8% the pathology is observed after fractures of the humerus.
What is Sudeck syndrome?
There is no clear definition of Sudeck syndrome today, but most experts by this term mean a pathological process of a dystrophic nature that affects bones, joints, soft tissues, blood vessels and nerves, develops as a result of traumatic injury to the extremities (most often due to bone fractures). That is, RSD is not separate disease, but only a complication of injury.
The pathology is progressive in nature, accompanied by chronic pain, dysfunction of the limb, its gradual deformation, trophic disorders, the development of osteoporosis and other degenerative changes, stiffness in nearby joints and, as a consequence of the described changes, disability of the patient.
Causes
It is important to remember that the fracture itself is not the cause of Sudeck syndrome. In most cases, such injuries are successfully treated without any complications or consequences. And after some time required for therapy and recovery, the person proceeds to normal daily and professional activity. But in cases where treatment was not provided to the required extent or was not provided at all, rehabilitation was not carried out or it was of poor quality, if the patient neglected the advice of the attending physician, various complications may develop, including Sudeck syndrome.
In most cases, Sudeck syndrome develops after a fracture of the radius bone of the forearm.
Risk factors for the development of limb algodystrophy:
- incorrectly rendered medical assistance during reposition of a bone fracture, during immobilization;
- too tight gypsum bandage;
- early removal of plaster;
- excessive activity of the limb in the first days after removal of the cast;
- non-compliance with specialist recommendations;
- lack of rehabilitation or its short duration;
- misuse physical therapy, physiotherapy and kinesiotherapy;
- misdiagnosis when a fracture is mistaken for a bruise or dislocation;
- unprofessional execution therapeutic massage or lack thereof;
- insufficient anesthesia at the stage of repositioning and immobilization of bone fragments;
- wearing a plaster cast for too long.
Thus, there are many factors that increase the risk of developing Sudeck syndrome. But according to experts in this field, in 75% of cases the pathology debuts due to the lack of necessary physiotherapy and kinesiotherapeutic treatment. Therefore, in no case should such procedures be neglected, since the completeness of recovery after injury and its outcome depend on them.
The exact mechanism of development of the disease has not yet been established, but all researchers agree that the main role in the development of the disease is given to dysfunction of the autonomic nervous system. The involvement of nerve fibers in the process of inflammation during a fracture leads to disruption of the regulation of vascular tone. Because of this, the normal permeability of the capillary wall changes, a disruption of the microcirculation process, and hypoxia of soft tissues and bones develop.
Damage to the fibers of the autonomic nervous system triggers the development of Sudeck syndrome
Local circulatory disorders become persistent, degenerative processes begin to prevail over tissue restoration, and proliferation begins connective tissue, dystrophic and atrophic changes in the bones and soft tissues, which over time negatively affects the function of the limb as a whole and leads to disability.
Symptoms and consequences
Clinical manifestations Sudeck syndrome are very demonstrative and depend on the phase of the pathological process:
- The first phase, or the beginning of the disease. At the same time, pain and vasomotor disorders are maximally expressed.
- The second phase, the height of the disease. At this moment, dystrophic processes are more active and trophic disorders are most pronounced.
- The third phase, or outcome. It is also called the stage of atrophy and stable decompensation, that is, in this period the disease approaches its logical conclusion with the formation of a defect varying degrees expressiveness.
The photo shows a healthy arm and an arm with Sudeck syndrome in phase 1 of one patient after a fracture of the radius
So, the first stage of Sudeck syndrome is characterized by following symptoms:
- abnormal color of the skin of the injured limb (redness);
- pronounced swelling of the soft tissues, which goes beyond the normal range for this injury;
- feeling of heat in the injured limb, increased local temperature;
- severe diffuse pain that extends beyond the boundaries of the injury, intensifies with any movement, and also bothers the patient at rest;
- violation motor activity in the injured limb.
The appearance of the described symptoms in rehabilitation period after a fracture, the patient and his doctor should be alerted. This will make it possible to diagnose RSD at the very beginning of its development, which will directly affect the success of treatment. Very often, neither the victims nor their doctors pay attention to the described symptoms, since they consider them a normal reaction of the body to injury, and in the meantime the pathology progresses and enters the second stage.
In the second phase, the skin acquires a bluish or purple tint, the swelling thickens and increases in area, and painful muscle spasms, the skin becomes cold to the touch. As the disease progresses skin covering thins, becomes smooth and shiny (skin atrophy), muscles become thinner and subcutaneous tissue, problems with hair and nails develop on the affected limb. X-ray and densitometry can detect bone osteoporosis at this stage.
If Sudeck syndrome is not diagnosed promptly and treatment is not started, a person may lose function of the affected limb.
If the progression of the disease is not stopped at the second stage, pathological process passes into the third phase, in which dystrophic processes end in atrophy. The affected limb is noticeably smaller than the healthy one, there is practically no muscle and fat tissue, the bones are thin and fragile. All this is accompanied by constant chronic pain. Various contractures develop, which cause loss of function of the arm or leg.
Diagnostic methods
Diagnosis of RSD is based on medical history (presence of injury in the patient, his medical history and a list of treatment and rehabilitation methods used), as well as characteristic clinical symptoms. At the second stage, radiography will be useful to confirm the diagnosis, with the help of which spotted osteoporosis of the bones is detected.
In some cases, they resort to additional diagnostic procedures, for example, thermography, ultrasound, vascular Dopplerography, neurovasography, myography, radioisotope scanning, dolorimetry, arthrocircometry, goniometry dynamometry, etc.
Sudeck syndrome on x-ray - clearly visible patchy osteoporosis
Treatment of Sudeck syndrome
Sudeck syndrome is treated by an orthopedic traumatologist. It can be conservative or surgical. Therapy should be comprehensive and include the following measures:
- immobilization of the affected limb;
- use of cold compresses;
- therapeutic exercises, kinesiotherapy;
- acupuncture;
- physiotherapy (ultrasound, magnet, etc.);
- drug treatment(analgesics, anti-inflammatory drugs, vasodilators, vitamins, muscle relaxants, alpha-adrenergic blockers, calcium antagonists, corticosteroids, antipsychotics, antidepressants).
If conservative treatment turned out to be ineffective, the patient may be offered surgery, which consists of sympathetic blockade of the nerve endings of the affected limb. In severe cases, joint arthrodesis, surgical stretching of the diseased area, osteotomy of the radius and other surgical interventions may be necessary.
Unfortunately, effective preventive measures Sudeck syndrome does not exist. Therefore, in order to avoid such unpleasant and dangerous complication fracture, you must strictly follow all medical instructions and in no case neglect the rehabilitation program after the injury.
The most common type of injury to the radius (ICD - 10 code S 52), as already mentioned, is a fracture of the radius in a typical location. In medicine, there are two types of injury: Colles and Smith.
In the first case, the fragments are displaced to the back of the forearm. The second type involves the front side.
This type of injury most often occurs due to a blow to the outstretched arm.
In addition to the typical fracture, there are other types of injury. They are caused by the area of the bone that has been damaged.
- Fracture of the head of the radius, as well as the neck.
- Damage to the area of the (central) elbow or neck.
- Wrist injury (may be combined with displacement of the head or neck of the radius).
Another type is a fracture of the styloid process of the radius. Occurs from severe injury to the wrist. With this pathology, damage to the neck of the bone often occurs. But the injury is rarely dangerous. In most cases, the impact only results in a crack.
Symptoms
Determining radial bone fractures (ICD - 10) can sometimes be very difficult. But still, there are a number of signs that help identify the presence of damage.
After an injury, a person’s wrist hurts. Also general state can get much worse.
Symptoms include weakness, nausea, loss of consciousness.
The main feature is:
- limitation of movement of the hand and fingers;
- with any movement the hand hurts even more;
- a hematoma forms in the area of injury;
- visual deformation of the hand.
If there are symptoms, the person must be given first aid or an ambulance must be called. After this, you should go to a traumatology department to diagnose the pathology and receive the necessary help.
Diagnostics
After first aid is provided to the patient, he will be sent for diagnostics. The diagnosis is determined not only by the results of a doctor’s examination. Main role play the data produced by the hardware examination.
For diagnosis use:
Depending on the type of fracture, the patient may be prescribed additional examinations, which will establish a more accurate clinical picture.
Treatment methods for Sudeck syndrome
It is important to seek help from a neurologist in time. The doctor asks if he has any injuries. To clarify the diagnosis, surrender laboratory analysis blood, an additional x-ray is taken. Afterwards, an individual course of therapy is prescribed.
If an acute form has been diagnosed, a special splint will be applied, so the limb can be immobilized. Then the necessary course of therapy is selected.
You can get back on your feet with the help of pills. If Sudeck syndrome has a chronic form of development, you need to perform a set of special gymnastics.
Some patients use it for treatment first traditional methods, this is a mistake, because this makes the disease even worse. They advise you to contact a special institution for help, they will provide you with all the necessary assistance. necessary help.
When the disease just begins to develop, painkillers may be prescribed. Patients are concerned strong pain, it gets worse when a person starts to move.
If discomfort do not go away even after the limb is motionless, you need to take medications medications, with their help you can relax muscle tissue, dilate blood vessels, and it is useful to use vitamin B.
Patients who experience dystrophy in the hand need a complex of therapeutic massage, special gymnastics, and physiotherapeutic procedures. These methods are used when a person has recovered or for preventive purposes.
Specific preventive methods, with the help of which you can get rid of Sudeck syndrome, no. To avoid exacerbations, it is necessary to carefully monitor the hand that has been injured.
If a person suspects the slightest complication, you need to consult with your doctor, this way you can protect yourself from a re-exacerbation of Sudeck syndrome.
Repairing a radius injury begins with first aid. If a mistake was made by specialists in traumatology, treatment may be complicated. Self-medication for such a pathology is not at all acceptable. The fracture cannot be repaired without professional medical care.
Treatment for injury in a child and an adult may differ. Since a child’s bones tend to heal very quickly, conservative methods are most often used for treatment.
Surgery to restore the position of a child’s bones is performed only for complex injuries. An adult, unlike a child, is often prescribed surgical intervention.
Conservative methods
With absence open fracture or displacement (fragmentation) of the head (neck) of the radius, the patient is prescribed treatment conservative methods. This treatment is used to eliminate pathology in children, adults and the elderly.
After all the examinations have been carried out, the patient is given a plaster cast or a special polymer fixative, which promotes proper tissue fusion.
As soon as the swelling subsides, it is necessary to undergo an x-ray examination. Based on its results, the doctor will determine the presence or absence of deviations and the period of wearing the plaster.
For a child, the fixing bandage can be removed after 1.5 months. But at the same time, the child should be monitored by a doctor regularly.
An adult can spend a month or more in a cast, depending on how quickly and well the bones heal. Treatment is more difficult for older people, since bone tissue is restored very slowly with age.
Surgical methods
Surgery is most often recommended if the patient has a fracture of the radial head (ICD - 10), neck displacement or other serious pathologies. The danger is a comminuted fracture. Surgical intervention carried out to reposition bone deformities.
When performing an operation on a child, use general anesthesia, so after surgical intervention the child must be under constant medical supervision.
The operation itself lasts differently, since most often surgeons restore the position of the bones manually. To fix the bone tissue, special clamps are used to eliminate the risk of bone displacement.
- Knitting needles.
- Plates.
- Ilizarov distraction apparatus.
The first two types of fixators are used if the patient is diagnosed with a fracture of the head of the radial bone or a displacement of the neck. When the bone is crushed, an Ilizarov distraction apparatus is used. After the operation is completed, the patient is given a plaster cast.
megan92 2 weeks ago
Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!
Daria 2 weeks ago
I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are
megan92 13 days ago
Daria 12 days ago
megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.
Sonya 10 days ago
Isn't this a scam? Why do they sell on the Internet?
Yulek26 10 days ago
Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only made after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars
Editor's response 10 days ago
Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!
Sonya 10 days ago
I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))
Margo 8 days ago
Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...
Andrey A week ago
Which ones folk remedies I didn't try, nothing helped, it only got worse...
