Sprained foot in a child. Ankle sprain treatment

It is difficult to keep active, emotional and curious children in one place, so they are often injured. Sprains in a child, abrasions and dislocations are injuries that are difficult to avoid when a child becomes familiar with the environment. Most often they persecute children of preschool and primary school age.

Causes of sprains in children

Ligament damage is caused by trauma. Unnatural bending of a joint causes sprain; this occurs when its angle of displacement is much greater than its natural capabilities when turning. Dense connective tissue protects human bones, so it always bears the first blow. Sharp jerks during movement and physical activity can cause both tissue stretching and rupture.

Characteristic symptoms

Connective tissues contain a large number of nerve endings, so the first sign that accompanies an injury is sharp pain. As a result, the functions of the movable joint of the bones are impaired. Depending on the location of the injury, the following symptoms appear:

If a child suffers a neck ligament injury, it will be painful for him to turn his head.

• Painful sensation. Damage to the ankle or knee joint limits independent movement. Injury to the cervical ligaments leads to limited head rotation and numbness of the phalanges of the fingers.
• Edema. It does not begin immediately after injury, but gradually, after a short period of time.
• Bruise. It appears on the damaged area after a few hours or even days.
• Malaise. The person is feeling unwell and has an elevated temperature in the damaged area.

Frequent localization

There was a clear regularity in the localization of damage:

• takes a leading position. The main reason is an awkward movement when walking, which ends with the foot turning inward. The leg twists, causing sharp pain. In other cases, the causative factor of foot injury is diseases: metabolic disorders, obesity, arthritis.
• are less common in everyday life. The most traumatic age is 2-3 years. Spraining is promoted by careless handling of the arm in an extended position. Often, damage to the ligaments in the elbow joint occurs while playing or wearing tight clothes.
• Injury to the cervical tendons, which is rare in childhood. Usually the cause of damage is an uncomfortable position during sleep, outdoor games, or an accident.
• Sprained knee joints in children are quite rare. The main culprit of such injuries is sports.

First aid

To immobilize the limb, a bandage made of an elastic bandage is applied to it.

First of all, it is important to create conditions under which the injured limb or part of the body will be motionless. A tight bandage is applied to the damaged area. An elastic bandage is the best material, but if you don’t have one, a scarf or headscarf will do. If the symptoms of a sprain are accompanied by a deformity of the limb, a tight bandage will not be needed. In such cases, a splint is used. Any dense material is suitable as a handy tool: a ruler, a board, which are placed on both sides of the leg or arm, and wrapped with a bandage.

Preventing the appearance of edema or reducing its manifestation is not the last task when providing assistance.

In order to reduce swelling, cold (ice) is applied to the damaged area. They keep it on the stretched area for about 2 hours, but to prevent frostbite, remove it every 20 minutes and take a break for 15-20 minutes. When a hematoma appears on a leg or arm, the limb is placed in an elevated position, which also helps relieve tissue swelling.

This article was checked and edited by Vladimir Alekseevich Anokhin, professor, doctor of medical sciences, head of the department of childhood infections of Kazan State Medical University.

Sprained ligaments are a fairly common injury in children, as they most often occur during active games in the fresh air or in the gym. Ligaments or muscles (foot, arm, hand, knee, neck or even muscles in the groin) are stretched when the joint bends unnaturally and the amplitude of its rotation significantly exceeds its natural one.

Due to the fact that it is the ligaments of the joint that protect our skeletal system from fractures, in case of injury they are the first to suffer. According to statistics, 85% of primary injuries in children are sprains of the hand, foot or knee joint.

Sprains

Sprains in children are more common in children who play sports from an early age. Sports such as tennis, boxing, wrestling, gymnastics and football are at risk for injuries to the knee joint, muscles in the groin and hands.

When a child sprains his or her foot, a stretch or tear occurs in the connective tissues (ligaments) that hold the joint in normal condition. This happens when a child falls or unsuccessfully turns the ankle (knee joint), hands or foot. Dislocation of the shoulder joint, and, as a result, stretching of the neck muscles, occurs when the arm is waved awkwardly.

Symptoms

Ligaments are tissue fibers with a large number of nerve endings and blood vessels. When children sprain the muscles and ligaments of the arm, hand or neck, they begin to feel a sharp sharp pain in the joint, then swelling of the injured area. These are the main symptoms that the injury is associated with a sprain and requires immediate treatment.

The same thing happens if the baby pulls a leg or shoulder. Pain occurs immediately at the time of injury or immediately after it.

When a 3-6 year old child sprains an ankle or knee joint, the damaged area begins to swell, and the symptoms of this injury are the appearance of a hematoma. The child cannot move his leg, and the motor functions of the leg are limited.

It happens that children do not always feel pain and the stretching of a leg, neck or arm goes away without obvious signs. This leads to the fact that the ligaments that are not fixed after the injury are stretched even more, and after a while the swelling increases sharply and the baby feels severe pain.

Doctors recommend that parents pay attention to the time when the baby began to complain of pain. If this happens immediately after an injury, then the ligaments are stretched, but if the limb is swollen and begins to hurt the next day in the morning, a muscle strain has occurred. In any case, treatment is necessary.

Three degrees of stretch

Sprains in children are classified by traumatologists into three main degrees:

1. Mild when a small area is damaged. The injury is accompanied by slight discomfort and after a few hours the baby’s motor functions are completely restored.
2. Partial rupture. This is a sprain of a leg or arm in a child, during which severe pain is felt for a significant period of time and bruises appear.
3. Complete break. In this case, unbearable pain is immediately felt in the damaged area, and if the child has a third-degree sprain of the leg, it is almost impossible to step on it.

First aid and treatment

Correctly provided first aid for ligament injuries is a guarantee that the child will not experience further complications, painful symptoms will go away and treatment will proceed quickly. Primary therapy and treatment of knee and ankle sprains in children includes complete peace and stillness. The baby must be put to bed or seated comfortably, placing a chair or stool under the sore leg, fixing the leg in one position and trying to ensure its immobility, explaining to the child that making sudden movements is dangerous.

What to do if a child has a sprained hand? As with an ankle injury, if you have a hand injury, immediately apply an ice pack or a cold compress. With this type of injury, the cold lasts for 1.5-2 hours: solely to avoid severe swelling in the joint area.

No matter in which area the ligaments are sprained in children (neck muscles, knee joint), it is necessary to protect the baby from possible stress. If your baby doesn't understand that an arm or leg needs to be held still, try putting a light splint on him to immobilize the limb.

It is quite possible that stretching the foot will cause not only swelling, but also bruising in the evening. In this case, it is recommended to place the affected leg on a hill to ensure blood flow away from the injured area.

On the second day after injury, treatment of the sprain begins using heat. First of all, these are compresses. In pharmaceuticals today there are many warming ointments for the treatment of joints, neck and ligaments. If a 2-3 year old child has a sprained leg, it is necessary to thoroughly lubricate the wounded joint, wrap it in cellophane, then apply a cotton bandage and wrap the leg with a woolen scarf or handkerchief.

When a child has a sprained neck muscle, a therapeutic pain-relieving patch is widely used. On sale today you can find Nanoplast - an excellent warming patch that has an analgesic and anti-inflammatory effect. The use of such funds allows a child under 10-12 years of age to get back on their feet not in 10-15 days, as happens with conventional treatment, but in a week, given its ability to activate blood circulation in the injured area and promote the resorption of hematomas.

A sprain in the groin or under the knee in a child from 3 to 12 years old is practically no different from any other type of sprain, with only one difference: these places are very inconvenient for applying bandages. For this type of injury, it is recommended to use elastic bandages.

Treatment of a sprained knee joint takes a little longer than usual, due to the fact that it is the knee and elbow that cannot be completely fixed and with a slight turn or movement of the body they are immediately involved.

There is no preventative treatment for this disease. Try to explain to your child how important it is to be careful in gyms and stadiums, at dance classes, or just when playing in the yard. Learn how to provide first aid for sprains. Perhaps awareness and quick response to the problem will allow you to quickly restore your child’s motor functions.

Ligaments secure joints and connect bones to each other, allowing them to move.

A sprain occurs when a certain movement goes beyond the boundaries of the natural - either the amplitude is greater than necessary, or the direction of movement is not the same as it should be. The essence of the sprain is that the natural elasticity of the ligaments is not enough, as a result, the connective tissue fibers and blood vessels in the ligament itself are damaged.

Sprains are accompanied by:

• acute intense pain, sharply intensifying with movement;
• swelling (sometimes);
• subcutaneous hematoma (sometimes).

Urgent Care:

• peace And exalted position the affected joint;
• cold: apply something for 25-30 minutes cold to the site of injury; replace what has become hot with a new cold one, it is advisable to repeat the use of cold within 24 hours after the injury, optimally 10-15 minutes every 2 hours;
• joint fixation bandage, which aims to limit passive movements as much as possible (the use of an elastic bandage is optimal).

It is forbidden:

• lean on the injured limb and (or) load it in any other way;
• rub the sprained area;
• apply warm compresses for 48 hours after a sprain (after 48 hours it is possible, but useless).

ATTENTION!

A sprain is a diagnosis made by a doctor. You can never be sure that there is nothing more dangerous than a sprained ligament (dislocation, fracture, torn ligament, etc.). At the first opportunity - see a doctor!

See a doctor immediately if:

• during stretching, a sound resembling a crack was heard;
• intense pain does not decrease within 24 hours;
• 2 days after stretching there is no improvement;
• the skin in the area of ​​the damaged joint turns red and becomes hot to the touch.

ATTENTION!

Movement in the damaged joint should be limited for at least 5-6 days, and this situation is especially important in the first two days.

(This publication is a fragment of the book adapted to the format of the article
E. O. Komarovsky “Handbook of sensible parents. Part 2. Emergency care".)

Hand injuries are common in childhood. Falls, bruises, fights lead to sprains and ruptures of ligaments, dislocation and subluxation of joints. Such injuries are more common in boys.

Doctors observe sprains of the upper limb with dislocation at any age. In young children, this is associated with improper holding of the hand by parents, rotation, and circling of the hands. With such actions, the child’s wrist and shoulder suffer, and sprained ligaments are complicated by dislocation. At school age, shoulder dislocation is more common; doctors diagnose elbow damage less frequently.

The peculiarity of childhood traumas is that the child does not always tell his parents about them. This leads to late diagnosis and the development of complications.

Frequent sprains cause hypermobility and instability of the arm joints, which leads to habitual dislocation of the shoulder, elbow or hand.

If the injury is diagnosed correctly, treatment requires immobilization. In case of dislocations, the arm is fixed with a bandage for several weeks. This is especially difficult for children aged 1–2 years; forced restriction of mobility disrupts the child’s psychomotor development.

Sprained hand in children

In case of hand injuries, any ligaments can be stretched, but in children, the lateral ulnar and radial ligaments, which limit the wrist joint, are more often damaged. At the age of 1–2 years, a sprained arm occurs due to incorrect actions of the parents.

Holding a child by the fingers without a tight grip on the wrist leads to stretching of the ligaments and dislocation of the hand when the hand is suddenly pulled out.

Raising children up, rotating by the wrists– the second most common cause of damage to the collateral ligaments and dislocation of the wrist joint.

In an older child, sprains and displacement of the hand occur when falling on outstretched arms, more often - with tucking. A rupture of the collateral ligament leads to joint instability and wrist dislocation.

Chronic hand sprain is observed in children with increased elasticity of the ligamentous apparatus. Some sports provoke this - tennis, tennis, shot throwing, discus. Increased stress on the hand over time leads to habitual wrist subluxation, which is often undiagnosed. Chronic instability of the joint due to severe trauma causes hand dislocation.

Sprained fingers are a consequence of sports injuries. Often found when playing basketball, handball, and volleyball.

Pathology of the elbow joint

Elbow sprains and joint dislocations are rare in childhood (read more about forearm sprains). Damage develops in a small child when holding a hand sharply while moving. The radius is dislocated when spinning a child, doing dynamic gymnastics, putting on clothes with narrow sleeves. This injury occurs if an adult tries to hold a child’s hand when falling. The amount of damage increases when there is ice.

Elbow ligaments are stretched when falling on bent arms or excessive movements in this joint. Under significant load, it is formed posterior elbow dislocation. Anterior dislocation is less common, as a result of a direct blow to the forearm with the arm bent at the elbow.

Joint instability occurs in child athletes. Increased stress on the elbow ligaments is observed in the following sports:

• basketball (when throwing the ball from a long distance);
• hockey;
• volleyball;
• tennis;
• handball.

Often, a sprained or dislocated arm in a child is diagnosed with connective tissue dysplasia or joint hypermobility syndrome.

Injuries are caused by excessive physical activity, impaired gross motor skills, and non-compliance with the recommendations of a trainer in sports.

The following types of elbow instability in children are distinguished:

• posterolateral rotational, or valgus (the external ligament is damaged, subluxation or dislocation is diagnosed);
• posteromedial, or varus (the elbow moves inward);
• fracture dislocation (with damage to the olecranon process).

Shoulder injury

In a small child, a sprain of the shoulder ligaments occurs when suddenly grabbing and lifting the arm. The ligamentous system suffers if parents forcefully pull their children along with them or pull them by the shoulders. At 1–3 years of age, the joint capsule and ligaments are elastic. The application of even a small force leads to stretching and tearing of the fibers. During this period, damage to the shoulder joint in a child is common, and the parents are usually to blame.

In schoolchildren, the shoulder suffers from falls and during sports activities - during strength exercises, direct injury in football and basketball.

Before shoulder reduction X-rays are performed to exclude fracture-dislocation. The reduction technique depends on how long ago the injury was. Manual closed reduction with the use of analgesics and muscle relaxants is more often used. The child’s arm is immobilized with a special splint for 3–4 weeks, the position depends on the type of dislocation.

If blood accumulates in the joint cavity (hemarthrosis), a puncture is performed to remove the fluid. If necessary, simultaneously wash the damaged area with antiseptic solutions.

If, after closed reduction, the dislocation recurs or the correct anatomical relationship of the articular surfaces cannot be achieved, surgery is indicated.

Rehabilitation

Rehabilitation after injuries in childhood is important, since prolonged immobilization leads to the rapid formation of contractures and joint stiffness. Repeated sprains in a child are fraught with habitual subluxation and dislocation. An early return to sports aggravates the severity of the injury and provokes increased extensibility of the ligamentous apparatus.

During the rehabilitation period, the following methods are used:

• physiotherapy (electrophoresis, heat treatment, magnetic therapy);
• aquatherapy;
• massage.

The recovery period after a sprained or dislocated arm lasts from 1 to 6 months.

Active movements of the healthy and injured limb begin during the period of immobilization. This prevents the formation of contractures (especially in the elbow joint) and improves the muscle corset (important for shoulder dislocation).

In young children, the main role is played. First, it is carried out by a specialist and teaches techniques to parents. They then massage the child's injured arm themselves. The following techniques are most often used: stroking, rubbing.

Prevention

Prevention of hand injuries in children - avoiding injury. Parents should follow the pediatrician's recommendations for caring for young children and avoid grabbing or jerking them harshly. The child should not be lifted by the fingers, wrists or hands without fixing the forearm, quickly dressed or undressed, or wear clothes with narrow sleeves.

The rehabilitation period for a child should not be neglected - this is the best prevention of recurrence of injury.

Results

Dislocations and sprains of a child's arm are a common injury. Failure to see a doctor in a timely manner leads to diagnostic errors. The consequence of self-medication is long-standing injuries, disruption of the location of articular surfaces, increased extensibility of ligaments, and habitual dislocations.

Improper treatment of hand injuries in a child leads to joint stiffness and chronic pain in adulthood.

Useful video

In the video, doctor E. Komarovsky talks about the signs of a dislocated arm in children and first aid measures.