Immobilization in the limbs. It consists of limiting the mobility of a member or segment of it with the aim of helping to heal her injuries. According to the Dictionary of Medical Sciences , immobilization is the temporary suppression of all kinds of movement of a part of the organism, the fractured bones or the joint.
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- 1 Types of Immobilizations
- 1 Emergency immobilization
- 2 Principles governing immobilizations
- 3 Immobilization for upper limbs
- 4 Immobilizations for lower limbs
- 5 See also
- 6 Source
Types of Immobilizations
- Immobilization emergency: Must be performed at the accident site for the transport of the injured.
- Immobilization for primary treatment: this is the name given to a group of techniques that are used in the early stages of treatment, which may or may not be definitive.
- Definitive immobilization: is the one with which the patient expects the healing of his injury or fracture.
It is indicated in the following cases:
- As prophylaxis and shocktreatment .
- Protect the injured during their transfer to reduce pain and prevent fractured ends from injuring neighboring soft tissue, vessels and nerves.
- Avoid bleeding, by facilitating the formation of thrombi at the vascular ends to cause secondary bleeding due to mobility.
There are two types, by attachment and by the use of splint . In the first case, segments of the body itself are used to immobilize the injured person. In the upper limbs, the injured is attached to the thorax and held together by a bandage (Velpeau and Dessalt type). In the lower limbs both come together and are bandaged or stabilized, called “siren limbs.” For these bandages can be used when there are no other resources ropes, belts, strips of water, etc.
Principles governing immobilizations
The splints must be lined with cotton , cloth, rubber foam , wadding to avoid injuring the soft parts by rubbing.
- The bony eminences should be padded to avoid pain or compression ulcers.
- Bandages should not be tightened so tightly as to cause compression, nor should they be loose enough to allow mobility.
- When the lesion is a shaft,neighboring joints must be immobilized. If the injury is articular, immobilize the proximal and distal diaphysis.
- When immobilized, always remember the axes of the limbs and the functional positions of the joints, ensuring their correct orientation.
- In the flexion folds of the elbow, knee, ankle, shoulders and hip, the bandage will be made in the shape of an 8 to avoid compressions.
- If there is any woundin the injured limb, it will be covered before applying the immobilization.
Immobilization for upper limbs
Sling and forearm immobilization
- It is the simplest method, the limb is attached to the chest with the elbow at a right angle, a bandage is passed under the wrist and it is tied in the posterior region of the neck. It can be done with a belt, head scarves, etc.
- Velpeau bandage. Pads are placed in the armpits and folds of the elbow, the affected member is placed on the chest, the hand is placed on the healthy shoulder and fixed with gauze wraps or bandages as seen in figure 2. A variant is the bandage from Dessault.
Immobilization of Velpeau (A) and Dessault (B)
- The use of aluminum ferrules or wires joined in the form of a ladder (Crammer) or wooden slats that are joined at their ends, guarantees better immobilization. It starts in the healthy shoulder, the splint runs down the back, then it outlines the arm making a right angle at the elbow and reaches the hand and fingers keeping the wrist in extension. The entire area is bandaged, while an assistant maintains the position. This is the fundamental structure and, depending on the needs, all or part of it will be used.
Total immobilization of upper limb while maintaining functional joint positions (A) and Way of immobilizing the hand and fingers (B)
Immobilizations for lower limbs
The union of both members (in mermaid). It should be kept in mind that the fixing points will be above and below the knee and above the ankle. When applying it, it will be necessary for an assistant to keep pulling the affected limb and another to help, gently lifting the limbs to allow the bandages to pass. When splints are available, a stiffer and better quality immobilization is obtained by including the hip. In this case, the splint will be placed from the armpit to the ankle on the outside and from the inguinal crease to the ankle on the inside. That way the member will be like a sandwich between the two splints. Traction will be maintained as indicated and one more fixation point will be included above the iliac crest. Depending on the need, this immobilization will be used in whole or in part.