Deo plaster cast on the shoulder joint. Dezo's bandage. Overlay technique. Ready-made dressings Deso

Dressing for a fracture of the clavicle plays an important role for the successful subsequent treatment of the victim and the prevention of possible complications.

Why is a bandage required and what are the basic techniques?

A clavicular fracture requires mandatory immobilization and fixation in a secure position. Correct application of a bandage is a mandatory procedure when providing first aid to a victim, which allows avoiding displacement of bone fragments and preventing the development of possible complications.

The bandage should be applied directly to the damaged area. Assistance to the victim is required in the presence of the following symptomatic picture, indicating the presence of a clavicular fracture:

Crepitus;
Tumor;
Bleeding (in case of open injury);
Nausea;
Dizziness attacks;
Pain syndrome;
Feeling of weakness, localized in the area of the joints and hand.

Transport immobilization

In order to provide first aid, before delivering the victim to the trauma department of the clinic, it is recommended to apply a transport bandage. For these purposes, you will need a scarf, at least 35-40 cm long.

There are several ways of transport immobilization in case of damage to the clavicular bone. These include the following:

An ointment with analgesic properties is applied to the skin in the area of damage. This manipulation will allow the most reliable fixation of the injured clavicle and create a dense layer in the fracture zone. The bandage itself is applied to the injured area with precise and accurate movements.
Binding. This method of immobilization allows you to firmly fix the area on both sides. The area of the fracture is fixed with a binder made of two pieces of fabric.

It is very important to carry out all the manipulations accurately and accurately, since an incorrectly applied bandage or lack of necessary fixation can damage displaced bone fragments, nerve endings and blood vessels, which threatens with severe bleeding, loss of sensitivity, cuts and other dangerous consequences for the patient's health..

Therefore, if you do not have the necessary skills and experience, before you deliver the patient to a hospital, you can immobilize with a scarf. Klondike is the easiest bandage method to perform, which allows you to temporarily raise the injured limb, avoiding the displacement of bone fragments.

If you don't have a scarf at hand, any piece of fabric (long and wide enough) folded into a triangle will do. The long ends of the scarf are fixed around the victim's neck, and the larger side is placed under his wrist. Thus, the bandage fixes the entire area of the injured forearm.

There are many ways to immobilize a broken clavicular bone. The optimal option is determined by the treating specialist on an individual basis, after preliminary diagnosis.

The structures necessary for fixing and maintaining bone fragments in the correct position differ, first of all, in the degree of their rigidity. The most rigid is a plaster cast. But for many patients, especially those who are in the age group over 60, the application of plaster is not recommended, due to the increased risk of developing complications such as arthrosis, severe pain. In such cases, softer fixing structures are used.

About the Delba rings

Delba's rings for clavicle fractures are often used in conservative treatment. The fixing structure is made of cotton wool wrapped in a sterile gauze cloth folded in several layers. At the next stage, the blanks are rolled up in the form of two rings.

The diameter of the Delbe rings should be quite slightly larger than the patient's shoulder circumference. How is such a device applied? According to the established instructions, the upper limbs of the victim are threaded into the rings, fixed in the armpits, and then tied together in the back area with a bandage threaded through the holes.

When tying the rings, you should try to leave a slight tension, the bandage should not be too tight and pressing. As a result, a kind of fixing circle is formed around the patient's shoulders, which creates additional support for the shoulder girdle. In this case, the bone fragments are carefully parted in different directions, which makes it possible to somewhat weaken the pain syndrome and alleviate the condition of the injured person.

Using Delbe's rings in the event of a clavicular bone fracture, it is possible to give the limbs the correct position, allowing optimal and reliable fixation of the bone fragments. The disadvantages of this technique include discomfort in the area of the patient's armpits, arising from the friction of the tissue or bandage on the skin.

In addition, the rings do not contribute to the lifting of the shoulder girdle, which is important to prevent the deviation of the clavicular bone fragments from their axis as a result of the influence of the adjacent muscle groups. For this reason, it is often recommended to use a scarf bandage for additional fixation. Delbe's rings are worn on average for about 1.5 months.

Seyr's immobilization technique

Sayra's bandage, which is applied using a plaster, is one of the most effective methods of transport immobilization in case of violations of the integrity of the clavicular bone. To help the victim, you will need 3 strips of ordinary plaster. The optimal length of each strip is about a meter, the width is from 5 to 9 cm.

Before applying, the patient's forearm is gently bent at a right angle in the area of the elbow joint. The overlay technique is as follows:

The first strip is applied across, passing through the outer, back and front surface of the injured shoulder, so that the patch passes through the back to the chest.
The second strip is placed on the intact side in the area of the scapula, raised to the forearm, thrown over the healthy clavicle bone, slightly lowered down and, passing through the chest, applied to the injured forearm (in the elbow joint area).
The third strip of the patch is folded in the form of a loop and applied in such a way that it captures the area of the injured forearm and wrist joint. After that, the strip is raised to the area of the scapula.

This method of immobilization allows the end of the clavicular bone to be slightly lowered, preventing further, extremely dangerous displacement of the bone fragments.

About Dezo's bandage

The Desot dressing is one of the most common ways to immobilize the clavicular bone in the event of a fracture. This technique is popular due to its extreme simplicity and availability. The use of the Dezo bandage provides the necessary support, allows you to reduce the mobility of the injured limb by pressing it to the body.

To provide assistance, you will need an elastic bandage, cotton or cloth roller. The overlay scheme is extremely simple:

A roller is placed under the forearm area.
Then, with the help of a bandage in the subclavian region, a binding is made from the shoulder.
After that, the bandage should be tied to a knot in the area of the elbow joint.

Fixation tours are made at the level of the chest, starting from the armpit on the healthy side of the body, capturing the area of the injured shoulder.

Even a person far from the medical field can easily make such a dressing. True, independently, without outside help, it is almost impossible to carry out such a procedure.

The disadvantages of this method include the fact that it does not contribute to the expansion of the shoulder girdle, respectively, and the comparison of bone fragments. In order to properly fix the broken collarbone, a few repetitions will be enough.

Features of the eight-shaped bandage

An eight-way bandage is perfect for fixing the edges of the injured bone with a clavicular fracture without accompanying displacement. When applied, the bandage passes through the muscle cavities, forming the number 8.

A wide bandage is applied in the interscapular region, leading one of its ends to the forearm and under the arm, and then returning to the scapula again. Similar manipulations are carried out with the second end of the bandage, only it is directed in the other direction. At the end of the procedure, it is necessary to firmly connect the ends of the bandage.

It is very important to take care of the correct, tight winding, which allows you to achieve the effect of traction and maximum immobility of the clavicle. This method of immobilization is considered quite convenient and effective, due to the fact that it provides uniform bilateral fixation, but it is not used to provide first aid. The eight-piece bandage is worn for 2-3 weeks.

The application of an eight-fold bandage is possible only in a clinic, after the clavicular fracture has been repositioned.

A properly applied dressing for a clavicular fracture not only helps to avoid displacement of bone fragments and prevent a number of undesirable consequences, but also allows for some traction. The method of applying a bandage for long-term immobilization is selected by the attending physician individually. The recommended terms of immobilization for injuries of the clavicular bone are about 1 month.

The main purpose of the bandage is to fix the limbs in case of injuries and dislocations... Let us consider how to apply a Dezo bandage and analyze the key mistakes made by healthcare workers, due to which the bandage does not fulfill its therapeutic functions.

Indications for use

Dezo bandage, the scheme of which is discussed below, is applied to patients when it is necessary to immobilize the arm - in case of fractures and injuries of the upper limbs. The application of this bandage is recommended by GOST R 52623.2-2015 for fractures of the humerus. Desmurgy considers Deso as part of the first medical aid, as an auxiliary immobilization after operations, as well as during the transportation of patients.

The indications for the use of the bandage are:

Dislocations of the shoulder.
Fractures of the humerus.
Clavicle fractures.
Various conditions after shoulder dislocation.

With the help of the Deso bandage, the limb is fixed to the body, but the shoulder joint is not retracted. If the Desot method is used for long-term immobilization of a limb, for example, with a fracture of the clavicle, it is necessary to apply additional elements in order to take the shoulder back.

For what cases the Dezo bandage is not suitable:

with open fractures;
with complex fractures with fragmentation of bones.

In this case, the bandage can aggravate the patient's condition - displace bone fragments, provoke the destruction of soft tissues by fragments, etc.

In many cases, a Deso dressing is not needed - there are Dezo dressings that are ready to use. However, in case of emergency, when a ready-made dressing is not available, ordinary gauze bandages are used.

There are two important things about dressing:

bandaging on the left hand begins from left to right;
on the right hand, a bandage is applied from the right to the left.

Desmurgy: Deso

Desmurgy is a section of medical knowledge about the properties and types of dressings, including how to apply medical dressings to different parts of the body. In desmurgy, recommendations are given on how to correctly apply certain dressing schemes. For Desot dressings, the scheme also focuses on the general principles of desmurgy.

Therefore, nurses should be guided in desmurgy, because bandaging is one of their immediate functions. This will allow the nurse to quickly and correctly apply the dressing correctly, even in an emergency and in times of pressure.

The bandage Dezo received its name from the inventor of the bandage bandage, which is used to immobilize the limbs, Pierre Dezo.

Today, this type of dressing is used everywhere in medical institutions, so healthcare professionals need to know how to apply the Deso dressing step by step and be able to apply this knowledge step by step.

How to apply a bandage step by step

Bandaging includes three stages - preparatory, main and final.

1. Preparatory stage:

tell the patient about the essence of the manipulation, get his consent to perform it;
the patient is asked to take a sitting position;
a nurse treats her hands with an antiseptic, puts on a mask and gloves.

2. The main stage:

the limb, on which the Deso bandage scheme will be applied, is given a mid-physiological position;
a cotton-gauze roller is placed in the armpit of the injured arm;
the health worker makes two circular fixing rounds of bandage on the chest, injured limb in the region of the middle third of the shoulder, back and under the axillary. The direction of the bandage is from the healthy side to the damaged one;
the second round is conducted from the healthy armpit to the shoulder girdle of the injured side, then down along the back surface of the shoulder under the elbow;
the third round - the bandage goes around the elbow joint. Then the hand and forearm are fixed, the bandage is slanted upward into the armpit of the healthy side, and is brought out along the back onto the sore forearm;
the fourth round - the bandage is carried out vertically downward in front of the shoulder, bends around the elbow joint. After that, the bandage is directed to the posterior surface of the chest into the armpit of the healthy side;
then all four circles are repeated at least 3 times;
the bandage is completed with a fixing round - the bandage is directed around the chest, the bandage is fixed in the front of the chest;
pins are used to fix the crossing points of the tour, they can also be stitched.

3. Final stage:

disinfect the outer surfaces of medical products;
take off gloves, place them in a container for disinfection, treat and dry your hands;
fill out medical documents;
disinfect used materials, products, etc.

Errors

In the event that, when applying the Deso dressing, the scheme of the health workers is violated, this can lead to the following consequences:

1. The hand is fixed in the wrong position. The ends of the fractured bone are displaced, the fixation is generally poor and insufficient.
2. The bandage is too tight. In this case, the pain at the site of the fracture increases, because normal blood circulation in the tissues is disrupted.
3. The bandage is not tight enough. In this case, the bandage will constantly slide off the shoulder, the arm moves freely, there is no immobilization. Such a bandage will not achieve the desired treatment results.
4. The bandage was applied to the injury site with uneven pressure. In those places where the dressing is too tight, the tissues are squeezed, and in those where the dressing is not tight enough, the dressing functions are not performed.
5. Wrong dressing material selected. In the event that there are no bandages of the required size in the medical kit, the paramedics use the materials at hand - tissue cuts, sheets, duvet covers, etc. This is a big mistake - such a bandage will not be able to perform the function of immobilizing a limb, moreover, it can harm it.

If there is no suitable material, the best solution is to leave the hand in the position in which it was after the injury and wait for the arrival of paramedics who will perform all the necessary actions before the surgeon examines the injury.

Attention! the information on the site is not a medical diagnosis, or a guide to action, and is for informational purposes only.

This bandage is applied to fix the upper limb in case of fractures and dislocations of the shoulder.

Necessary tools

bandage 20 cm wide
pin

Note. The right hand is bandaged from left to right, the left - from right to left.

Sequencing

1. Sit down the patient facing him, calm him down, explain the course of the upcoming manipulation.
2. Place a cotton wool roll wrapped in gauze into the armpit.
3. Bend the forearm at the elbow joint at a right angle.
4. Press your forearm to your chest.
5. Make two fixing rounds of bandage along the chest, sore arm in the shoulder area, back and armpit from the side of the healthy limb.
6. Lead the bandage through the armpit of the healthy side along the front surface of the chest obliquely on the shoulder girdle of the affected side.
7. Go down the back of the sore shoulder under the elbow.
8. Bend around the elbow joint and, supporting the forearm, direct the bandage obliquely into the armpit of the healthy side.
9. Lead the bandage from the armpit along the back to the sore forearm.
10. Lead the bandage from the shoulder girdle along the front surface of the sore shoulder under the elbow and go around
forearm.
11. Direct the bandage along the back into the armpit of the healthy side.
12. Repeat the rounds of the bandage until the shoulder is fully fixed.
13. Finish the bandage with two reinforcing rounds along the chest, sore arm in the shoulder area, back.
14. Pin the end of the bandage with a pin.

Note. If the bandage is applied for a long time, the tours of the bandage should be stitched.

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The Desot bandage was invented by the French surgeon P.J. Desot during the period of his practical activity (from 1760 to 1795).

In previous years, this bandage was used everywhere, but today it has been replaced by other methods of fixation that are more convenient for both the patient and the doctor.

In modern medicine, Desot is used primarily for immobilization of a limb at the prehospital stage, as well as in the process of rehabilitation after a fracture of the shoulder or collarbone.

Indications for use

The Dezo bandage on the shoulder joint is used for injuries and fractures of the upper limbs, requiring immobilization of the hand. Indications for use are:

Dislocations of the shoulder;
Conditions after shoulder dislocation.

In this case, with the help of a bandage, fixation of the limb to the body is achieved, however, the shoulder joint does not move back.

When using the Desot method for long-term fixation in case of clavicle fractures, additional elements are required to allow the shoulder to be pulled back.

The Desot method is not used for complex comminuted fractures and open fractures, since its imposition can aggravate the patient's condition, provoke additional destruction of soft tissues by bone fragments, and lead to increased displacement of bone fragments.

You can buy a ready-made fixing bandage on the shoulder joint, or you can apply it using a bandage.

Overlay technique

The patient is seated facing oneself, the injured limb is bent at an angle of 90˚, and a roller wrapped in a bandage or gauze is placed in the armpit. To apply a fixing structure, a bandage 20 centimeters wide is required, a pin, which will later be used to fix the bandage, and scissors.

In critical conditions, just one bandage is enough. If necessary, you can use an elastic bandage or a long, wide strip of fabric.

Dezo bandage technique:

To achieve a positive result, experts recommend repeating each round of the bandage three times. Otherwise, the material may weaken and displace during the movement of the victim and his transportation to the hospital.

Bandage care

When applied for the period of transportation of the patient to the hospital, the Deso dressing does not require special care. If it is used as a permanent fixation device (after the dislocation has been repaired, if it is impossible to apply more reliable immobilization techniques), it requires certain care:

Reapplication

Reapplication of Deso may be required when the bandages are heavily soiled, as well as when it is weakened due to excessive patient activity. At the same time, the old one is removed completely and replaced with a new one. The injured limb must be held in the position in which it was fixed.

Terms of use

The terms of use can vary widely. At the prehospital stage, the time of fixation of the limb using this method directly depends on the time of delivery of the victim to the hospital.

When using the Dezo bandage to fix the shoulder after a dislocation, it can be worn for 1 to 3-4 weeks.

At the same time, young patients undergo a longer immobilization than patients over 30-40 years old. This is due to the high physical activity of young people, leading to repeated dislocations.

The wearing times for fractures of the shoulder or collarbone are approximately the same. It is worth noting that in such cases, methods of fixation using a conventional bandage are used extremely rarely, only in situations where the imposition of plaster or a full-fledged splint is impossible for some reason.

After removing the bandage, during the rehabilitation period, and are important.

Possible overlay errors

The following mistakes can be made:

The limb is in the wrong position - in this case, bone fragments can be displaced, fixation is incomplete and of poor quality;
Bandage tours are applied too tightly - a mistake leads to increased pain, circulatory disorders in the fixed limb;
The tours are too weak - the bandage slips off the patient's body, the bandage does not fulfill its functional purpose, the limb changes position;
Uneven pressure on the surface of the body - in areas where the bandage is too tight, it will pinch the blood vessels. Where the bandage is applied with low tension, the bandage will lose its original position, slide down;
The dressing is not made of the right material. Sometimes people who provide assistance to the victim before the ambulance arrives try to apply a Dezo bandage using sheets and duvet covers. Such bandages are not fixed on the body, fall off, do not fulfill their function. It is better to use a sheet to apply a "kerchief" bandage. Here it will be more appropriate.

Full fixation of the limb can only be performed with the correct, error-free Dezo bandage. In the absence of the necessary skills, it is better not to try to immobilize the limb, but to leave it in the position that it assumed after the injury, until the ambulance team arrives.

Alternative dressings

The list of fixation methods alternative to the Deso dressing includes:

Delbe's Rings are 2 rings made of bandage or wide belts and held through the shoulder girdle of the victim. Behind the back, the rings are connected in such a way that they spread the patient's shoulder joints to the sides.

Eight-shaped bandage is an improved version of the Delbe rings. For its manufacture, a bandage is used, which is applied in such a way that the patient's shoulder girdle is divorced, and behind his back the bandage takes the form of the number "8".

Scarf bandage is the easiest to apply. Use a square piece of fabric with a side of at least 1 meter. The dressing is designed to prevent the arm from sagging and stretching the muscles that can pull apart bone fragments in the event of a fracture.

Velpo headband is a type of Deso. In this case, the limb is fixed at a sharper angle, the palm of the affected limb of the patient is in the area of the healthy shoulder girdle. The advantages and disadvantages of Velpo are similar to those of using Dezo.

Treatment of shoulder injuries involves immobilizing the joint, and fixators of various designs are used for this purpose. Deo dressing is prescribed for injuries of the clavicle, forearm, arthritis, arthrosis in the shoulder area, fractures, dislocations of the arms and sprains of the upper extremities.

For a deo bandage, you will need a 20 cm bandage and a pin to secure it. You can use a cloth or elastic bandage. To avoid displacement of bone fragments, the hand must be fixed in the anatomically correct position. Do not tighten the bandage too tight. The retainer can be used for up to several weeks.

This fixator was named after the surgeon P.Zh. Desot, who lived in France and practiced there from 1760 to 1795.

Features of the bandage Dezo

The advantage of fixation is the ability to immobilize the entire upper limb, fixing it to the body, to exclude any of its movements in all joints. At the same time, wearing a bandage does not lead to squeezing of the tissues of the hand and disruption of its blood circulation, if it is applied correctly.

In addition, ease of application and availability of materials are important.

A wide enough bandage - gauze or elastic from the first-aid kit, to quickly provide assistance to the victim.

Overlay technique

The patient is seated facing oneself, the injured limb is bent at an angle of 90˚, and a roller wrapped in a bandage or gauze is placed in the armpit. To apply a fixing structure, a bandage 20 centimeters wide is required, a pin, which will later be used to fix the bandage, and scissors.

In critical conditions, just one bandage is enough. If necessary, you can use an elastic bandage or a long, wide strip of fabric.

Dezo bandage technique:

First, 2 fixing rounds of bandages are applied, passing along the injured arm pressed to the body and the lateral surface of the body from the healthy side. At the same time, the healthy hand remains free;
From the healthy side, along the front surface of the body, the bandage is slanted onto the shoulder girdle of the injured hand;
The bandage is lowered under the elbow of the sore arm along its back surface;
Bending around the elbow, the bandage along the front surface of the body is directed to the armpit of the opposite side, from there - to the injured forearm along the back surface;
The bandage is carried out along the front side of the sore shoulder with its removal under the elbow. Then the bandage is directed into the armpit and fixed in 2 rounds through the victim's chest, along his sore arm and back;
Fixing with a pin is made.

When should you apply the Dezo bandage?

The Dezo dressing and its various variants can be used for both first aid and treatment.

The indications for transport immobilization in case of injuries are:

shoulder dislocation;
shoulder joint injuries - contusion, sprain and rupture of the ligaments;
fracture of the clavicle;
fracture of the neck of the shoulder;
fracture of the bones of the forearm;
damage to the elbow joint - bruises, sprains and ligament ruptures.

In the course of treatment, fixation is used in the following cases:

after surgery for a fracture of the clavicle, shoulder, rupture of ligaments;
after closed or open reduction of shoulder dislocation;
in the initial period of rehabilitation after injuries;
with an acute inflammatory process in the shoulder joint.

Indications for use

In the conditions of modern medicine, a deo bandage for the shoulder joint is used mainly for the purpose of immobilizing a limb in the prehospital and rehabilitation periods. At the recovery stage, an immobilizing bandage is prescribed exclusively by a doctor, since the imposition of a bandage requires adherence to certain rules.

The indications for the use of the deo bandage are as follows:

upper limb injuries (fractures, dislocations, subluxations, sprains),
injuries of the collarbones, forearms,
inflammatory diseases in the shoulder girdle (arthrosis, arthritis),
damage to the nerve roots as a result of trauma,
paralysis of the upper limbs,
elimination of pain by fixing the shoulder joint in its natural anatomical position.

When should you not apply a Dezo bandage?

With all its advantages, the bandage cannot be applied in case of open injuries of the upper limb and shoulder girdle, when there is bleeding, measures to stop it and constant control are necessary.

Also, in the case of complex fragmental fractures and fracture-dislocations with pronounced displacement and deformation of the limb, it cannot be used, because for imposition you will have to straighten the arm and bend at the elbow joint. This cannot be done when providing assistance, you need to try to fix the limb in this position as it is, using the available means.

When and how to use?

Dezo bandage is used for:

Uncomplicated shoulder injuries.
Minor fractures of the clavicle.
Sprains of tendons and ligaments.
Dislocations in the shoulder or forearm.
Immobilization of the injured site after surgery.

Separate dressings are produced for children in smaller sizes.

The doctor should appoint it to wear it, he also explains how the orthosis is put on and selected in size. Since there is no exposure to chemicals on the body, and the dressing itself is often made of hypoallergenic tissues, it has practically no contraindications. The exceptions are skin infections and dermatitis, which can be worse and worse under these conditions.

Sprained shoulder ligaments

In the presence of such diseases, it is necessary to consult a doctor, who can simultaneously prescribe a course of treatment for skin diseases or suggest another method of fixation.

If the dressing is purchased from a pharmacy, it is dressed as follows:

First, cotton clothes are put on the body.
A belt is attached in the abdomen, which is used to fix the upper limb.
A special forearm buckle is attached to the belt.
The shoulder strap is passed from the side of the non-injured area and is attached with a Velcro fastener.
With the help of a retainer, the joint itself is fixed.

If there is no opportunity to purchase a ready-made bandage, you can make it yourself. This will require:

Bandage 20 centimeters wide.
A roll of cotton wool or gauze, placed under the bandage.
Scissors.
Pins or adhesive tape to secure the ends.

It is better to put a bandage on Dezo not on a naked body, but on cotton clothes, so there are fewer chances of rubbing and the appearance of diaper rash. A sick person is placed on a chair erect, the injured arm is bent at the elbow and held. A cotton-gauze pad is placed under the arm, which does not allow the hand to come into close contact with the body. Then a bandage is applied according to the scheme:

First, it is taken out from the axillary zone of the healthy arm along the front of the body to the injured forearm, after which it is lowered down to the elbow, from there it is taken out through the chest back to the armpit of the healthy arm. The loop is repeated a second time.
The bandage is held close at hand and is held up to the sore shoulder girdle.
The bandage is pulled from the armpit of the intact joint through the chest to the injured shoulder girdle, here it is taken down behind the shoulder, covering the elbow, then covering the forearm and returning to the healthy arm again. Now the bandage is returned to the injured shoulder girdle and is moved along its front part, fixing the elbow joint and again returning to the armpit of the healthy arm.
Several turns are made on the body until the shoulder is firmly fixed.

Overlay rules

All that needs to be prepared is: a bandage at least 20 cm wide, scissors, a pin or sticky tape, a small roller made of soft cloth or cotton gauze. In order for the dressing to perform its fixation function as much as possible, without causing inconvenience and undesirable phenomena, the following rules must be observed:

Sit down the victim face to himself, calm down, let him relax.
Before applying, a roller is placed in the axillary region of the injured arm, after which the arm is carefully brought to the body.
The arm is bent at the elbow joint at a right angle, the hand should be relaxed, the healthy arm is taken to the side.
Wrap 2 times with a bandage around the chest with the hand pressed to it above the level of the elbow. In this case, if the patient's right hand is fixed, the bandage is led around the chest from left to right.
Having made 2 turns on the back, the bandage is led in front of the chest obliquely up to the top of the shoulder joint of the sore arm, bends around it and the bandage is lowered along the back surface of the shoulder.
Bending around the elbow area, the bandage is led obliquely upward in front into the axillary region of the healthy side, from it they move to the back and repeat the previous move.
The end of the bandage cannot be tied; it is fixed to the main bandage with a pin or plaster.

When applied to the left hand, the algorithm of actions is the same with the difference that they begin to bandage in the other direction - from right to left.

How to apply a Dezo bandage correctly

Contraindications

Do not use the Dezo bandage on the shoulder joint for the following pathological conditions:

dermatitis;
skin infections;
individual intolerance.

In the absence of contraindications, the use of the Dezo orthosis brings positive results. The minimal impact of external factors on the injured limb accelerates rehabilitation after injuries, trauma, operations. Such bandages are the main preventive method to help prevent complications after hand injuries.

Possible overlay errors

When applying a bandage, the following mistakes should not be made:

fix the hand in the wrong position, this can lead to displacement of fragments, increased pain;
bandage is too tight, you can pinch the blood vessels, cause swelling of the hand;
bandage is not tight enough, leave the possibility of hand movements when transporting the patient;
use strips of fabric, sheets, scarves and other materials instead of a bandage, they will not provide normal fixation.

How to care

When used temporarily, the dressing is not taken care of. For example, if it is applied for a while as a splint (during transportation to the hospital), then it is removed there. If it is worn instead of plaster for a long time, then it needs care.

In this case, some nuances are required:

bandages are changed after they are heavily soiled;
in case of deformation of the bandages, when they are not able to perform the functions of a tight retainer, I completely change them, while keeping the hand in the desired position;
when weakening individual areas, there is no need to completely replace the bandage, you can tighten the sagging areas and fix them again;
if the pharmacy fixative is dirty, then it is washed by hand in water at room temperature;
while not using chemical bleaches or solvents;
dry cleaning is contraindicated;
after washing, the product should be thoroughly rinsed;
rubbing and squeezing is strictly prohibited;
it is recommended to dry the product in a straightened position away from heating appliances and ultraviolet rays;
do not iron the product, store in a dry place;
avoid water and direct sunlight.

Ready-made dressings Deso - indications and rules of imposition

Today, ready-made Dezo dressings produced by the industry are very popular - bandages of various models. They are easy to use, provide fast, reliable and adjustable fixation with hooks, Velcro, and locks.

In essence, these are braces for the shoulder and forearm, they can be purchased at a pharmacy or medical equipment and orthopedics stores, as well as in online stores. The price varies from 800 to 4000 rubles, depending on the type of model, materials, fixation rigidity. All types of such fixation bandages are selected in accordance with the size, in most cases they are marked by the size of the clothes - S, L, M, XL and so on, or the corresponding numbers 1, 2, 3, 4.

Other fixation methods

In addition to the Deso bandage, other fixation methods are used to secure the position of the upper limb. They are prescribed depending on the nature of the injury and the individual characteristics of the patient.

"Klondike"

The easiest to apply method of fixing the injured upper limb, which is often used as first aid to the victim. It is also used to secure the bandage and isolate the wound. For a high-quality dressing, a piece of cotton fabric in the shape of an isosceles triangle is used.

The technique of applying the "Klondike" is significantly different from the Dezo bandage:

one end of the tissue is placed on the injured shoulder, the other on the wrist;
the free end wraps around the forearm;
the other end turns the shoulder towards the forearm;
the two ends are tied tightly.

It is a shoulder girdle fixator, which is prescribed for fractures and other injuries of the clavicles. It has the shape of 2 rings worn on the shoulders with a tight fixation on the back. During the period of wearing the bandage, the shoulders are pulled apart to recline the upper part of the thoracic spine, the position of the clavicular-acromial joint is fixed, and the load is distributed from the clavicles.

Eight-shaped gusset

A bandage made of elastic bandage, used to fasten and fix the position of the edges of the broken bone. Unlike the Desot dressing, the application is carried out strictly in the hospital after an X-ray and reduction of the elements of bone tissue:

the bandage is placed on the back in the area between the shoulder blades;
one end is wound on the shoulder girdle, held at hand and returns to the shoulder blades;
the algorithm of actions is repeated for the second forearm using the other end of the bandage;
all loose ends of the bandage are tied tightly or secured with safety pins.

Dezo's dressing technique is easy to perform and does not require special medical knowledge. If it is necessary to fix a hand to a loved one at home, manipulations are carried out independently.

You can find out the nuances of the method from a medical professional and consolidate your knowledge by watching specialized videos. For training, it is recommended to use an elastic bandage, which is not subject to destruction, unlike the usual one. But if there is not enough experience for the correct application, it is better to entrust the implementation of the procedure to specialists.

Bandage care

If immobilization is imposed temporarily only for transporting the victim to a hospital, no care is required for it. You just need to make sure that the tours of the bandage do not shift and the fixation does not weaken.

When wearing the bandage for a long time, you need to keep it clean so that there is no infection of the limb with pathogenic microbes. In case of contamination or wetting, you need to reapply it, but at the same time make sure that during the removal and new bandaging the hand remains in the same position.

Terms of use

The operational times of a deo dressing range from a few minutes to several weeks. If the limb was fixed in order to immobilize the hand for transporting the patient to a medical facility, then the wearing time depends on how quickly the patient is taken to the hospital.

The application of the fixation bandage after the dislocation has been reduced lasts from 1 to 4 weeks. However, for patients under the age of 30, doctors recommend extending the service life due to increased physical activity, which can provoke secondary dislocations.

After fractures of the shoulder or collarbone, the brace should also be worn for 3-4 weeks. For children, this period is reduced to 2.5 weeks. It should be noted that this method of fixation with a bandage is used infrequently and only in those situations in which the imposition of a plaster cast or an immobilizing splint is not possible due to some circumstances.

Alternative dressings for fixing the shoulder joint

Other types of bandages are applied to the shoulder joint area:

the plaster version of the Dezo bandage is fixed only in a hospital for the purpose of rigid and prolonged immobilization in case of fractures;
Velpo bandage is an alternative to the classic Desot bandage with the difference that the arm is bent at the elbow joint at an acute angle, the hand of the injured hand is fixed at the level of the shoulder girdle of the healthy side, swells less, the indications for application are the same;
Eight-shaped bandage and Delbe rings - applied to both shoulder joints, providing shoulder abduction in case of a clavicle fracture;
kerchief bandage - used only for first aid, hangs the arm from the neck, excluding movements in the shoulder and elbow joints.
spike-shaped - for dressing the shoulder and joint in the presence of open injuries, fixing the dressing on the wound.

In the course of treatment for injuries and diseases, the doctor determines the optimal dressing option in each case. And for first aid in case of injuries, the Dezo bandage is the best option.

Alternatives to the Dezo bandage

Rules for imposing a finished bandage

It is necessary to wear the Dezo alternative dressing correctly, taking into account the following recommendations:

The patient wears comfortable cotton clothing.
The body is wrapped with a belt designed to securely fix the hand, which fastens on the stomach.
A latch is attached to the waist buckle that connects the brace on the forearm.
A tape is stretched along the healthy side of the body, fixing the sore shoulder, and fastened with Velcro.
The affected shoulder joint is secured with a retainer.

Output

All dressings available and used in traumatology provide favorable assistance in the subsequent treatment and rehabilitation of the patient. Among the variety, it is important to choose the right product for you. A doctor with experience and qualifications will help you with this, allowing you to determine the severity of your injury and take into account the details of its treatment. Self-administration and treatment can cause irreparable consequences and complications that can lead to the patient's disability or negatively affect the quality of his later life.

Preparatory stage

First you need to make sure that the shoulder has been dislocated. The most reliable option is to consult a specialist. Typically, this injury occurs in the following cases:

intense sports activities;
landing when falling on an outstretched arm.

This type of injury is characterized by the following symptoms:

inability to move your shoulder;
sharp pain;
edema;
bruise;
displacement of the shoulder joint.

Any suspicion of a shoulder dislocation requires specialist advice. Before applying a bandage on the shoulder in case of a dislocation, the traumatologist will definitely give a referral for an X-ray examination. This must be done to exclude a possible fracture. The doctor will also select a pain reliever to relieve the patient's condition.

A traumatologist should be consulted without fail. Only a qualified specialist knows what to do with a dislocated shoulder joint. First of all, it should be adjusted. The spherical head must be returned to the articular bag of the shoulder girdle. In order to carry out a closed joint reposition, it is necessary to carefully stretch and rotate the forearm. This is important to get the head of the joint back in place.

An injection of pain medication can help reduce severe pain. Reduction and fixation of the shoulder joint in case of dislocation should not be done by a person who does not have special education or the necessary experience. This can only aggravate the situation and lead to even more damage. Do not bandage an unreset joint.

After setting, it is recommended to apply ice, wrapped in a cloth, to the injured shoulder. This will reduce painful manifestations and make it possible to reduce the likelihood of an inflammatory process. The compress should be kept for about a quarter of an hour. The patient will feel significant relief after such manipulation.

Delbe rings overlay

The conservative methods include the imposition of the Delbe rings. To make such a structure, you will need cotton wool and gauze. Cotton wool needs to be wrapped with gauze, making 2 rings. The diameter should be small, almost equal to the circumference of the upper arm. Putting the rings on your hands, they should be secured in the armpit, tied on the back with a rubber tube. The use of Delbe's rings helps to securely fix the limb, position the bones in the correct position.

To correct clavicular injuries in adults and children, a bandage such as Seira can also be used. To do this, you will need 3 strips of plaster, 6 to 8 cm wide and 1 m long each. The elbow of the injured limb must be bent at the elbow, and then secured with strips. Seira allows the forearm to be suspended by pointing down the center of the collarbone. Thus, the fracture caused by the trauma will prevent the bone fragments from dislodging.

To cope with a fracture of the clavicle also allows such a device as Titova's oval. It must be placed in the armpit from the side of the injury, and then with plaster bandages to tie the oval to the body. Before applying the plaster, the upper limb should be slightly pulled back, the arm should be brought together at the elbow at an angle of 45º. The oval is supported by a kerchief or a regular bandage, the ends of which must be fastened around the neck.

Recovery from a clavicle fracture

Exercise therapy after trauma includes three main stages, each of which is an important component of the recovery process for any patient, be it an adult or a child. First, the patient is immobilized with bandages, which includes simple exercises for the hand and fingers. The second stage of recovery after a fracture of the clavicle is carried out using special gymnastic sticks. During this period, the patient needs to develop the shoulder joint. After removing the plaster, physiotherapy exercises are added, including additional procedures:

amplipulse therapy;
high-frequency magnetotherapy;
distance shock wave therapy;
mineral water;
low-frequency magnetotherapy;
hydrogen sulfide baths;
SUV irradiation in erythemal doses;
UHF therapy;
ultrasound therapy;
physiotherapy;
physiotherapy;
sodium chloride baths;
electrophoresis of pain relievers;
electrophoresis of vasodilating drugs.

A bit of history

The headband is named after its inventor - Pierre Dezo

The bandage was invented by Pierre Joseph Desot (1738 - 1795), surgeon, anatomist. During his career, Pierre Desot won the title of the best surgeon in France, but he was in disgrace with the revolutionary government. He was arrested right in the middle of a lecture on May 28, 1793 and put in the Luxembourg Palace, three days later he was released. Remarkable is the death of the great surgeon, who was summoned to the young king Louis XVII on May 31, 1795, he fell seriously ill, and Pierre Dezo died the next day, he could not provide assistance. Rumors of the poisoning instantly spread throughout Paris, but Deux Marie's student Francois Xavier Bichat, who performed an autopsy on his teacher's body, easily denied them.

Advantages and disadvantages

Applying the Velpo bandage

The main purpose of the bandage is to reliably support and fix the arm, preventing it from making unnecessary painful movements. But as a method of treatment, the bandage will not dilute the forearms and thereby contribute to the reduction of the fragments. It is difficult to perform it not only without preliminary preparation, but also independently, someone must definitely support the brush.

To correctly and competently apply a bandage, you can use an elastic bandage and someone from your home. So the scheme will be more understandable, and after a few repetitions, the algorithm will be deposited in the head by itself.

The consequences of the fracture

No treatment process can give one hundred percent guarantee of healing of the injury, so the consequences of a clavicle fracture can be very different. And although in most cases this ailment passes quickly, some patients have experienced complications such as slow healing during therapy. In addition, with a multi-splintered fracture, the following may occur:

arthrosis of the joints;
violation of the ratio of soft tissues;
the risk of rupture of the skin;
damage to the neurovascular bundle;
bone infections or growths.

Types of chest bandaging with elastic bandages

In the course of the treatment of various injuries, the rehabilitation of athletes, in order to start their further training, the practice of therapeutic and restorative sports medicine has developed different types of dressings that are used in different situations. Bandaging is needed immediately after injury to immobilize the chest; fixation of the edges is required for their successful and correct fusion; sternum support is needed already at the beginning of training during the rehabilitation phase.

Features of the star headband

Stellate (cruciform) ligation of the shoulders

In another way, in different sources, the bandage is called cruciform.

But the essence remains the same. It is required to use it for chest injuries. An elastic bandage on the chest is chosen with a width of at least 10 cm. Its application requires the use of the "figure eight" technique. The first few circles around the torso to fix the tape, then the direction of the bandage under the right armpit, around the shoulder joint. From the right shoulder, the tape is passed obliquely along the chest towards the left armpit. The result is a cross. Next, you need to circle the second shoulder joint with a tape, lifting the bandage over the left shoulder. This sequence is repeated several times, with the fulfillment of the rule: the bandage falls on the previous one by at least ½. After that, circular turns on the chest are repeated.

For back injuries, the star-shaped bandage is applied in the same order, only the bandage is crossed over the back. Layers of bandages are conveniently applied when a person is bandaging from left to right, and the bandage itself is held in his right hand. The circles of the bandage are made alternately, alternately, coil by coil, covering the chest and back. The upper part of the chest bandage effectively fixes the shoulder grip, for which the bandage is carried diagonally from one shoulder and armpit to the other shoulder.

This bandage is similar to a back brace to support posture after injury. But at the same time there is a nuance: the bandage tours take the shoulders back, in an eight-shape. The disadvantage of such a bandage is that it does not hold well, often slips, and is more suitable for bedridden patients. For reliable fixation of the chest, other methods of bandaging are chosen.

Features of the spiral dressing

Spiral dressing

A spiral bandage on the chest is suitable for a variety of injuries, including pneumothorax. The longest bandage with a width of 10 cm is used as standard. The peculiarity of this bandage is that before applying it, you should cut off two pieces of the bandage longer than the back, lay one piece obliquely from the lower back to the shoulder, and the second piece - from the shoulder down to the stomach , also obliquely. After that, at the bottom of the chest, circular moves should be performed to secure the edge of the tape, and then, moving upward in a spiral, bandage the entire chest and back area, completing the bandage at the level of the armpits. We remind you: the rule of applying the bandage to the previous round by about ½ is observed.

Here the edge of the bandage is fixed with the pre-laid edge of the tape, by simply tying it on a knot. You also need to secure the edges of the gauze on the other shoulder. This creates additional fastening for the spiral passages.

Spiral bandage with a harness

A kind of spiral dressing with a shoulder strap differs from the classical dressing by the imposition of an additional tape for subsequent dressing at the end of the bandage. At the first stage, the bandage is applied in the form of a harness, always over a healthy shoulder, not affected by injury. The main part of the bandage is applied in spiral turns from bottom to top, according to the rules of spiral bandaging.

Practice shows that with a bandage width of 10 cm, no more than 8-10 turns are required. The edges of the tape are secured to the unharmed part of the chest, creating a "harness" appearance.

Features of hermetic occlusive dressing

Hermetic (occlusive) dressing

The main task of an occlusive dressing is to prevent air from entering the pleural cavity with open pneumothorax. This is necessary to exclude contact of the pleura with the external environment. To apply it, you must use a material that would not let air under the bandage. Since the elastic band itself is "breathable", then additional material is required.

What's always at hand? Cellophane bags, which, although it will not comply with all hygiene requirements, will help solve the main problem.

Hermetic occlusive dressing

If in an emergency there is no medical dressing bag at hand, it is allowed to use non-sterile materials, but first apply several turns of a sterile elastic bandage. Alternatively, apply a sterile napkin from the PPM package to the wound, then place non-sterile material to block the flow of air into the wound. After a couple of turns of elastic bandage on top of the wound, it is required to apply a large ball of cotton wool, and after that, carefully finish the bandage. This sequence of actions makes an open pneumothorax closed.

Good to know: tightness is ideally provided by a roll-on adhesive plaster, which is applied directly to the wound in a "shingle" manner, as shown in fig. 1 Having glued the wound in this way, it is necessary to attach a large layer of cotton wool on top, and apply a bandage with an elastic bandage.

The technique of dressing fixation differs according to the location of the wound.

If the wound was in the upper part of the chest, it is better to use a spike-shaped bandage method.

If the wound is located below 3 ribs, then the spiral type of fixation will be optimal.

Dezo's bandage

The purpose of such a bandage is to bandage the arm to the body for immobilization upon delivery to the emergency room with a suspected fracture of the clavicle, shoulder joint. Judging by the drawings, the difference with the Velpo bandage is not significant, but there is a nuance here: the palm of the hand must be bandaged higher to the collarbone, for this the arm at the elbow must be bent as much as possible, but without increasing pain in the victim. Equipment for performing such a bandage: a bandage 10 cm wide. Peculiarities of applying the bandage: the left hand is bandaged to the body, the bandage is held with the right hand, and the bandage is bandaged from left to right, as usual. When immobilization of the right hand is required, the bandage must be held in the left hand, and the bandage is then performed from right to left.

Sequencing:

first, with many circular movements of the bandage, the bandage presses the arm bent at the elbow to the body;
under the arm is pre-compacted with a cotton roll, if there is no cotton - a soft cloth rolled up with a roll, the same T-shirt; it is required to wrap it with gauze or bandage for hygiene;
the second part of the bandage consists in carrying the bandage from the armpit of the healthy side in an oblique direction in front of the chest to the supraclavicular part of the tram side;
then the bandage is transferred from the back from top to bottom under the elbow, the bandage is wrapped on the forearm and again in an oblique direction lead in front along the front side of the hand under the healthy armpit;
on the back, the bandage tape should go in an oblique direction to the supraclavicular region, transferring it down to the front surface of the shoulder;
having wrapped the elbow in front with a bandage, it must be held on the back and in an oblique direction - under the arm of the healthy side.

The sequence of all moves is repeated. When the bandage moves correctly, triangles are formed in front and behind.

Signs of a clavicle fracture

The characteristic clinical signs indicating deviations from the natural state of the bone are a direct indicator of the presence of an ailment. The main symptoms of a clavicle fracture are directly related to severe pain in the affected area that the patient experiences after injury. Attempts to make any movement with the injured limb will be doomed to failure, since severe pain will not allow the victim to even raise his hand. In addition, swelling or swelling will appear on the forearm, which clearly indicates the presence of a bruise.

Rehabilitation and possible consequences

In addition to basic treatments for collarbone injury, physiological rehabilitation methods must be used to restore normal range of motion. They can be conditionally divided into several groups:

those that are used during the immobilization of the limb for fracture healing (these can be the procedures of SUV irradiation and electrophoresis);
procedures after removing the immobilizing agent (therapeutic massage sessions, magnetotherapy to improve blood supply and restore local immunity, different types of therapeutic baths);
methods that do not depend on the presence of gypsum or other means of immobilization (the use of mineral waters and magnetotherapy at low frequencies).

Physical therapy is of great importance, a set of exercises for which is selected by a specialist on an individual basis.

Typically, this type of injury does not produce hazardous health consequences. The only danger is possible damage to blood vessels and nerve plexuses by displaced fragments. If the broken bone was incorrectly fixed, then after recovery, some asymmetry of the shoulders may be noted, but the consequences hazardous to health are usually not observed.

Beneficial features

Dezo dressing has a number of useful qualities:

Allows you to securely fix the upper hand in a functionally advantageous position for a person.
Possesses hypoallergenic properties due to the use of natural fabrics that do not irritate the skin.
Provides anesthesia by immobilizing the fracture site.

The bandage has universal design... Therefore, it is allowed to use it on the right and left hands. Today you can see ready-made clamps on sale. They are made of hypoallergenic material and are able to maintain a good appearance for a long time.

For the treatment of clavicle fractures with conservative methods, it is recommended to apply Delbe rings. The design of the dressing is made of tightly folded cotton wool, fixed with a sterile gauze cut. The workpiece is shaped into two rings so that their diameter is slightly larger than the circumference of the patient's shoulder. The limbs of the victim are alternately threaded into rings, fixed at the level of the armpits and fixed on the back with a bandage, thereby connecting both rings.

When applying a bandage in the form of Delba's rings, too much pressure on the damaged area should be avoided. There should be a slight tension, which will be quite enough to fix the shoulder girdle. In this case, the fragments of bones are bred to the sides and removed from the muscle tissue, which reduces the risk of damage during transportation of the patient. In addition, the slight pressure of the collarbone orthosis reduces pain and provides support for the shoulder girdle, thereby reducing the likelihood of complications from injury.

The main advantage of Delbe's rings in a clavicle fracture is the ability to give the damaged bone apparatus an anatomically correct position. The only drawback is discomfort in the armpits due to the pressure of a tight bandage and friction of tissues against the bandage.

To raise the shoulder girdle to prevent the displacement of the bones relative to its axis, an additional scarf bandage can be applied simultaneously with the rings. The duration of wearing rings is selected depending on the quality characteristics of the fracture and is usually about 1.5 months

Prognosis and possible complications

Most clavicle fractures heal relatively quickly and easily. It takes an adult six to eight weeks to heal, a child three to six. Regenerative cells are much more numerous and active at an early age. However, rehabilitation takes approximately the same time for both adults and children. In general, people return to normal life within three months of an uncomplicated collarbone fracture, although age and previous health conditions are important factors.

Long-term complications are rare and include:

What represents and indications for use

The bandage looks like a spikelet, from where it got its name. Thanks to the characteristic turns, immobilization of the hip joint and the thumb joint is ensured. However, most often the bandage is applied to the shoulder joint. This is a rather complex construction that requires skills to apply turns correctly.

Orthopedic spike bandage is an effective method of fixing joints. Immobilization allows you to ensure complete functional rest of the area, excluding even minimal accidental movements. A fixing bandage on the shoulder is applied in case of dislocation, bruising, any damage to the area. Lack of movement speeds up recovery from degenerative pathologies. In case of fractures, spike-like ligation prevents damage to blood vessels, nerves and soft tissues by bone fragments.

In the case of large wounds or ulcers, a soft bandage keeps out contamination and the entry of pathogens.