How to distinguish a fracture from a sprain: description of the main symptoms and first aid

or
damage to the musculoskeletal system
are one of the most common types of damage that occur with various anatomical and functional disorders of tissues and organs resulting from the action of aggressive environmental factors (during a fall, awkward or unexpected movement, during car accidents or natural disasters ).

Causes

Often, muscle strains and bone fractures have similar causes. They may be as follows:

1. Falling and then landing on your heels. Thus, the limbs are exposed to sudden and brute force, which can lead to both disruption of the integrity of bones and rupture or stretching of tendons or muscle tissue.
2. Sports injuries that occur when playing a sport that places a lot of stress on the legs. Most often, football players, basketball players, runners, and gymnasts suffer from this.
3. Wearing high heels or the wrong size. In such cases, the leg most often turns inward.

Unfortunately, even in the absence of intense sports activities or the correct selection of shoes, it is impossible to completely protect yourself from injuries of this kind.

Ankle fracture

The difference between a sprain and a fracture is that with the latter type of injury, damage to the integrity of the bone tissue is diagnosed. There are two types of fractures:

1. Open, in which there is a significant displacement of the bone with rupture of soft tissue and the formation of a large number of fragments. Such fractures are difficult to treat, and the rehabilitation period takes much longer. With an open fracture, heavy bleeding often occurs.
2. Closed ones are characterized by slight displacement of the bone. In this case, small vessels are affected, causing a hematoma to form.

It is closed fractures that can often be confused with muscle or ligament sprains, since their symptoms are similar.

Main differences

Many victims who have been injured wonder how to identify a dislocation or fracture in their legs. Let's look at a comparative table showing the difference between a fracture and a dislocation:

In any case, it is not always possible to independently determine the difference between dislocations and fractures, so consultation with a specialist is important.

Distinctive features

There are some indirect signs of an ankle sprain or fracture that can help you distinguish them from each other:

1. With a fracture, pain may not appear immediately, but after a certain period of time. This is due to the fact that a large amount of adrenaline is released into the blood, which blocks pain. When tendons, ligaments or muscle tissue are sprained, pain appears immediately.
2. When the ankle joint is sprained, it immediately loses its mobility. When a fracture occurs, a person does not feel pain for some time and can move the damaged joint as if he had a simple bruise.
3. Symptoms of a sprain also include swelling, which can even extend to the plantar area. Swelling of the soft tissues during a fracture is usually localized slightly above the site of injury. In both cases, swelling does not occur immediately, but after some time. It can vary from several hours to days.

How can you tell the difference between an ankle fracture and a sprain? Despite the presence of specific symptoms, the nature of the injury can only be understood using x-rays.

Sprains or torn ligaments

Damage to tissue with partial rupture while maintaining anatomical continuity is called sprain . The most common joint sprain . The mechanism of this type of injury is caused by tissue stretching by two forces acting in opposite directions, with the body, organ or area fixed. This usually happens when falling, lifting something heavy, running, etc. Sprains are the most common musculoskeletal injury encountered in everyday life. It manifests itself as pain in the joint area. Such pain during a sprain usually does not go away for a long time, although there are no external manifestations of the injury.

A muscle or tendon rupture is a fairly rare injury. It requires excessive effort to occur. The rupture most often occurs in the muscles that experience the heaviest stress - the biceps of the arm or the triceps of the calf. A tendon rupture (a muscle ruptures extremely rarely) is manifested by the formation in the area of ​​the shoulder or lower leg of a relief that is uncharacteristic for these parts of the body - hunching of the muscles . This is accompanied by severe pain and immobility of the limb. If the acting force exceeds the resistance of the tissues, then ligaments, fascia, muscles, tendons, nerves, etc. rupture.

Symptoms of a sprain

There are 3 main degrees of ankle sprain:

1. In grade 1, a slight tear of the muscle fibers occurs. The pain is mild, and slight swelling is felt upon palpation. The mobility of the joint is completely preserved, but the victim cannot fully step on the affected leg for a long time.
2. In grade 2, tendon fibers are damaged. The pain is quite severe and is similar to pain caused by a fracture of long bones. There is significant swelling of the limb. With such an injury, a person can completely lose their ability to work for up to 2 weeks.
3. In grade 3, a rupture or separation of one or more ligaments is diagnosed. This type of damage blocks the functionality of the leg. The pain is very pronounced, and emphasis on the affected foot is impossible.

The nature of first aid and subsequent treatment also depends on the severity of the injuries received.

Dislocations

Dislocation

- This is a displacement of the articular surfaces of bones in the articular joints. In this case, damage to the joint capsule with injury to blood vessels and nerve trunks is possible. Dislocations occur from excessive stress on the joints. The most common dislocations are the shoulder and elbow joints. Dislocations of the ankle and finger joints are less common. Dislocations of the knee and hip joints are extremely rare.

With dislocations and subluxations, the normal shape of the joint is disrupted, movements in it are limited or become impossible. These signs are combined with symptoms that occur with damage to the ligamentous apparatus and joint capsule.

Symptoms of a fracture

An open bone injury is quite difficult to confuse with something else, since it tears the soft tissue and shows out. A closed fracture does not have such pronounced manifestations, and therefore a preliminary diagnosis can be made based on the following indirect manifestations:

1. Pain that does not go away over time, nor does its intensity decrease. When you try to palpate the injury site, it intensifies significantly.
2. The injured area becomes swollen, redness and increased skin temperature are observed.
3. Significant hematomas appear as a result of subcutaneous hemorrhage when blood vessels are damaged by bone and its fragments.
4. In some cases, when pressed, a crunching and grinding sound of broken bones is possible.
5. Sometimes deformation of the limb becomes noticeable.

If such symptoms are observed, it is necessary to conduct an X-ray examination in order to prescribe subsequent adequate treatment.

You need to see a doctor if:

• Injured head, chest, spine, stomach
• Trauma associated with a child falling from a height (especially in the head area)
• A crash was heard at the time of the injury
• The pain that arose at the time of injury does not subside, but intensifies
• There is a significant wound at the site of injury, bleeding
• Swelling intensifies
• A bruise from a bruise does not “bloom” over time (that is, does not turn yellow), but turns red, and the skin becomes hot.
• There are no active or passive movements in the injured limb
• There is a decrease or complete disappearance of sensitivity in the limb
• The condition worsens (loss of consciousness, decrease or increase in blood pressure, shortness of breath, urinary retention).

Author:

Evtushenko Anna Aleksandrovna obstetrician-gynecologist

First aid for sprains

It is recommended to provide the victim with all possible first aid for fractures and sprains before the medical team arrives. If muscles and tendons are damaged, the following set of measures must be taken:

1. Free your feet from shoes and socks so that they do not impede access to the damaged area.
2. It is important to raise your leg above heart level. This can be ensured by helping the victim take a horizontal position and placing a pillow, towel or even a bag under the limb.
3. In the first few hours after injury, it is recommended to apply ice or a wet cold towel to the sore spot, which should be changed as it warms up.
4. The injury site should be bandaged tightly with an elastic bandage. This measure, although indicated for sprains, is difficult to implement in the conditions before the ambulance arrives, since the average person may confuse a sprain with a fracture, in which self-application of a tight bandage can only cause harm.

While waiting for a team of qualified medical workers, you can give the victim painkillers.

First aid for fractures

How to determine whether a person has a foot fracture or sprain? To do this, you need to ask the patient about the symptoms. The information obtained will help determine what first aid measures are necessary in this case. For fractures of the ankle joint, it is recommended to perform the following set of measures:

1. It is necessary to remove the victim’s shoes and assess the situation.
2. In case of a closed fracture, you need to apply ice until the ambulance arrives.
3. With an open type of fracture, you must try to stop the bleeding if it is profuse. This can be done by applying a bandage above the injury site.
4. It is necessary to provide the victim with peace. It is also recommended to offer him a painkiller.

It is also extremely important to ensure complete immobility of the limb. This is necessary to ensure that the damaged bone does not move, as this can significantly worsen the situation.

What is a dislocation?

A dislocation is a permanent separation of joint surfaces that are normally adjacent to each other. Usually occurs as a result of mechanical impact (more often in middle-aged men). If the articular surfaces are not completely separated, then this phenomenon is called subluxation. Its symptoms are similar to a complete dislocation.

Signs of dislocation

• Severe joint pain
• Inability to actively move the joint
• Forced position of the limb (least painful)
• Often - external deformation of the joint, relative shortening of the limb

Treatment of dislocations

Trying to cure a sprain at home with poultices, lotions, and compresses is a very dangerous undertaking. A doctor can correct a fresh dislocation (up to three days) much easier than an old one, so every minute after an injury counts. Under no circumstances should you correct a dislocation yourself, as you can worsen the situation by tearing ligaments, muscles, and even breaking a bone. The only thing that can be done is to provide maximum rest to the injured person, apply ice and call an ambulance, or quickly get to the emergency room yourself.

Health care

• Pain relief (often with strong narcotic drugs)
• Repositioning a dislocated limb (there are special techniques for each type of dislocation)
• Applying a bandage to the reduced limb to restrict movement
• Recovery period: physiotherapy, therapeutic exercises.
• Surgical treatment for habitual dislocations (when the slightest injury causes the joint to “pop out” again and again).

Diagnostics

After the victim is taken to a medical facility, it is necessary to distinguish a fracture from a sprain. How to do it? It is recommended to consult a traumatologist; he will collect information about the symptoms, as well as the situation in which the injury was received. After examining and palpating the affected limb, X-rays must be taken. They are performed in two projections: lateral and direct. In some cases, a CT scan may be required. Based on the information obtained as a result of the diagnosis, the correct treatment is prescribed.

Fracture treatment

How to distinguish a fracture from a sprained ankle? This is done using x-rays. After all diagnostic measures have been carried out, treatment is prescribed. In the event of a fracture, it consists of the following measures:

1. Immobilization of the injured ankle joint by applying a plaster cast for up to 1 month.
2. When bones are displaced, repositioning is necessary. After this, the skin is stitched together and a cast is applied to the leg.
3. The patient also needs a course of painkillers, since in the first time after receiving an injury and applying a plaster, pain will be observed.
4. Surgical treatment may be required in case of improper fusion of bones, as well as in the presence of a large number of bone fragments.

While wearing a cast, any emphasis on the affected limb is prohibited, as the bone may move.

What is a fracture?

A fracture is a violation of the integrity of a bone, which is caused by mechanical action or a pathological process in the body. Due to the huge variety of types of bones in the human body, there are many types of bone fractures (see rib fracture).

Types of fractures:

Signs of a fracture

• Pain

• Unnatural limb position
• Abnormal mobility (limb may be slightly bent in an area where there is no joint)
• Visible bone fragments in a wound with an open fracture
• Crepitation (crunching) of small fragments when pressing on a sore spot (this symptom distinguishes fractures from sprains or bruises)
• Swelling in the area of ​​injury
• Hemorrhage and hematoma
• Symptom of axial load (increased pain at the fracture site when tapping along the axis of the limb - for example, pain in the heel when the bones of the leg are fractured)

Treatment of fractures

Fractures are often accompanied by other injuries, skin wounds and bleeding. Therefore, the most important thing is to provide first aid before the doctors arrive. In this case, there is no point in wondering whether a fracture or dislocation caused the pain. First aid will be the same.

First aid:

• If there is bleeding, stop it using one of the following methods: pressing a vessel visible in the wound
• apply a pressure bandage
• apply a tourniquet in case of severe bleeding (indicate the time in the note, keep it for no more than 1-1.5 hours)

• Cover the wound with a clean, or better yet, sterile material.
• Administer painkillers
• Ensure the immobility of the broken part of the body (using splints, fixing the joints located adjacent to the fracture site)
• Apply cold to the injury site
• If the fracture is closed, then you need to start with pain relief

Health care

• Pain relief (often novocaine blockades)
• Comparison of bone fragments and their fixation conservatively (plaster casts, skeletal traction)
• surgically (manually or using special devices, internal or external osteosynthesis)

Sprain treatment

How to distinguish a fracture from a sprain? To do this, you need to compare the symptoms and the nature of the damage and undergo x-rays. If an ankle sprain has been diagnosed, the following measures are prescribed to treat the injury:

1. Reduce or remove the load from the injured limb. To do this, a cane or crutch can be used as a support when walking.
2. Cooling with ice or a cold towel is necessary in the first few hours after a limb injury. As the towel warms up, you need to replace it, and apply ice at intervals of 10 minutes so as not to aggravate the situation with frostbite.
3. Applying a tight elastic bandage that starts from the fingers and ends at the level of the middle of the calf.
4. Doctors also often prescribe painkillers to relieve pain and ointments that relieve swelling and speed up healing.

In some cases, surgical treatment may be necessary. It is prescribed for ligament rupture and is necessary to restore the musculoskeletal function of the limb.

Recovery after injury

Both with a fracture and with a sprain, a rehabilitation period is required with the implementation of a certain set of measures to restore the functions of the joint. Recovery can last from 2 weeks to several months, depending on the nature and severity of the injuries received. It must include the following points:

1. Taking vitamin complexes with calcium, which is necessary for bone healing during a fracture. When sprained, vitamins with collagen are needed to restore the elasticity of the ligaments and tendons.
2. A diet that must include meat and fish products, as well as cereals, legumes, nuts, and fruits.
3. In case of severe injuries, after removing the plaster, it is necessary to develop the limb. This can be done both at home and in a hospital setting. To do this, the doctor prescribes a special set of exercises that must be performed daily.

The recovery period is necessary in order to restore limb mobility, prevent muscle tissue atrophy, and increase the elasticity of ligaments.