What is a consolidated fracture?
In order to determine what a consolidated fracture means, it is necessary to find out in detail what causes can influence it and how the recovery process occurs.
Common Causes
The most common causes of fractures include:
- The presence of diseases leading to a pathological decrease in bone density. Often these problems are encountered by female representatives who have undergone surgery to remove appendages during their reproductive years. In addition, osteoporosis at a young age can be caused by a malfunction of the parathyroid glands.
- Elderly age. This condition is a physiological condition in which a decrease in bone tissue density occurs.
- Bumps and falls. In this case, the force of the traumatic effect exceeds the strength of the bone tissue.
A little about fractures
A fracture is a disruption of bone tissue due to increased mechanical stress. If the damage enters the consolidation stage, this means that the bones begin to grow together without pathological deformations. This most often happens in childhood, when the body is still young and strong enough to easily cope with the problem.
Sometimes, especially in adulthood, the situation develops differently - with an unfavorable prognosis. In the case of an unconsolidated fracture, the patient needs immediate hospitalization and surgical intervention - one in-person or, especially, an absentee consultation with a surgeon is not enough.
Recovery process
Consolidation of a fracture, like other recovery processes, occurs in several successive stages. They replace each other and promote rapid tissue healing. The following stages of recovery are distinguished, including:
- Autolysis stage. During this period, groups of leukocyte cells migrate to the lesion site within 3-4 days. They trigger a local inflammatory reaction, destroying necrotic cells. It should be borne in mind that the duration may vary from person to person. Depending on the characteristics of the body, it may increase.
- Proliferation stage. This stage indicates the launch of regenerative processes. Consolidation of fractures is accompanied by an increase in the volume of healthy tissue due to the proliferation and migration of cells to the lesion. There is an active production of minerals that contribute to the formation of cartilage tissue with the subsequent formation of callus.
- Triggering bone tissue remodeling. In the lesion, vascular and nerve fibers begin to form, which provide sufficient bone trophism. Beams are formed in the bone tissue, characteristic of healthy bone.
- Recovery stage. Consolidation in the area of bone fractures is accompanied by the formation of periosteum. Gradually the bone grows together and restores its functional activity.
In order to determine what a consolidating fracture is and what severity of harm to health occurs when the stages are violated.
Main deadlines
The timing of consolidation of various fractures depends on the severity of the injury, as well as the localization of the pathological process. The table for the timing of fracture consolidation reveals the duration for open and closed damage. A shorter recovery period is necessary for small bones, these include the phalanges of the fingers, ribs, and small bones on the extremities. On average, this period lasts no more than one month.
Consolidated fractures of the collarbone, shoulder, arms and feet take 2 to 3 months to heal. It must be taken into account that the healing period also depends on the type of fracture. For open injuries, recovery time increases.
If the hip is damaged, healing requires a period of 4-5 months. The longest duration is observed when restoring a fracture of the pelvic bones. Healing of flaccid consolidating fractures lasts up to several years.
The approximate duration for the formation of a consolidated fracture is determined by the doctor after examining the patient and reviewing the documentation.
How to speed up recovery
Acceleration of recovery is possible with additional influence on natural healing processes.
As a result, there is an acceleration of the process due to an increase in metabolic rate. To do this, you can use medications, physiotherapeutic procedures, as well as non-drug methods.
Non-drug methods include changing the composition and norms of nutrition with the inclusion of a sufficient amount of protein products, these can be fermented milk products, as well as vitamins and microelements. To heal the fracture, more zinc, phosphorus and magnesium are added to the diet. The daily menu should also include fish, cabbage or spinach.
Physiotherapeutic procedures include techniques that are aimed at improving local blood flow. Medicines are selected to increase the intake of calcium, phosphorus and collagen into the body. Among them is the popular drug osteogenon.
Nonunion fracture
The goal of treating nonunion fractures is to restore limb function. The main objectives are to ensure complete consolidation, eliminate deformity, eliminate joint stiffness, and sanitize infectious foci. In the presence of common provoking factors (hormonal imbalance, vitamin deficiency, etc.), appropriate general therapeutic measures are carried out. The local treatment program is drawn up taking into account the type of non-union fracture.
Treatment of delayed consolidation
Conservative therapy is possible. The limb is fixed with a plaster cast or orthosis for the period necessary for the fusion of the fragments. To stimulate consolidation, shock wave therapy, UHF, electrophoresis of calcium salts, and electromagnetic waves are prescribed. Anabolic steroids are used. An osteochondral extract made from fetal tissue is injected into a non-union fracture.
The advantages of conservative therapy are the absence of additional trauma, anesthesia and postoperative risks. The disadvantages are prolonged fixation, which can result in joint stiffness and limb atrophy. To prevent these complications or in the absence of effect from conservative measures, surgical treatment is resorted to. The following options are possible:
- Osteosynthesis.
It is performed using screws, compression plates, intraosseous pins and external fixation devices. Indicated in the presence of fusion elements, the absence of pronounced displacement and violation of the limb axis. - Bone grafting.
Autografts are used, which are usually taken from the patient’s iliac wing. The displaced cancellous bone promotes the restructuring of the surrounding callus into normal bone tissue. - Stimulation of osteogenesis.
It is carried out using biological techniques - decortication and tunnelization. During decortication, a coupling is created around the fracture using a sharp osteotome from a large number of bone fragments connected to the periosteum. During tunnelization, tunnels are formed that activate bone formation.
The listed methods can be combined with each other in various variations. If interposition is detected, the fragments are separated, and the soft tissue interfering with fusion is removed. Deformities are eliminated using the Ilizarov apparatus. After surgery, conservative techniques are used to stimulate osteogenesis.
Treatment of non-united fractures
Non-surgical methods are ineffective; surgical correction is indicated. If there are contraindications to surgical treatment, patients with non-union fractures are recommended to wear orthoses. Interventions include removal of scars and altered tissue in the damaged area, exposure of fragments with subsequent processing of the ends, comparison of fragments, and biological stimulation of bone formation. Fixation in most cases is carried out using the Ilizarov apparatus.
Alternate compression and stretching of fragments in a compression-distraction apparatus additionally activates the formation of blood vessels and the replacement of fibrocartilaginous callus with normal bone. In case of significant bone defects, autoplasty is performed (for example, a missing fragment of the tibia is replaced with a part of the fibula). In the postoperative period, stimulating techniques are prescribed and comprehensive rehabilitation is carried out.
Treatment of false joints is described in the corresponding article.
How long does it take for callus to form?
It is necessary to take into account various factors to identify the period during which callus is formed. Among them, the types of fractures, their type, as well as concomitant pathologies and risk factors play a decisive role. You can determine what a consolidating fracture means by the formation of a callus, which means that the recovery process has occurred.
Less time is enough to restore fractures of small bones without displacement. In this case, it is important that the periosteum does not become damaged. The minimum period for callus formation is 2-3 months; restoration of large bones may require more than six months.
Principles of treatment
In order to achieve a quick recovery, as well as reduce the risk of complications, it is necessary to adhere to the principles of treatment. These recommendations should be followed early after injury. Among them, the principles of first aid are of great importance, including:
- Timely detection of a fracture.
- Perform immobilization.
- Prevention of unnecessary trauma.
- Prompt transportation of the victim.
After the patient enters a medical facility, it is necessary:
- Correctly perform an x-ray of the damaged bone in several projections and consolidation of the fracture.
- To straighten bone fragments, surgical intervention is required if necessary.
- Securely secure the injured limb.
- Ensure patient immobility.
- Adequately anesthetize the patient.
- Compliance with recommendations, which include taking medications followed by physiotherapeutic procedures.
Folk remedies
To speed up fracture recovery, it is necessary to combine traditional methods with medications and non-drug methods. Their use is possible only after consultation with a specialist and determination of the safest method of traditional therapy. To achieve a therapeutic effect, decoctions, infusions are used, and compresses and lotions are applied. The most effective folk methods include:
- Taking a decoction of meadow cornflower. To prepare the solution, you need to boil 50 grams of dry herb for two hours, after which the mixture is cooled and filtered. They should be taken twice a day with a single dosage volume of 200 ml.
- Mumiyo. Shilajit tablets are consumed within 10 days before meals.
- Comfrey compress. First you need to boil 50 grams of the herb and then mix it until the contents are homogeneous. The paste is applied to the area of injury before going to bed and after applying a bandage, it is kept until the morning. The procedures are performed throughout the entire length while bone consolidation occurs.
- A mixture of juniper and oil. Juniper branches along with needles are mixed with butter. The mixture is left in the oven for 3-4 hours, then the ingredients are thoroughly crushed to form an ointment. It is used for massage to achieve anti-inflammatory and warming effects.
What to do if consolidation does not occur
During the recovery period, it is important to regularly evaluate signs of recovery. This is due to the fact that cases may arise when a weakly consolidated fracture does not have time to heal completely or the damaged area does not heal at all. Reasons for slowing down the recovery process include:
- Patient's age. In older people, healing takes longer due to a natural decrease in bone density, decreased vascularity and the presence of associated pathologies. In addition, if the patient is elderly, infection is more common.
- Bad habits.
- Excess body weight.
- Metabolic disorders, such as diabetes.
- Concomitant diseases that are accompanied by impaired blood flow.
- Infection in the damaged area. The most common reason why a patient retains an unconsolidated fracture is osteomyelitis and tuberculosis.
- Incorrect reduction or plaster cast application. Increased load on the damaged area.
Detection of a slowdown in fracture consolidation on an image is possible based on characteristic signs. These include the appearance of a cleft between the fragments, as well as the unnatural position of the area of influence of the traumatic factor. The fracture area becomes painful and excessively mobile.
In this case, it is important to consult a doctor early, since the specialist will decide what to do if the consolidation of the fracture is weak.
In order for the restoration of fragments to occur faster, it is necessary to seek help from a doctor early after injury.
Compliance with recommendations for nutrition, lifestyle, physical activity, as well as taking medications and conducting physiotherapeutic procedures. Neglecting these rules prolongs the healing process and leads to an increased risk of complications.
Features of the period of consolidation of various fractures
The period of fusion can take place in different ways. If a rib, phalanx or macula is damaged, it begins after about three weeks, in the case of the collarbone - no earlier than the fourth. The fusion of the bones of the upper extremities takes 2-3 months, and the lower ones – even longer, up to four. Consolidation of the femur occurs only after six months, so such injuries are extremely dangerous.
Violation of these deadlines indicates problems in the body, such as exhaustion, vitamin deficiency, diabetes mellitus, purulent infection, poor circulation or other pathology. In this case, additional examination and urgent measures are necessary, otherwise the patient may face repeated surgery.