A fracture is a serious life situation for which it is impossible to prepare in advance, so many people, when faced with it, fall into panic or depression. The emotional loss of strength in the injured person begins to be felt most clearly during the period of bone fusion. As a rule, in children and people with strong immunity, bone tissue fusion occurs quite quickly. But there are cases when the bone does not heal and patients have to walk in a plaster cast for months. What processes occur in the human body during this period and, if the fractures do not heal, what should the patient do?
A fracture is a complete or partial disruption of the integrity of a bone during a traumatic situation. The fracture can be closed or open. During an open fracture, damage to the skin occurs. A closed fracture is often more difficult to identify because the skin is intact. This leads to the fact that the patient considers the injury to be a bruise and delays going to a medical facility.
Peculiarities
In children and people in middle age, bones grow together quite quickly. But in older patients, the bones become thinner and more brittle, which slows down consolidation.
Bone density becomes much less, causing osteoporosis. Osteoporosis affects most people in old age. Only for many people this disease manifests itself differently. For example, people who lead a sedentary lifestyle develop osteoporosis much more often than people who are more active.
There are approximate healing times for a fracture depending on the location. Thus, a fracture of the phalanges of the fingers heals in about 2 weeks, and a radial fracture in a typical location takes an average of 5 weeks.
However, there is no strictly defined time frame for bone consolidation. Everything depends on the human body. For some people, the bone may heal in a couple of months, while for others it will take more than a year to heal.
If bone displacement is not observed during the fracture, a plaster cast is applied, and then a course of treatment is prescribed: medications, massage treatments, physiotherapy, ointments and compresses. If a displacement is detected during diagnosis, surgical intervention or reposition is performed.
It will grow together - it won’t grow together...
It is believed that the likelihood of healing of a hip fracture directly depends on the person’s age. The younger the patient, the higher this probability. For example, if such an injury occurred in an 80-year-old patient, then doctors can be 80% sure that the bone will not heal. And if this is a 30-year-old woman, then by 30%, which is also a lot. Therefore, in case of a hip fracture, doctors prefer to perform surgery.
In young people, operations, as a rule, lead to bone fusion and a return to normal life, but after the operation a long recovery period is required - massage, gymnastics, walking training. In older people, unfortunately, even surgery does not always help.
Stages
Bone fusion is divided into several stages or stages:
- A blood clot forms. It accumulates in the area of the injured limb in the form of a soft lump. Then the substance is converted into a fibrous composition, which is responsible for the formation of bone tissue.
- Cells that promote rapid healing completely fill the blood clot. They are then transformed into a granulation bridge.
- Over time, a bone callus is formed from the granulation bridge, which is subsequently transformed into a still fragile, but already bone.
- Over the course of two to ten weeks, calcium begins to be supplied to the site of injury, which helps strengthen the callus - ossification. The callus becomes strong and the plaster cast is removed. Over the course of about a year, the callus undergoes changes and is rebuilt.
Acceleration
There are cases when a fracture does not heal for a long time. This can happen for any reason: lack of vitamins, macro- and microelements, reduced immunity, chronic diseases, dysfunction of the endocrine system, or individual characteristics of the human body. The reasons may be different, but the result is the same: the bones do not grow together. It is then that the patient has a completely natural question: what to do if the fracture does not heal.
The recommendations are:
- It is imperative to follow all doctor's instructions. If, in his opinion, the patient must walk in a cast for at least six weeks, then the bandage cannot be removed without permission.
- Until the callus, which is not yet fully strengthened, has formed into bone, you should not move the limb excessively, testing its strength.
- To strengthen bones, you need to eat a large amount of foods rich in calcium and phosphorus: cottage cheese, fish, cheddar cheese, white beans, figs, white and cauliflower, sesame seeds.
- You can take calcium supplements as prescribed by your doctor. One of the most effective is Calcium D3 Nycomed (it contains both calcium and vitamin D3).
- Eating foods rich in calcium is not enough. Proper absorption of calcium requires vitamin D, which is found in fish oil.
- We should not forget about vitamin C. Thanks to it, collagen is synthesized, which is a component of muscle and bone tissue, so citrus fruits, sauerkraut, and parsley must be present in the daily diet.
- Along with vitamins, experts advise eating dishes containing gelatin: jelly, jellied meat.
Treatment of nonunions, defects and false joints of bones
In most cases, bone restoration after a fracture occurs in normal or normal time, rarely in a shorter time. Much more often, the time for fusion is extended, although the fusion process itself proceeds normally and is not disturbed by anything.
Fractures with delayed healing include those in which, after the usual period of time sufficient for healing of the fracture, the ends of the fragments are not connected by a mechanically stable bone callus; clinically, some very limited mobility of the fragments at the level of the fracture is determined.
X-ray examination shows
- lack of bone fusion of fragments, their ends may be separate or small cavities are visible on them,
- the ends of the fragments have a sclerotic border,
- the medullary canal is not closed by a bone plate.
In all cases, first of all, one must strive to find out whether there are objectively ascertainable local or general causes that slow down or may slow down the process of fusion. In this case, it is necessary to take into account the different healing periods of fractures, which depend on their type, location, age of the patient, etc. It is known that different bones are restored in different periods. Fractures of the same bone at different levels also heal unequally quickly.
A thorough clinical analysis usually makes it possible to establish objective reasons delaying bone union, e.g.
- displacement of fragments,
- a small diastasis or gap between them,
- infection,
- sequestration,
- incorrect or insufficient immobilization, etc.
Elimination of these causes inhibiting fusion, creation of favorable conditions and, above all, good and continuous immobilization lead to normalization of the fusion process and the formation of callus.
The term persistently nonunion fracture, or pseudarthrosis, should be used only when, after a period sufficient for the formation of bone fusion, persistent abnormal mobility resulting from a disruption in the process of callus formation is clinically determined at the site of the former fracture.
Clinical and radiological data allow us to conclude that fusion of the fragments is impossible without appropriate intervention. A non-union fracture is clinically characterized by mobility of the fragments.
X-ray reveals that the periosteal callus did not fill the defect between the ends of the fragments and did not connect them with a bridge. Excess callus formed along the edges of the fragments becomes dense, the medullary canal of the ends of the fragments is closed by a compact layer of bone substance. In some cases, the ends of the fragments are rounded, sclerosed and become dense, in others, on the contrary, the ends are reabsorbed, they become sparse and rounded. The recovery process has completely stopped.
To heal pseudarthrosis (without a bone defect), it is enough to induce mesenchymal proliferation at the site of the damaged bone by mechanical and chemical means (tissue decay products), to ensure stable long-term immobilization of the fragments, after which, as a rule, the fragments grow together with callus. Emphasizing the diversity of pathogenetic factors and putting forward the concept of the role of developing limb diseases in the pathogenesis of pseudarthrosis, it should be noted that the principles of treatment of pseudarthrosis (i.e., fractures with persistent nonunion) and fractures with delayed union are nevertheless the same.
The basic principles of treatment of pseudarthrosis and fractures with delayed healing boil down to the following: creating conditions for restoring reparative regeneration in the area of the pseudarthrosis and fusion of fragments.
This is achieved
- ensuring complete immobility of fragments,
- bringing their ends together
- identifying and eliminating factors inhibiting fusion.
Physiotherapy
Physiotherapy allows bones to heal much faster, while possessing wonderful properties. Physiotherapeutic procedures are prescribed on the third day after injury, if the fracture is simple. Physiotherapy can relieve swelling, reduce pain, and promote rapid resorption of hemorrhages and bone tissue regeneration.
For delayed consolidation, calcium electrophoresis has worked well. Magnetic therapy helps relieve swelling.
Exercise therapy
During the rehabilitation process, the patient is required to be prescribed a course of exercise therapy. Initially, a person who has been injured must visit a special office, where a specialized specialist will give useful recommendations. Exercises will not only improve the health of the body, but will also contribute to the rapid recovery of the damaged limb. But in order to avoid getting injured again, performing physical exercises requires a number of restrictions. In particular, if severe physical pain is felt while performing an exercise, they should be stopped.
Walking is fundamental to exercise therapy, so it should be made part of your life. You need to start walking for half an hour 2 times a week. If after walking you do not feel any discomfort or severe pain, the number of days can be increased to 5 times a week. In addition to walking, patients are recommended to do a number of specific exercises and also go to the gym.
Massage
After removing the plaster cast, the patient is prescribed massage treatments. With their help, you can relieve swelling, restore normal blood circulation and joint function. It is recommended to use pine needle oil for massage. Herbal medicines will help relieve pain, including:
- Diclosan cream;
- Balm by V. Dikul.
Folk remedies
Drug treatment, proper nutrition, physiotherapy and exercise therapy are excellent methods for restoring a damaged limb, but traditional medicine should not be neglected.
So eggshells are an excellent remedy containing huge amounts of calcium. It is ground to a powder and consumed every day. Eggs from domestic chicken, and absolutely healthy ones, are better suited for this purpose.
However, calcium is better absorbed in the form of vitamin-mineral complexes (this includes the above-mentioned calcium D3 nycomed and any other complexes containing calcium and vitamin D3).
The fusion of bones is influenced by a wide variety of processes: physical therapy, proper and healthy nutrition, massage, physiotherapy, and most importantly, the patient’s desire to get better as quickly as possible.
Movement is life
Why is it so much more difficult for older people to overcome injuries? The fact is that with age, physical activity decreases. Without load, a bone weakens and becomes brittle, blood circulation in the joint area is reduced to a minimum, so an elderly person only needs to stumble slightly to get a fracture.
All this means that maintaining mobility at any age, including the elderly, is the key to minimizing such injuries. Physical therapy, gymnastics, as well as proper, nutritious nutrition are undoubtedly the key to longevity.