A bone fracture is a partial or complete disruption of the structure of bone tissue. The main cause of fractures is the physical load created on the human skeleton, which exceeds the strength of the bones. But fractures also occur due to various diseases, due to which bone tissue becomes thinner and loses strength, and crunching appears in the joints.
Let's take a closer look at the concept of a fracture and how it differs from a dislocation based on symptoms; we'll also talk about the main causes of injuries and the rules of first aid.
Bone fracture - definition and significance of the problem
Fracture is a common natural injury. The mechanism of occurrence of this type of injury in humans is the same as in all vertebrates. About 80% of all broken bones are tubular: femur, radius, pelvis. Not only bones are damaged, but also nearby soft tissues - muscles and blood vessels. Less commonly, compression or complete rupture of nerve endings occurs, followed by bleeding.
Fractures in real life are combined with damage to various organs and systems of the body. In medicine, such diseases are called combined injuries. For example, when rib fractures develop, pleurisy develops, and when the skull bones are damaged, intracerebral hematomas develop.
Rehabilitation
In general, a victim with a screw fracture of the tibia recovers completely within 4 months. And if he has complications, a comminuted fracture or a combined injury, then he will recover for 6 months.
The following will help speed up the patient’s recovery process:
- Massage, rubbing.
- Motor activity of the injured limb in the early stages of recovery.
- Daily physical therapy sessions.
- Physiotherapy.
- Dosed physical activity, mechanotherapy.
- Swimming in the pool.
- Taking special medications.
- Following a strict diet.
What types of fractures are there: generally accepted medical classifications
Fractures are classified according to several criteria: the location of the fragments, the location of the injury and the shape of the fractured area.
Depending on the location of the fragments, bone fractures can be open or closed. In the first case, the injury is accompanied by damage to soft tissue, to the point that the bone is visible. With a closed fracture, this does not happen: the soft tissue remains intact, there is no hemorrhage.
Open fractures are divided into primary and secondary. In the first case, soft tissues are injured due to an external provoking factor, and in the second, due to the fact that a bone fragment injures the tissues, forming a through wound in them.
There are separate types of closed fractures:
- Combined . Characterized by multiple injuries to internal organs.
- Combined . Appear due to external influences, such as trauma or radiation.
- Multiple . Several bones are damaged at once.
- Single . Only one bone is injured.
- Full . The ends of the bone are separated from each other.
- Incomplete - the bone does not separate, but cracks and marginal fragments form on its surface.
The most severe type of injury is a displaced bone fracture. Due to a displaced fracture, complications arise: such as paralysis of the limbs or loss of sensitivity, loss of ability to work, and sometimes death.
Based on location, the fracture is classified into the following types:
- Epiphysiolytic - with damage to the growth zone of bone tissue in children.
- Epiphysial - with injury to the joint cavity.
- Diaphyseal - damage to tubular bones.
- Involved - associated with damage to cancellous bone elements.
The epiphyseal type of fractures is considered the most difficult to cure. It is often combined with dislocations, which makes it difficult to immediately determine the type of injury and prescribe precise treatment.
Another classification of types of fractures is given by the form of bone damage:
- Transverse - the fracture line is perpendicular to the bone itself.
- Longitudinal - the fracture line is located parallel to the damaged skin tissue.
- Oblique - the fracture line is located at an angle to the tubular bone itself
- Helical - a type of fracture in which bone fragments are displaced relative to their original position.
- Comminuted - during an injury, not a single fracture line is formed, but individual fragments appear on a section of the bone.
- Wedge-shaped - this type of fracture is characteristic of spinal injuries, when one bone is pressed into another and forms cracks and wedge-shaped defects on its surface.
- Compression fracture is a type of fracture in which many small fragments form on the damaged area of bone tissue.
Diagnosis of fractures
Diagnosis of injury is carried out by a surgeon or traumatologist. You can independently distinguish fractures from other injuries (dislocation, bruise), but only a doctor can determine the degree of its severity.
The main diagnostic method is radiography in two projections. See what the fracture looks like in the picture:
If there are signs of an open fracture of a limb, the doctor will additionally prescribe an MRI or ultrasound to the patient to determine how much the fragments damaged the soft tissues and whether the nerve endings are affected.
Complications
Often, after breaking a leg or arm, a person faces dangerous consequences. But their appearance can be avoided. It is enough to follow the doctor’s recommendations and avoid traumatic situations that could cause injury to a limb.
To summarize: a helical fracture is considered a fairly complex injury. But taking good care of your body, and in general, your feet, will help you avoid it. But if injury could not be avoided, the victim should immediately seek help from a doctor. Amateur action in this case can lead to dangerous consequences. It is also prohibited to set bone fragments on your own. It is better to trust the hands of an experienced specialist who will do everything competently and as painlessly as possible for the patient.
Providing first aid for fractures - 3 very important steps
In case of fractures, it is very important to provide correct and timely first aid. Consistent, competent actions will prevent the consequences of injury and pain shock in the victim.
Rules and procedures for providing first aid:
- Call an ambulance . Setting a joint yourself is something you should not do if you have a fracture. Before the ambulance leaves, the victim is given consistent first aid .
- Give the victim painkillers - Ketanov or Nise. It is better if painkillers are administered intramuscularly, so they will act faster. If you don’t have an ampoule of medicine on hand, use the drugs in tablet form. Pain relief is something that must be done for fractures. Otherwise, a person will feel intense pain in the joint when trying to fix the affected limb, and even painful shock is possible.
- Secure the joint with a splint . A splint is placed at the fracture site to prevent bone fragments from damaging soft tissue. When providing first aid, you can use available means: a wooden board, ski poles. If there are no objects suitable for splinting, then the victim’s body is used as a splint. For example, a broken leg is fixed to a healthy one using a bandage or clothing. The upper broken limb is fixed with a splint to the neck or torso.
Subsequent first aid procedures will depend on the type of fracture. If it is open, then help will include disinfecting the wound and stopping the bleeding before applying a splint. Bacteria can quickly enter through a wound and cause gangrene of the limbs. Before fixing the joint in one position. It is necessary to place an antiseptic wipe moistened with hydrogen peroxide on the injured area.
With an open fracture, blood often oozes from the wound, so you need to know how to properly stop it. Assistants must correctly determine the type of bleeding that has opened:
- Venous. The blood flows slowly and has a dark red tint (brown). In this case, the tourniquet is applied below the fracture site.
- Arterial. The blood flows out in a pulsating stream and has a scarlet color - the tourniquet is fixed above the wound as quickly as possible so that as little blood spills out as possible.
Instead of a tourniquet, you can use bandages, bandages or scraps of clothing; If necessary, cut off the clothing with a knife. You should definitely put a piece of paper with a note under the bandage. In it, first aid providers must indicate the time of application of the compressive bandage. If the ambulance is delayed, the tourniquet is loosened every 30 minutes!
If a person breaks the thoracic or lumbar spine, then they do not put a splint on him. In this case, first aid only includes calling emergency services, pain relief and stopping the bleeding. If you need to move a victim from the scene of an accident, for example from a roadway, then only a rigid stretcher is used for this. The person is secured on a stretcher to prevent him from flying off. For a fracture of the cervical spine, an immobilizing collar is used.
Fracture treatment methods: what is done in the hospital
The basic principles of treatment in a hospital are preserving the patient’s life, eliminating anatomical disorders (muscle tension), restoring the functioning of internal organs and damaged limbs.
Operative methods
The main method of treating closed fractures is fixation of the joint using a plaster, splint or rigid orthoses. If bone fragments have shifted, then the treatment plan additionally includes traction—long-term comparison of fragments using a weight system.
There are also surgical treatment methods. Fractures are treated using osteosynthesis - connecting bone fragments using pins and screws.
Modern methods of treating fractures involve complete prosthetics. This is when the joint changes completely or partially. This is the “gold standard treatment” for hip fracture in elderly patients.
Conservative methods
After an injury, people experience pain, so they need to know what to take for fractures. Typically, in a hospital, patients, especially those with broken spines, are given narcotic painkillers - Codeine. After this, they switch to non-steroidal medications - Analgin, Ketarol.
After fractures, the risk of blood clots increases, so you additionally need to take drugs that prevent blood clotting, otherwise called anticoagulants - Heparin, Enoxaparin.
If the fracture is open, then it is necessary to prevent a bacterial infection that gets inside the wound. For this, antibiotics (Ceftriaxone or Cefotaxime) or antibacterial drugs (Metronidazole, Pefloxacin) are used.
How successful the treatment is will determine how long you will have to walk in a cast for a fracture. On average, the treatment period ranges from 1 to 2 months.
Physiotherapeutic method
Physiotherapy in the treatment of fractures is used for this purpose. to relieve swelling of soft tissues and relieve pain. The procedures promote rapid bone regeneration, as they improve blood supply to the injured area.
In the acute period, patients are prescribed treatment methods such as magnetic therapy (it is even done through a plaster cast). Magnetic therapy not only reduces pain, but also eliminates compression of soft tissues.
In addition to magnetic therapy, another effective treatment method is cryotherapy. But the procedure is only possible on those areas that are free from a plaster cast. The main purpose of cryotherapy is to relieve swelling from soft tissues due to the narrowing of blood vessels.
After the exacerbation stage subsides, ultrasound therapy with hydrocortisone and electrical stimulation are added to the listed physiotherapeutic treatment methods. These techniques help restore lost muscle volume after fractures.
Therapeutic physical education also plays an important role in treatment. After removing the plaster, you need to gradually develop the limbs and joints so that they acquire their initial mobility. Learn how to develop the radius and humerus after a broken arm from the video and advice from doctors.
Surgery
If the victim has broken the tibia and has displaced bone fragments, then he undergoes closed reduction.
Next, the injured limb is immobilized with a plaster splint.
If bone fragments cannot be fixed, then the victim is subjected to skeletal traction on the heel bone. Moreover, this procedure completely replaces a conventional operation.
If the victim has undergone all the procedures, but the bone fragments are still displaced, then he undergoes osteosynthesis using the Ilizarov apparatus and special plates. The device is secured to the limb with special knitting needles, which are passed through holes in the broken bone. Next, the knitting needles are crossed at an angle of 90 degrees and fixed on a special ring. The doctor measures the required length with special nuts. The length is also adjustable by them. In this case, the victim is put under anesthesia. The device pulls the bone fragments close to each other. Therefore, the process of bone fusion occurs faster. Usually the device is installed for a fairly long period. But only a specialist can accurately determine the period of wearing the plates and the device.