First aid for fractures. Do's and Don'ts

Prices for services

• Removing the plaster cast (splint) 660a
• Treatment of open fracture site 825a
• Removing the cellocast bandage 860a
• Application of an immobilization bandage for bone fractures 1320a
• Strengthening and correction of plaster, cellocast, turbocast bandages 1320a
• Application of a Turbocast (Orthosis) bandage without the cost of material 1320a
• Application of an immobilization bandage for spinal fractures 1760a
• Application of a small plaster cast (for injuries of the hand and foot) 2200a
• Closed manual reduction for fractures of small tubular bones 2640a
• Application of a medium plaster cast (for injuries to the bones of the forearm, radial joint) 3520a
• Application of a small cellocast bandage (for injuries of the hand and foot) 3850a
• Closed manual reduction for long bone fractures 4620a
• Application of a large plaster cast (for injuries of the shoulder, shoulder joint, knee joint) 5280a
• Application of a Turbocast bandage (Orthosis) for hand injuries 5390a
• Application of a medium cellocast bandage (for injuries of the forearm, lower leg) 6050a
• Application of a Turbocast bandage (Orthosis) for foot injuries 6160a
• Application of a large cellocast bandage (for injuries of the shoulder, knee joint) 7700a
• Application of a Turbocast bandage (Orthosis) on the wrist 14190a
• Application of a Turbocast bandage (Orthosis) to the ankle joint 19690a
• Application of a Turbocast bandage (Orthosis) to the elbow joint, knee joint 21890a
• Primary appointment (examination, consultation) with a traumatologist-orthopedist 1210a

The information and prices presented on the website are for reference only and do not constitute a public offer.

Diet

Diet for fractures

• Efficacy: therapeutic effect after a month
• Timeframe: 2 months
• Cost of food: 1600-1800 rubles per week

Diet for fractures of the arm bones is an obligatory component of complex treatment and is aimed at accelerating the process of bone healing. A feature of the diet for fractures is:

• Sufficient content of complete animal protein containing all the necessary amino acids. The amount of protein in the daily diet should be about 100 g and is provided by consuming lean red meat, chicken eggs, poultry, dairy products (hard cheese, cottage cheese), and white/red fish.
• Sufficient content of products containing macro/microelements (calcium, zinc, magnesium, phosphorus). The main products containing calcium include fermented milk products, cottage cheese/milk cheeses, sesame seeds, spinach, hazelnuts, and salad. But effective absorption of calcium can only occur against the background of the presence of vitamin D in the diet (mainly in fatty sea fish and its fat). Phosphorus can enter the body with beef liver, meat, egg yolk, fish, beans, buckwheat porridge, walnuts, buckwheat/oatmeal, dairy products; magnesium - with any wholemeal flour products, porridge (buckwheat, wheat, oatmeal), legumes, bananas, almonds; zinc - with bran, pumpkin seeds, yeast, seafood, sprouted grains, mushrooms, potatoes, beef, sesame seeds, peanuts, onions.
• No less important is the presence of products containing sufficient amounts of vitamins A , E , B , C , D , which are necessary to accelerate reactions during the healing of fractures. Vitamin D is especially important , which is rich in chicken yolk, fish oil/fatty fish (sprats); vitamin E , contained in various cold-pressed vegetable oils; vitamin C - in fruits/berries; rose hips, sea buckthorn; B vitamins - in garlic, yeast, offal, cereals, sweet peppers, walnuts, hazelnuts, milk. A fracture of the radius heals on average in 27-35 days, and throughout this entire period, as well as for another 1-2 months, you must follow a diet. It is recommended to supplement dietary nutrition with a vitamin-mineral complex. It is also necessary to completely exclude alcohol-containing drinks and tea/coffee from the diet, the consumption of which helps to reduce the absorption of calcium.

Our clinics in St. Petersburg

Structural subdivision of Polikarpov Alley Polikarpov 6k2 Primorsky district

• Pionerskaya
• Specific

• Commandant's

Structural subdivision of Zhukov Marshal Zhukov Ave. 28k2 Kirovsky district

• Avtovo
• Avenue of Veterans
• Leninsky Prospekt

Structural subdivision Devyatkino Okhtinskaya alley 18 Vsevolozhsk district

• Devyatkino
• Civil Prospect
• Academic

For detailed information and to make an appointment, you can call +7 (812) 640-55-25

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An open fracture is a type of fracture in which damage to the skin or mucous membranes occurs. Open fractures of the extremities are more common. The main danger of open fractures is that various microorganisms penetrate through the wound, which can infect soft tissues, bone fragments and cause such serious complications as wound suppuration, osteomyelitis and even tetanus.

List of sources

• Edinak A.N. Main principles and methods of treatment of forearm fractures / A.N. Edinak, V.N. Kostik // Trauma. - 2002. - T.Z, No. 3. - P. 315–318.
• Matsukatov F.A., Gerasimov D.V. On factors influencing the timing of fracture consolidation // Bulletin of Traumatology and Orthopedics named after. N.N. Pirogova N 2, 2021. pp. 50-57.
• Vorontsov P.M. Treatment of fractures of the distal metaepiphysis of the forearm bones / P.M. Vorontsov // Man and his health: Materials / Russian National Congress. – St. Petersburg, 1997. – P. 80.
• Angarskaya, E.G. Features of fractures of the radius in a typical location / E.G. Angarskaya, B.E. Munkozhargalov, Yu.N. Blagoveshchensky // Siberian Medical Journal. - 2008. - No. 3. - P. 33-35.
• Ardashev, I.P. Surgical treatment of improperly consolidated fractures of the distal metaphysis of the radius / I.P. Ardashev, V.N. Drobotov, A.V. Ivanov et al. // Modern high technology. - 2009. - No. 12. - P. 19-21.

First aid for an open fracture

First aid for open fractures is provided not by the attending physician, but by those people who happen to be close to the patient. Of course, it is not always possible to complete all of them, but even a little help before the ambulance arrives can greatly facilitate further treatment.

• First of all, you need to immobilize the injured limb. This is done using immobilization splints or improvised materials.
• If there is bleeding, you should try to stop it by applying a tourniquet or a tight fixing bandage to the limb.
• If possible, you should treat the wound with an antiseptic solution and apply a sterile bandage to it to prevent microorganisms from entering the wound.

The patient must be taken to the clinic as soon as possible to provide qualified assistance.

Immobilization rules

Immobilization is a set of measures aimed at ensuring the immobility of the injured limb. For this, various tires are used, including those made from handy materials - sticks, boards, rods, etc.

Splinting rules

When applying a splint, you must follow a number of rules:

1. It needs to be applied as early as possible. The fracture is accompanied by swelling, which will not allow splinting to be carried out correctly.
2. The splint is applied after pain relief, and not vice versa.
3. The object is applied on both sides of the damaged limb, fixed with a bandage along the entire length, except for the fracture site.
4. If the femur is fractured, a splint is applied from the armpit to the foot.
5. If the fracture is open, first treat the wound, apply a sterile or clean bandage, and only then begin splinting.
6. The bleeding must be stopped before a splint is applied. If a tourniquet was used, a splint is applied so that it can be removed without disturbing immobilization.
7. The arm is suspended in a sling; if a leg is broken, something soft is placed under it.
8. In the cold season, the injured limb is wrapped in a warm cloth.
9. To control blood circulation, the first phalanges of the fingers are left open.

When transporting a victim to a medical facility, it is necessary to ensure the correct position of the body. If the legs are broken, the patient is transported in the “lying” position, placing a soft cushion under the injured limb. If an arm is broken, transportation while sitting is allowed.

Additionally read:

Skeletal injuries: types

Stages of treatment of open fractures in the Medicenter clinic network

Immediately after an open fracture, the main danger for the patient is pain shock and blood loss, so first of all we administer painkillers and correct the patient’s general condition.

Next, you need to determine the severity of the damage. In order to establish the location of bone fragments, patients need an x-ray examination. The X-ray room at the Medical Center is open from 09:00 to 21:00.

Then we perform surgical treatment of the wound. We thoroughly rinse with an antiseptic solution and remove necrotic tissue. It is optimal if this is done in the first hours after injury, so we emphasize once again that it is very important to immediately take the patient to the clinic. If there is suspicion of damage to nerve endings and blood vessels, we call our consultants in the field of neurosurgery and vascular surgery. Given the risks of infection, our surgeons may recommend not suturing the wound immediately. It is left open so that regular processing and monitoring of its condition can be carried out. If the first signs of infection appear, we immediately begin the entire range of measures aimed at treating the wound infection.

The next stage is the direct healing of the fractures. Since the initial contamination of the wound prevents immediate reduction (comparison of bone fragments) and osteosynthesis (operations for fusion of bones using metal structures), we treat such fractures using skeletal traction, open orthrodesis (such as a plaster or polymer bandage) or compression-distraction devices.

The final stage of treatment is rehabilitation. For rehabilitation, we use an integrated approach, including physical therapy, physiotherapy and massage.

Symptoms

In the clinical picture of a bone fracture, regardless of its type, it is customary to distinguish absolute and relative signs of a fracture of the arm. Absolute signs of a bone fracture include: pathological mobility, severe pain, especially during physical examination, the presence of deformation of the longitudinal axis of the limb and crepitus of bone fragments at the fracture site. Absolute signs that allow you to determine a bone fracture include pain with pressure, swelling at the fracture site, pain on palpation of the bone, muscle spasm, and change in skin color. These are general signs of a broken bone, but when a specific bone is broken, specific symptoms appear. Due to the large number of bones that form the upper limb and the possibility of fracture of any of them, we will consider below only a few of the most common fractures of the arm.

Radial head fracture

A characteristic symptom is the appearance of sharp pain in the elbow joint, which intensifies when trying to bend/rotate the arm, as well as during palpation. Objectively, hemarthrosis / edema , limited movement, especially when trying to perform a rotational (circular) movement of the forearm, and joint deformity are determined visually. With a combined fracture of the head of the radius and dislocation of the forearm, a more severe deformation is observed, there is practically no movement in the joint, and there are often disturbances in sensitivity and blood supply, which is manifested by numbness of the fingers.

In case of a fracture of the diaphysis of the radial bone, the symptoms are relatively blurred and manifest themselves as swelling in the area of ​​the fracture, pain, which intensifies when attempting to perform rotational movements and palpation of the bone fracture. Typically, there is no bone mobility or crepitus because the radial bone fragments are held in place by the interosseous membrane.

Fracture of the radius in a typical location (photo below)

Characterized by severe pain and swelling, hemorrhages , crepitus and pathological mobility . When bone fragments are displaced, deformation with localization slightly above the wrist joint is visually determined. The pain syndrome increases sharply with palpation and attempts to perform movement. When Galeazzi is damaged, there is pain in the middle-lower third of the forearm, which intensifies when pulled by the fingers, severe swelling, and, less commonly, the formation of subcutaneous hematomas. All types of movements in the wrist joint are practically impossible or extremely limited. This type of fracture is often accompanied by damage to nerves/vessels and the development of compartment syndrome (compression of blood vessels/nerve fibers by edematous soft tissues), which can manifest as loss of sensation in the hand area.

Fracture of the phalanges of the fingers (photo below)

Signs of a finger fracture are typical of the typical manifestations of most fractures - pathological mobility, deformation, swelling, severe pain with axial load, subcutaneous hematoma . It is quite easy to distinguish a fracture from a bruised finger by the absence of such symptoms. In addition, with fractures of the diaphysis of the phalanx of the fingers, as a rule, a displacement of the phalanx with an open angle to the rear is formed.

A relatively rare symptom is shortening of the arm, which appears in cases of fracture of two bones of the forearm (radius/ulna) and the presence of displacement of bone fragments along its length.

The most common types of open bone fractures

As we have already said, open fractures of the extremities are the most common. In the first place is an open fracture of the leg, in particular a fracture of the shin bones. This is primarily due to the fact that the bones in the lower part of the lower leg are least protected. With open fractures of the arms, the forearm is most often affected.

In children, treatment features are due to the high ability to regenerate bone tissue and low resistance to the development of bacterial complications.

The high level of medical care in the network of our clinics is due to the availability of the necessary modern equipment, and, of course, a qualified team of traumatologists and orthopedists.

Classification

The classification of fractures of the arm bones is based on several factors, according to which it is customary to distinguish different types of fractures.

By origin: congenital, caused by abdominal trauma during pregnancy or during childbirth, and acquired, among which are traumatic and pathological fractures.

According to the presence/absence of damage to the integrity of the skin and adjacent tissues: open and closed fracture.

According to the location of the fracture:

• Epiphyseal proximal/distal (at the end parts of the bones).
• Metaphyseal (localization between the epiphysis and diaphysis).
• Diaphyseal (the fracture is localized in the middle of the tubular bone).

According to the complexity of the fracture (position of bone fragments): with displacement and without displacement.

In relation to the longitudinal axis of the bone: transverse, oblique, longitudinal, spiral, splintered, impacted.

Shin

Shin – located between the knee and ankle joints. Formed by the tibia on the outside and the fibula on the inside. Around these bones there is muscle tissue responsible for the mobility of the foot. The knee joint connects the tibia above and the femur below, and is protected in front by the patella. Inside the joint, the heads of the bones are protected from friction by the menisci - cartilaginous layers.

Injuries to the lower extremities are common - these are bruises and ruptures of muscle tissue, fractures and cracks. The reason for this is falls, blows, dislocations or unsuccessful movements. In older people, poor circulation, stiff joints and lack of minerals in the diet lead to injury. As a first aid, you need to leave the injured leg alone, apply cold to the injury and elevate the limb.

If the injury is extensive, then so-called immobilization is necessary - immobility of the injured leg for 2 - 3 weeks, depending on how you feel. After a period of rest, rehabilitation measures are prescribed - physical therapy and massage.