An absolute sign of a bone fracture. Signs of a closed fracture and first aid rules. Symptoms of a broken arm

A closed fracture is an incomplete or complete destruction of any bone in the human skeleton without damaging the soft tissue. Such damage occurs due to increased traumatic effects on the injured bone, intense pressure on it, or due to a disease called osteoporosis. If available, strength bone tissue deteriorates significantly, and it is destroyed even with weak mechanical stress. Most often in medical practice fractures of the limb bones occur.

With timely provision of first aid and rapid subsequent hospitalization, there are huge chances of complete and complete rehabilitation of the injured bone. Closed bone fractures can be treated conservatively and surgically. The choice of therapy is determined by the doctor and depends on the nature and severity of the injury.

Classification

Broken arm closed type with displacement of fragments

A closed fracture can occur with or without displacement of bone fragments. The causes of injury can be mechanical or pathological, and the severity of such injuries can be severe, moderate or mild.

Depending on the nature and characteristics of the fractures, they are:

transverse;
oblique;
longitudinal;
helical;
splintered and multi-splintered;
driven in;
wedge-shaped;
compression.

Accompanied by injury may be:

traumatic shock;
heavy bleeding;
damage to nearby organs;
wound infection;
sepsis.

Before listing the signs of a closed fracture, it is necessary to define what a closed fracture is. It must be said that fractures are divided according to different signs. One of them is whether the skin over the fracture is broken or not.

As you understand, if the skin is damaged and a wound is visible above the fracture site, then this is an open fracture.

If at the fracture site - open wound and a broken bone or its fragments is visible, there is no doubt about that. The injury is serious, you need to call ambulance and take the patient to traumatology.

But it happens that a person twists his leg, decides it is a simple sprain and goes home. At home I applied a tight bandage to myself and calmed down. However, there are such insidious fractures in which there seems to be no need to run to the doctor. One of them is a broken ankle. There may be a slight swelling and aching pain at the fracture site.

Therefore, you need to know exactly what symptoms accompany a closed fracture.

Pain - main feature fracture But strong pain It can also occur when ligaments or muscles are torn.
A change in the shape of a joint, lower leg or thigh is a deformity. One of the main signs of a fracture
Pathological mobility. Movements in the joint may be of unusual amplitude or in an unusual direction.
Crepitation is a characteristic sound (crunching) when moving and palpating the fracture site.
The body’s general reaction to a fracture is a possible increase in temperature, general malaise

Diagnostics

If all these signs or at least one of them are present, you must definitely contact the emergency room. traumatologist After examining and palpating the site of the suspected fracture, the doctor will send you for an x-ray.

This required method examinations for fractures or suspected fractures . The x-ray image shows what kind of fracture it is, whether there are fragments and displacement of bones or their fragments.

This helps the doctor decide on treatment tactics - a cast, a splint, or whether surgery will be required.

non-absolute signs - with a closed fracture - shock, limitation of joint movement, unnatural position of the limb, pain when pressing. with open fractures there are no non-absolute signs

- Pathological mobility (with complete fractures is not always determined). The limb is mobile in the place where there is no joint.

Clinical signs of fractures

You must remember to immediately remove the shoes from the victim’s feet, otherwise in a few minutes the foot will swell greatly, and this will be very difficult to do, and it is possible that in the future the shoes will even have to be cut.

The topic of this article is not a consideration of the types of fractures, but methods of providing

Periosteal
After a fracture occurs, the integrity of the bone is disrupted, bleeding and severe pain occur. With complete fractures of tubular bones, displacement of bone fragments also occurs. This is due to the fact that when pain impulses occur, the muscles reflexively contract, and since they are attached to the bones, they pull the ends of the bone fragments with them, aggravating the severity of the injury and often leading to additional damage. In the area of a closed fracture, a hematoma forms, and with an open fracture, severe external bleeding occurs. The more massive muscle layer in the area of the broken bone, the more difficult it is to reposition bone fragments and keep them in correct position for adequate bone restoration. In case of fractures of the femur, the development of fat embolism from the yellow bone marrow, leading to sharp deterioration condition and even death.
Comminuted fracture of the tibia in the middle third - the so-called “bumper fracture” - is a widespread type of injury, usually occurring in road traffic injuries.
For similar injuries folk medicine The most popular remedy is considered to be mumiyo, which ensures good regeneration of bone tissue if consumed for 10 days at 0.3 g per day.
Treatment of a fracture is made taking into account the characteristics of the fall, the patient’s age and other indicators

Traumatic occurs as a result of a sharp sudden action mechanical impact force on the bone. Depending on integrity skin There are closed and open bone fractures. When opened, not only the bone is destroyed, but also the skin and all structures are damaged, that is, nerves, ligaments, blood vessels, muscle fibers. Depending on the severity of the lesion, complete and incomplete lesions are distinguished. With an incomplete fracture, a break or crack occurs, and the perforated effect of the bone appears. A fracture of a bone into two parts is called complete. In this case, displacement often occurs at the fracture site when bone fragments change position.

Swelling at the fracture site can occur quickly (within 15 minutes after injury) or develop over several hours. At the same time, such a symptom has a minor role in determining a fracture, because it also accompanies other types of damage.

A fracture occurs when the integrity of a bone is broken due to injury. Many types and signs of fractures are easy to detect on the spot, without the help of a specialist, but some of them are insidious in that the victim may not immediately understand that he has a fracture, and urgently needed health care: he continues to lead his previous lifestyle, experiencing minor pain and limited movement, believing that he has suffered a severe injury.
- Crepitation (a kind of crunching sound). It is felt under the hand at the fracture site, sometimes heard in the ear. It is clearly audible when pressing with a phonendoscope on the site of damage.
As a splint to immobilize the lower leg, you can use absolutely any straight and long objects: sticks, rods, boards, even tree branches. If there is absolutely nothing at hand that could be suitable for fixing a broken limb, it needs to be fixed by taping it to the shin of the healthy leg. For fastening, scarves, belts, shawls, towels and anything else that can be used will do.
first aid for broken leg bones

- a slight thickening forms along the fracture line.

Signs of a closed fracture

The fusion of fragments after a fracture is accompanied by the formation of new tissue, which results in the appearance of a bone callus. The healing time for fractures ranges from several weeks to several months, depending on age (in children, fractures heal faster), general condition body and local reasons- relative position of fragments, type of fracture, etc.

Fracture of the medial and lateral malleolus.

Separate the shell from the hard-boiled egg for 20 minutes, peel it from the film, and chop it. Then it is poured lemon juice and place on the bottom shelf of the refrigerator until the shells are completely dissolved. Take the finished medicine for a month, 1 tsp. 2 times a day. The proportions are based on the following calculation: the shells of three eggs to the juice of 1 lemon.

The most common injury to the upper extremity is a displaced fracture of the radius. This happens because when people fall, they instinctively put their hand up. This type of fracture is called a “typical” fracture. There are several options for displacement of fragments - Smith, Barton or Colles. Impacted fractures also occur, in which the edge of the bone is flattened.

Signs of an open fracture

Swelling and pain are felt in the area of the fracture

Hematoma. It may be absent, but often still occurs at the site of the fracture, and not always immediately. If it pulsates, it means the bleeding is continuing.

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Types of fractures

Let's figure out which signs of a fracture reveal themselves in the very first minute after the injury, and which only indicate that the bone is probably damaged.

- Bone fragments in an open fracture can be visible in the wound.

Yes important rule immobilization, it is important to comply with it. It consists in the fact that at least two joints must be fixed with the splint. Providing

Symptoms

. Therefore, it would be logical to simply divide them into closed (the integrity of the muscles and skin is not compromised) and open, which are accompanied by wounds and bleeding, with or without displacement. Moreover, the vast majority do not know their more detailed classification and this is how they will evaluate them.

Endoosteal

Bone tissue restoration occurs due to the division of cells of the cambial layer of the periosteum, endosteum, poorly differentiated bone marrow cells and mesenchymal cells (vascular adventitia).Femoral neck fracture. Difficult to heal, but quite common fracture, especially in older people. Most effective method treatment - installation of an artificial hip joint. Relieves pain well, accelerates the healing process, and also mobilizes the body's defenses fir oil. It is recommended to take it 3 times a day orally, instilling 5-10 drops into bread balls. The oil can also be rubbed near the fracture site, but not more than 10 ml per day.

Treatment

Treatment is prescribed taking into account all types of falls. Even the age, gender, activity of the victim, as well as whether he is left-handed or right-handed - everything is taken into account. As a treatment, provided that the fragments are fixed in an acceptable position, a plaster splint is quite suitable. In case of secondary displacement, the need for surgical treatment arises. Young and active people who need full recovery after a fracture often undergo surgery immediately.

If you receive multiple fractures, especially if there are open ones, the victim is in in serious condition, sometimes leading to traumatic shock. In this case there is a low arterial pressure, the pulse becomes weak, breathing and heart rate increase. There is swelling and bruising in the area of injury, the injured limb loses its functions, movements are painful and limited. All this can be attributed to relative (supposed) symptoms of a fracture. The same signs may occur with dislocations and sprains

Limited mobility. As a rule, the damaged part cannot function either at all or partially. If there is a fracture not of a limb, but, for example, of the coccyx, then the person will feel difficulty walking, i.e. There is not only a limitation in the function of the damaged part, but also of those that come into contact with it.

Depending on the type of fracture, its signs can be divided into reliable - those that leave no doubt that the bone was deformed from an impact, and relative - those that may raise doubts: there is a fracture or bruise.

Stalin first aid for broken leg bones

Examples

The most common reason why a fracture occurs is the twisting of the bone and its rupture due to a person’s fall, when two multidirectional forces applied between the lower and middle third of the lower leg act on the lower leg. Such injuries often occur during icy conditions, when people fall en masse due to slippery conditions. When a person falls on his leg, he throws the entire weight of his body onto it or awkwardly tucks his leg under him. A shin fracture can also occur when the leg is crushed or hit by a heavy object. Eg, car crashes also often cause severe injuries to the shin bones. Some of the most serious injuries to the lower leg and foot occur when falling from a height or squeezing the leg with some kind of weight.

- callus is located inside the bone, a slight decrease in the bone marrow canal at the fracture site is possible.

The regeneration process can be divided into 4 main stages:

Various fractures of the skull bones.

An infusion of calendula flowers will reduce pain, soothe and speed up the regeneration process. For this, 1.5 tsp. flowers need to be poured with 0.5 liters of boiling water. Leave for an hour, then strain. You need to consume 1/3 cup 4 times a day.

Meals during treatment

A fracture of the calcaneus occurs only under the influence of great strength because it is very durable. Therefore, with such an injury, treatment takes a long time, and the consequences can be very serious. Often such damage occurs after a fall from a height or as a result of a traffic accident. Treatment in best case scenario limited to a plaster cast for at least 6–8 weeks. This is possible in the absence of displacement of broken bone fragments, as well as serious damage to soft tissues. Otherwise, an operation is required in which the bone fragments are connected using staples.

Absolute signs of a fracture are those that accurately indicate its presence.

The presence of these signs cannot indicate a fracture with 100% probability, but many from this category accompany any fracture (pain, swelling, limitation of movement).

Reliable signs of fractures:

when the bone sticks out

Traditional methods

It will be necessary to immobilize two joints, the ankle and knee.

There are absolute and relative signs of a fracture. Absolute ones directly indicate the presence of a fracture, while relative ones only suggest the presence of one.

Intermedial
Autolysis
In addition to these fracture sites, many others are possible. In fact, any bone can be broken at any point along its length.
Bone fractures are not the best a pleasant phenomenon, as well as their treatment. But if you consult a specialist in time, and also take a set of measures to restore the damage, then the result will not keep you waiting.

The recovery process depends on the severity of the injury, but in most cases, mobility of the lower leg and foot is rarely fully restored. In addition, complications may occur such as slow healing of wounds in some areas, irritation of the tendons from staples and in the suture area, chronic pain and joint stiffness, bone collapse, arthritis, infections, blood clots.

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Bone fracture - Wikipedia

A characteristic feature of a fracture is deformation, abnormal mobility in the sore spot, shortening of the limb, crepitus (a characteristic sound from the friction of bone fragments).

All fractures are classified into open and closed. The latter are much easier to diagnose than the former without x-rays and the help of a specialist.

Unnatural position of an arm or leg (if we are talking about signs of a limb fracture).

Etiology

It is better to apply the splint together. The first will hold the injured leg in a slightly elevated state, the second will fix it to the splint using a bandage or improvised means. On the injured leg, it is advisable to leave the toes open to control blood circulation.

The absolute symptoms of a fracture include: disruption of the natural shape of the tibia, that is, when it is twisted or bent, if there is abnormal mobility of the part of the tibia that is located below the fracture zone.

- callus is located between bone fragments, the bone profile is not changed.

- in response to the development of injury, edema develops, active migration of leukocytes (in particular osteoclasts), and autolysis of dead tissue occur. Reaches a maximum 3-4 days after the fracture, then gradually subsides.
Bone tissue consists of mineral and organic components. The composition of bone is quite complex, the organic part of the bone makes up 30% of its mass, mineral 60%, water accounts for 10%. The mineral component provides strength and consists mainly of calcium, phosphorus and trace elements. The organic component is collagen, which makes bone more elastic. Collagen tensile strength is 150 kg/cm², notch strength is 680 kg/cm², elongation at break is 20-25%. When heated, collagen fibers contract by about a third of their length. Tubular bones are most resistant to load along their axis. Sponge ones are less durable, but are equally resistant to load in all directions.
Also, the most common types of fractures have generally accepted names - after the name of the author who first described them.
Eating cauliflower promotes healing of fractures
With an intra-articular fracture, hemarthrosis is observed - hemorrhage in the joint area.

A closed fracture is not accompanied by damage to soft tissues: in this case, bones and joints suffer, which can change position (the so-called displaced fracture) or simply lose integrity: split (the so-called comminuted fracture), while maintaining the same position .

Pathogenesis

Mobility of the broken part in the place where there is no joint.

open fracture - there will be no doubt!!!

After completing first aid, you must immediately transport the injured person to the nearest place where he will receive medical assistance.

Mechanism of occurrence

Another sign of a fracture, which is also absolute, is bone crepitus, i.e. crunch of bone fragments. It occurs when moving a broken limb or moving or shifting the patient. Paraosseous

Proliferation and differentiation When a bone tissue is fractured, bleeding occurs, which is difficult to stop due to the fact that the vessels are fixed in the mineral part of the bone and cannot collapse. The amount of bleeding depends on the type of fracture and its location, for example, with fractures of the leg bones, the victim loses 500-700 ml of blood. As a result of this hemorrhage, a hematoma is formed, which subsequently surrounds the bone fragments.

For example, a fracture of the styloid process of the radius is called a Colles fracture. Also quite well-known types of injuries of the upper limb include the Monteggia fracture, which occurs when ulna in the upper third and dislocation of the head of the radial bone with damage to the branch radial nerve, and the Goleazzi fracture, which is a fracture of the radius in the lower third with a rupture of the distal radioulnar joint and dislocation in this joint.

Consequences of injury

In case of bone fractures, the main goal of treatment is to normalize lost functions and fuse bone fragments. This is a rather lengthy and complex process, therefore, in addition to medical treatment, you can use other methods: exercise, nutrition, as well as traditional medicine recipes.

Regeneration

Application of a plaster cast is conservative method treatment of fractures

The first signs of a fracture are pain in the area of injury and swelling. Movement is limited, causes pain, and bone movement may also occur outside of the joint area (depending on the location of the injury). A hematoma often forms.

Audibility of crunching.

GRANDFATHERSince the victim cannot fully move independently, he must be transported on a stretcher, possibly even a homemade one.
Relative signs will also help to recognize a fracture: swelling, edema and bruising in the suspected area of the fracture, severe sharp pain, which is again present in the area of the suspected fracture, significantly limited joint mobility.- surrounds the bone with a fairly large protrusion, which can distort the shape and structure of the bone.
- active reproduction of bone tissue cells and active production of the mineral part of the bone. At favorable conditions first formed cartilage tissue, which then mineralizes and is replaced by bone. At the site of bleeding, swelling occurs and fibrin threads fall out, which subsequently serve as the basis for the formation of the protein matrix of bone tissue. Stopping bleeding from bone tissue is not an easy task and, in case of complex comminuted open fractures, is only possible in an equipped operating room.
In childhood and adolescence, fractures along the non-ossified growth (epiphyseal) line - epiphysiolysis - are observed. In old age, fractures occur with a significantly lower traumatic load and recovery time increases. This is due to a change in the ratio of mineral and organic components of bone. To speed up the process of bone fusion, nutritionists recommend eating foods enriched with silicon, which is found in pears, turnips, radishes, radishes, cauliflower, and lungwort. Food should be rich in calcium; dishes containing cartilage or gelatin will benefit.

When treating bones, the main thing is to heal the bone fragments and restore normal functions of the limb. The doctor compares the fragments and ensures their secure fixation. At the same time, it is important not to pinch adjacent joints, which should be mobile, and also not to forget about the normal functioning of nearby muscles.

The only way to be sure that there is a closed fracture is with the help of an X-ray.With an open fracture, bone fragments are visible in the wound.
X-ray.For those who have had an ankle fracture, when the plaster cast is removed, it is better to temporarily wear special shoes in order to prevent post-traumatic deformation of the foot.
This is usually the case; with a fracture, swelling quickly begins to increase, there is sharp pain and perhaps even deformity that is caused by the displacement of a broken bone. An ankle fracture is often accompanied by a dislocated foot.Type of formed callus depends on the person’s regenerative abilities and the location of the fracture.
Restructuring of bone tissueTraumatic fracture

Bone fractures occur as a result of stress exceeding their strength limit. For each bone, along different axes, the maximum load values are different. The type of fracture in each specific case depends on the direction of the applied force vector. For example, if the blow is perpendicular to a tubular bone, a transverse fracture occurs; when a force vector is applied parallel to the axis of the bone, longitudinal and comminuted fractures occur.

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The menu should include porridges made from corn, rice and millet, as well as onion, which contains natural aluminum, which promotes the absorption of calcium in bone tissue. The diet should include milk, vegetable juices, cottage cheese, and low-fat cheese. Depending on the nature of the fracture, open or closed reduction is performed, i.e., artificial restoration of the position of displaced bone fragments. With open reduction, a surgical incision is made in the area of the fracture, followed by the connection of bone fragments using special fixing devices. Closed reduction involves eliminating the displacement of bone fragments using special devices and various manual manipulations. Often in such cases the system is used skeletal traction. Closed reduction is performed for closed bone fractures. An open fracture is a more severe injury than a closed one, because in this case, in addition to damaging the bone, the tissue also loses its integrity. This can happen from an external influence (during an accident, or a limb getting caught in a moving mechanism at work) or due to the fact that the broken bone itself damages the tissue.

Shortening or lengthening the injured area.

Causes of fracture

Kitin To reduce swelling during rest, you can place it on the side of the sofa or on a pillow. It is extremely important to give the injured leg the correct position. You need to carefully pull the leg lengthwise. To do this, you need to grab your heel with one hand and your toes with the other.

Symptoms of a fracture

- blood supply to the bone is restored, compact bone substance is formed from the bone beams.

is damage to the structure of bone tissue under the influence of an external force that exceeds the standard strength characteristics of the damaged skeletal element. This type of fracture is the most common nowadays. It can occur for many reasons, ranging from a fall from a height to gunshot wounds. The most severe are considered combined and combined fractures - fractures of several bones or their combination with other injuries, for example, wounds or burns.

Ratio various types fractures has changed over time, for example, if before the mass introduction of automobile transport, bumper fractures of the tibia and extensor fractures of the cervical vertebrae were quite rare, now they make up a significant percentage of fractures in automobile injuries.

A medicinal jellied meat prepared from ear cartilage, tails, tendons, bones of pork legs and chicken drumsticks is recommended. All this needs to be cooked for 5 hours in a pressure cooker, then add spices and garlic. Pour the cooled broth into jars and should be consumed after it has hardened.

Treatment of bone fractures is carried out conservatively and surgically. Conservative therapy consists of closed reduction followed by application plaster casts, external orthopedic devices. If it is not possible to perform closed reduction and hold the fragments in the correct position, surgical intervention is performed.

First aid for broken leg bones

Based on this, the main signs of an open fracture are a wound, bleeding, visibility of a broken bone or its fragments, pain and swelling. If the damage was very severe, the victim may experience traumatic shock.

If at least one of these symptoms is confirmed, then we can say with 100% probability that there is a fracture. However, the presence of these signs does not eliminate the obligation to undergo an X-ray examination.

broken bone

Even while still in a cast, you should do light exercises, try to tense your muscles injured leg. The leg will be almost immobilized for some time, so this should be done to improve blood circulation, and this will also prevent “hardening of the joints.”

With an open fracture, you do not need to try to set the bone or remove it yourself foreign objects. When there is an open bone fracture, the first step is to stop the bleeding. If there are disinfectants nearby, treat the skin around the wound with them, these can be iodine, hydrogen peroxide, potassium permanganate solution. After this, you can begin immobilization.

fracture of the leg bones

Full recovery Pathological bone fractureWith the development of technology, the kinetic energy that humanity can control increases. Power of modern technical devices significantly exceeds the strength of the human skeleton. Now it has become quite common for a person to be exposed to energy of such an order that only a hundred years ago would have been unique or completely impossible. In this regard, as the level of technical development grows, traumatology and orthopedics are faced with new, increasingly complex tasks.

Folk medicine for bone healing is prepared from eggshells

The operation is inevitable if it is easier for the victim to endure surgical treatment, rather than conservative.

Femoral neck fractures

Relative signs of fracture:

Person

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Is this an absolute sign of a bone fracture?

When providing first aid, it is imperative to immobilize (immobilize) the injured limb. In the case of an open fracture, which may also be accompanied by bleeding, a tourniquet must also be applied.

this is an athlete's injury, but in Everyday life This trouble does not happen rarely, especially when there is ice.
- restoration of the bone marrow canal, orientation of the bone beams in accordance power lines loads, formation of the periosteum, restoration of the functionality of the damaged area.
- a bone fracture in the area of its pathological restructuring (affected by any disease - tumor, osteomyelitis, osteoporosis, etc.).
There are typical fracture sites. As a rule, they are located in those places where the bone experiences the greatest load, or where its strength is lower. The most common fractures include:

Among other things, healers have compiled many recipes for infusions, ointments, and lotions that should be used when healing broken bones.

If bone fractures are open (with or without displacement), in order to prevent infection, primary surgical treatment of the injury site is performed.

Depending on the size, type and location, the severity of the damage is determined. Based on the cause of their occurrence, pathological and traumatic fractures are distinguished. Pathological ones occur when exposed to any pathological process on bone tissue. This may occur as a result of the development of a tumor or cyst. In this case, bone tissue is destroyed, and even a small load can lead to a fracture.

Painful sensations at the fracture site when immobilized or during movements. Also, if you apply an axial load, the pain intensifies (for example, if you knock on the heel during a fracture of the tibia).

symptoms are an absolute sign - with an open fracture - bones protruding outwards, with a closed fracture - only an x-ray.

- Unnatural position of the limb.

It is necessary to securely fix the limb in order to avoid possible complications due to the displacement of bone fragments during the movement of the victim or his transportation to a treatment center so that he can receive medical assistance from specialists.

Fractures of the ankles and shin bones are the most common injuries lower limbs. From total number of injuries to long tubular bones, fractures of the leg bones account for 1/3. They are divided into distal and proximal end fractures, tibial malleolar fractures and diaphyseal fractures.

A bone callus forms at the fracture site. There are 4 types of callus:

The most striking symptom indicating a pathological nature is the occurrence of a fracture from an injury of inadequate force (or without injury). In some cases, a history can reveal pain or discomfort in the area of the fracture before it occurs. The methods of radiography, computed tomography or magnetic resonance imaging are more reliable in diagnosing the pathological nature of a fracture. In some cases, the nature of the pathological process that caused the fracture can only be determined by a biopsy.
Fracture of the radius in typical place. In 70% of cases, the mechanism of injury is an extension fracture.

A fracture of the lower limb belongs to the category of traumatic violations of the integrity of bone tissue that occurs after a traumatic mechanical impact from outside. Moreover, the intensity of the impact must exceed the limits that the bone can withstand. Development is not only determined by mechanical damage, the presence of concomitant systemic pathology also plays a role, leading to increased fragility of bone tissue and predisposition to fractures.

The severity of injury in a lower limb injury directly depends on the location of the injury, the condition of the bone tissue and the nature of the injury. If the fractures are multiple after massive exposure, the general condition of the body may suffer, the temperature may rise and general intoxication may develop. After a fracture, massive blood loss with the development of shock is possible. Treatment and rehabilitation in such cases are greatly complicated.

In medical practice, it is customary to distinguish a number of classifications. Lists are compiled based on the location of the injury, the nature of the damage and the condition of the tissues after the traumatic impact. Below are common types of fractures, the classification of which has practical significance.

Compression fractures of the lower extremities are minor cracks that develop after prolonged exposure to a traumatic object on the legs. This type of injury is typical for people who play sports professionally.
Fracture of the bones of the lower limb or pelvic bones without displacement of bone fragments. With this type, there is no deviation of bone fragments from the general axis of the limb. Damage to the surrounding soft tissues of the leg is determined.
Fracture with displacement of bone fragments. In this situation, the broken part of the bone is displaced relative to the other part and relative to the axis of movement. The described disorders can be easily identified upon examination by the characteristic deformation of the lower limb. Rehabilitation for injuries is long. When bone fragments of a child's tibia are displaced, a pin is not used; instead of inserting a pin, patch traction is performed.
A comminuted fracture is characterized by the breaking of bone into separate pieces.
An open fracture is accompanied by damage to soft tissues, disruption of the integrity of the skin, and protrusion of a bone fragment. With such a fracture, infection quickly develops, the temperature rises, and signs of general intoxication appear. Trauma can lead to rupture large vessel and the development of massive bleeding. Large blood loss can lead to hemorrhagic shock.

In a child, injury to the tubular bones of the leg sometimes occurs without damage to the periosteum. the child received the name “like a green branch.”

General characteristics of fractures

After exposure to a traumatic agent of various nature are developing characteristic features and symptoms:

All of these signs are considered relative and may have another clinical explanation. Similar symptoms are possible with a bruise. Then the patient is given a splint, painkillers and rest are prescribed. To make a diagnosis of the foot and pelvic regions, a number of absolute diagnostic criteria have been created. In this case, painkillers are prescribed, a splint is applied and symptomatic therapy is carried out. When fragments are displaced, wires are used to ensure proper fusion.

If a child is injured in the lower leg, thigh or pelvic bone, the general condition worsens - the temperature rises and general weakness develops.

Absolute signs

The absolute criteria for diagnosing a fracture of the lower extremities are clinical signs characteristic exclusively of a bone fracture. With a bruise, such phenomena are not observed.

The limb is in the wrong position and takes on an unnatural appearance.
Mobility develops in uncharacteristic areas of the lower leg or thigh, where it is normally absent. With this type of pathological mobility, nearby joints are not involved.
On palpation in the area of the lower leg or in the area of the pelvic bones, a characteristic crepitus is felt. Caused by friction of shin bone fragments against each other. Similar symptoms occur when the integrity of the pelvic bones is violated.
With the open type, fragments of the bones of the leg or foot are visible protruding through the wound on the leg. In this situation, it is recommended to apply a sterile dressing and stop the bleeding. In case of an open fracture, a splint is applied to the uninjured side of the limb.

Foot injuries

Requires special care and attention. The foot anatomically consists of large quantity individual bones interconnected with each other and with other bones of the leg. If one fragment is damaged, the same will inevitably affect the remaining parts. With improperly healed or untreated foot injuries, there is a risk of developing flat feet or arthrosis.

Happens in metatarsal, tarsal region and phalanges of the fingers.

Any type of damage requires a treatment duration of 2 weeks, or three weeks for complicated forms of bone loss. A plaster splint is applied to the limb, and the patient is instructed to move using crutches. Rehabilitation will be required in the future.

General signs of a violation of the integrity of the foot include similar symptoms as with the other option: pain in the affected area, swelling, dysfunction. Painkillers provide relief only for a short time.

Characteristic clinical picture after damage to the metatarsal bone or one of the tarsal bones of the leg, it consists of pain on palpation or when trying to stand on the leg, swelling of the plantar part of the leg and deformation of the foot. Swelling may develop and the local temperature in the ankle joint may increase. When you try to turn your leg, you feel a sharp pain in the joint. The foot is noticeably deformed, which can be seen upon examination.

A displaced foot injury in a child exhibits a number of characteristic clinical signs. Pain is expressed in the area of destruction of the bone fragment. The foot is severely swollen and deformed. Edema in a child is especially pronounced in the first day. There may be a high temperature and signs of general malaise.

What is discovered during additional examination?

In addition to clinical manifestations, it will finally help determine the diagnosis X-ray examination. The damaged limb is viewed in two projections.

After the operation and installation of the needle, a control study is carried out.

If there is no clear data on the x-ray (often happens when a child is injured), after it is performed, it is possible to conduct magnetic resonance imaging, especially often the study occurs with injuries to the small bones of the foot. If the patient cannot be placed in the scanner for a certain reason, examination using a computed tomograph is possible. This happens with trauma to the pelvic skeleton. The examination of the child is usually carried out under general anesthesia.

Magnetic resonance imaging often reveals signs of injury where x-rays show nothing.

Reliable diagnostic study osteoscintigraphy is used. However, the research method has a number of contraindications for use. In particular, in older people, due to a decrease in metabolic rate, the picture becomes unclear and unreliable or gives a false negative result. Relative contraindication is childhood age.

It happens that the patient is shown surgery. Then a full examination is required, including clinical tests and an electrocardiogram. An indispensable condition must be a satisfactory general condition and normal temperature. Otherwise, surgical intervention is postponed until the general condition normalizes.

A bone fracture is pathological condition, at which it occurs complete violation of the anatomical integrity of the bone. Fractures are usually caused by external force or force that exceeds the physical strength of the bone tissue.

Causes

Road traffic accidents;
Industrial injuries;
A person falls from a height;
A strong blow to a bone with a heavy object;
Diving into water at shallow depths;
Sports injury;
Sudden contraction of large muscles;
Excessive hyperextension of the bone;
Lifting heavy objects;
Bone compression (for example, due to blockages in mines);
Tuberculosis of bone;
Bone metastases;
Osteoporosis;
Occupational injury (for example, loaders).

Fracture mechanism

There are two mechanisms for the occurrence of a fracture:

Direct (a person experiences a bone fracture at the site of application of force);
Indirect (far from the place where the force is applied).

Types of fractures:

Closed
- Single;
- Multiple;
- Combined;
- Combined.
Open
- Non-firearm;
- Firearms.

How to recognize a fracture

All signs of a bone fracture are divided into reliable and probable.

Reliable or absolute signs of bone fracture:

After injury, a change in bone length occurs. This sign is associated with the displacement of bone fragments along its axis;
The victim experiences pathological mobility in the area of bone damage;
By palpating the site of injury, crepitus of bone fragments can be determined (by hearing);
With open fractures, bone fragments may be visible in the wound.

More often reliable signs bone fractures are observed with closed fractures.

Possible signs of a broken bone:

When examining the damaged area, you can notice deformation at the fracture site (occurs due to displacement of bone fragments, as well as swelling of soft tissues and the formation of a hematoma);
When palpating the injured area of the bone, the victim experiences or intensifies local pain;
When an axial load is created in the damaged bone, the victim experiences pain at the fracture site;
A broken limb occupies a non-physiological position;
Swelling of the soft tissue occurs at the fracture site (however, this symptom can cause false deformation in cases where an incomplete bone fracture has occurred;
At the site of the fracture, the victim experiences a hematoma or hemorrhage (in some cases, the location of the fracture site and hemorrhage may differ, due to the fact that the bruise spreads through the interfascial spaces);
When fractures occur, nerve trunks are often damaged. This symptom manifests itself in the form of a sensitivity disorder;
After a fracture, the physiological function of the injured limb is impaired;
Elderly patients may show signs of impairment main arteries(in the form of hemorrhage, pulsating hematoma or thrombosis).

How to distinguish a fracture from a bruise

In case of a fracture, there are absolute signs, and in case of a bruise, reliable signs are present. The final diagnosis is established after an X-ray examination of the injury site. With incomplete bone fractures (for example, with a crack), the patient may not have reliable signs of a fracture.

Local manifestations of open and closed fractures

Pain

Any bone damage causes pain. The intensity and duration of pain in the victim depends on the type and location of the injury. For example, fractures distal phalanges fingers or toes cause more intense pain syndrome than with equivalent injuries to the bones of the thigh or lower leg. This is due to the peculiarities of the location of nerve trunks and nerve endings. Pain is tolerated differently by patients.

Each person has a certain pain sensitivity threshold. Patients with unstable nervous system and psyche, and children react to pain more severely than older patients.

People who were in a state at the time of injury alcohol intoxication, perceive pain less acutely. That's why pain is not the leading symptom in recognizing the nature of the fracture.

Swelling

In most victims, a few hours after the injury, smoothness of the contours of the limb appears. This sign is caused by hemorrhages and impaired microcirculation and lymph. Typically, more pronounced swelling appears in those places where the bone is practically not covered by muscles and there is well-developed subcutaneous fat.

After about 2-3 days, swelling at the fracture site can develop into traumatic edema, which is characterized by diffuse compaction of soft tissues and the appearance of an area of hyperemia. However, these signs are not pathognomonic in the case of differential diagnosis damage.

Hemorrhages

With fractures, victims often experience damage to blood vessels.

Types of hemorrhages during fractures:

Subcutaneous;
Subungual;
Intermuscular;
Subfascial;
Subperiosteal;
Intra-articular.

Subcutaneous hematomas usually occur 15-30 minutes after injury; if the victim has significant subcutaneous fat, then 2-3 hours later. The prevalence of subcutaneous hematoma depends on which vessels were damaged as a result of injury (arterioles, venules, small veins and arteries).

With more severe injuries the victim develops subcutaneous and interfascial hemorrhages. They cause bursting pain in a person and an increase in body temperature. The patient has an increase in the circumference of the damaged area of the limb and a violation of its physiological function.

In some victims, a subcutaneous hematoma may become infected and develop phlegmon (purulent melting of tissue). Subungual hematoma usually occurs with fractures of the distal phalanges of the fingers or toes. Very often, victims experience detachment of the nail phalanx, which is accompanied by intense pain.

Hemarthrosis

Most intra-articular fractures are accompanied by hemarthrosis. Hemorrhage into the joint usually occurs in the first hours after injury and is accompanied by damage to the ligaments and joint capsule. If the victim has excessive accumulation of blood in the joint, this leads to overstretching of the joint capsule, deformation of the menisci and the cartilaginous part of the bones. Hemarthrosis very often leads to disruption of the physiological function of the joint - limitation of active movements.

Limb deformity

Limb deformity occurs when bones are fractured.

The degree of deformation of an arm or leg, as a rule, depends on the length of the damaged segment and the degree of displacement of bone fragments.

So, for example, if the victim has a fracture of the femur, then under the influence of the traction of the gluteal muscles, a “breeches-like deformation” of the bone occurs.

Impaired blood circulation, innervation and lymph flow

In severe injuries of the musculoskeletal system, compression of large blood vessels and nerves occurs with the resulting bone fragments and hematoma. If a blood vessel is compressed or ruptured, the victim experiences pain below the damaged bone segment, which is caused by tissue ischemia processes.

Main clinical signs circulatory disorders in the injured limb are:

Absence of pulsation in the peripheral vessels of the limb;
Change in color of the skin of the limb - blanching;
The appearance of a characteristic “marble” pattern;
Local temperature decreases (the limb is cool to the touch);
Soft tissue swelling develops;
Pain sensitivity in the damaged area disappears completely.

If the victim has an anatomical rupture of the peripheral nerves, as a rule, all types of sensitivity are impaired, a violation occurs motor function. In some patients, the nerves may be compressed by the resulting hematoma, resulting in burning pain, swelling, and limited movement of the limb.

Diagnostics

Anamnesis;
Complaints;
Clinical signs of fracture;
Additional examination methods;
Consultations narrow specialists(neurologist, vascular surgeon, neurosurgeon).

A final diagnosis can be made to the victim only after an X-ray examination of the fracture.

The injured bone is removed in at least two projections with the obligatory capture of adjacent joints. In some cases, the patient needs to undergo a computed tomogram or magnetic resonance imaging.

First aid

Anesthesia (general and local);
Anti-shock measures (restoration of cardiac activity and breathing);
Stop bleeding;
Replenishment of circulating blood volume;
Immobilization of the injured limb;
Prevention of various complications (shock, wound infection);
Transporting the victim to the trauma department of the hospital.

Treatment

There are two main ways to treat fractures:

Conservative;
Operational.

Types and methods of treatment depend not only on the severity of the fracture, but also on which bone was damaged.

Conservative treatment includes;

Reposition of bone fragments;
Immobilization of the limb to fix bone fragments.

After reposition, the traumatologist must choose a method of fixation of bone fragments that not only provides reliable fixation, but also does not cause complications in the patient.

Unfortunately, not all immobilization methods allow the patient to join the rehabilitation process early and contribute to his early activation.

Methods for fixing bone fragments:

Plaster splints;
Plaster casts;
Therapeutic splints;
Skeletal traction method;
Devices for extrafocal transosseous fixation;
Immersion osteosynthesis method.

Surgical treatment is permissible only after stabilization of the patient’s general condition. During the operation, the surgeon fixes the bone fragments using metal structures (wires, plates, bolts).

After a fracture, to speed up the formation of callus, elderly patients and postmenopausal women, as well as patients with signs of osteoporosis, are recommended to take calcium supplements (Calcium - D3-Nycomed, Kalcemin) and multivitamin complexes. IN acute period after an injury and in the postoperative period, the doctor prescribes painkillers and anti-inflammatory tablets and injections to the patient (Nimesulide, Analgin, Tempalgin, Spazmalgol, Meloxicam, Ketorol, Diclofenac).

After injury to reduce pain in the extremities you can use ointments (Ultrafastin, Diclofenac, Voltaren, Ketoprofen, Fastum gel).

Rehabilitation program after fractures

Physiotherapy;
Massage;
Physiotherapy;
Proper nutrition;
Wearing an orthosis;
Spa treatment.

After a bone fracture, the patient during the period of treatment and rehabilitation should eat foods enriched with fat-soluble and water-soluble vitamins and minerals. Must be included in your diet daily foods that contain calcium– eggs, milk, cheese, cottage cheese, vegetables and fruits.

If the patient has an intra-articular fracture or cartilage has been damaged as a result of injury, then medications are prescribed that prevent their destruction (Teraflex, Dona, Alflutop).

Success rehabilitation measures depends on the wishes and efforts of the patient.