Fracture of bones
Contents:
- Description
- Reasons of the Fracture of bones
- Symptoms of the Fracture of bones
- Diagnosis
- Treatment of the Fracture of bones
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see also:
- Shovel fracture
- Clavicle fracture
- Hip neck fracture
- Not growing together change
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Description:
The change is a full or incomplete disturbance of integrity of a bone as a result of influence of excessive force.
Reasons of the Fracture of bones:
Persons with the high level of activity, most likely, are exposed to bigger risk of changes. The children and athletes participating in contact sports enter into this group. Thanks to increase in fragility of a bone with age, elderly people are also included in group of high risk. To 50-year age of the man suffer from changes more often. However, after 50-year age of the woman men are more inclined to changes, than. Specific diseases, the changes leading to increase in risk - Pedzhet's disease, rickets, imperfect bone formation, osteoporosis, cancer and benign tumors of bones, long not functioning of an extremity, for example, after a stroke.
Symptoms of the Fracture of bones:
The change usually is followed by pain which amplifies in attempt of movement of bone fragments. There is a puffiness of the damaged body part. Skin in the field of a change can be pale, on it quite often there are traces of damages. In more hard cases loss of pulse can be lower than the place of a change, for example, in extremities. It is sometimes observed numbness is followed, the pricking or paralysis is lower than the place of a change. The change often is followed by bleeding.
The change usually results from traumatic injuries of bones that leads to disturbance of a continuity of a bone tissue or bone cartilage. Classification of changes includes simple/difficult and incomplete/complete fractures. Simple changes (often called "closed") can not be as explicit as skin is not injured. Difficult changes (usually called "open") are characterized by disturbance of integrity of skin, baring bones and causing additional damages of soft tissues with a possibility of infection. Also changes are classified on single and multiple if there was a simultaneous injury of several bones. Unlike a complete fracture, the incomplete change, or a change as "bent", is characterized by partial injury of a bone tissue. This type of a change often is result of the mediated impact on a bone.
Additional classification of a change includes the description of the line of a change. Thus, linear, slanting, cross, longitudinal and spiral changes meet. Besides, an injury can be classified as a dislocation-fracture.
Linear changes it is characterized by disturbance of integrity of a bone tissue which takes place parallel to the main axis of a bone. For example, the linear fracture of a bone of a forearm can extend on all length of a bone. Inclined and cross changes differ in the fact that the line of a change crosses a bone approximately at an angle 45 ° to a bone axis. Unlike a cross change, the line crosses a bone axis at an angle 90 °. The longitudinal change is similar to linear cracks. Its line of a change passes along a shaft, but has irregular shape and does not pass parallel to a bone axis. Spiral changes are described as crossing of a bone under a slanting corner in the form of a spiral. This change is usually observed in long bones of a body, such as humeral or a femur.
The smashed changes are characterized by existence of the 2nd and more bone fragments adjacent to upper or bottom edge of a change. Changes at which splinters of bones keep the physiological situation are described as changes without shift. However bone fragments can be displaced under the influence of external force, and also due to reduction of muscles or resistance of sheaves.
People of all age and nationalities are exposed to changes. However the majority of changes are registered at children owing to their increased activity level; also among elderly people in connection with insufficient consumption of calcium and development of osteoporosis.
Diagnosis:
It is possible to suspect a change according to the characteristic anamnesis (falling, an injury, blow) and complaints of the patient. Fezikalny survey of the doctor practically always suggests an idea of a change. For reliable diagnosis the radiographic method is used. The place damage should be inspected radiographic in 2 projections. It is required since not all changes are visible in a direct projection. It is difficult to define some changes, and several pictures in different foreshortenings can be required to see accurate lines changes. It is in certain cases reasonable to use KT, MPT or other diagnostic procedures. Happens that symptoms of a fracture at the typical anamnesis and complaints are not found in children on primary x-ray film. In these cases it is necessary to repeat inspection 7-14 days in time.
In case of suspicion on microcracks of a bone carrying out the simple test by means of a tuning fork is possible. The tuning fork represents the metal tool with a stalk and two teeth which vibrate at blow. If the patient notes strengthening of pain when the tuning fork is put on a bone (tibial or femoral), then the probability of existence of microcracks is high. Also scanning of a bone is carried out. For this diagnostic procedure radioactive isotope is entered into a blood stream, and images of specific areas or all skeleton are visualized by means of KT or MPT.
Treatment of the Fracture of bones:
Treatment depends on type of a change, its weight, age of the person and the general state of health of the person. If the open change is followed by serious damage of soft tissues, it is necessary to take measures for a stop of bleeding and stopping of shock which can be observed at a loss of blood.
First aid consists in overlaying of the tire, control of a loss of blood and monitoring of the vital functions, such as breath and blood circulation.
The main objective of an immobilization consists in prevention of further shift of bone fragments and providing their adequate union. For an immobilization tires are more often used. It can be the main and only procedure for treatment of changes. The tire should be imposed carefully, without causing additional pain and without displacing bone fragments.
Treatment of microcracks consists in reduction or the termination of any activity which provokes or strengthens pain.
Reposition of bone fragments is a procedure by means of which bone fragments are returned to normal situation. This procedure can be closed or opened. The closed reposition is made without disturbance of integrity of integuments and carried out manually using anesthesia. Open reposition is an operation, peculiar "assembly" of bone fragments. With the purpose to correct bone deformation extension which is one of forms of the closed reposition and can be used as an alternative to surgical intervention is used.