What Is a Simple Fracture?

A fracture is a complete or partial break in the continuity of the bone structure. More common in children and the elderly, young and middle-aged people also happen from time to time. Patients often have fractures at one site, and a few have multiple fractures. After timely and proper treatment, most patients can restore their original functions, and a few patients can have sequelae of varying degrees.

Basic Information

English name: fracture
Visiting department: orthopedics
Multiple groups: Children, elderly

Common causes: Direct and indirect violence, cumulative strain
Common symptoms: Deformity, abnormal activity, bone fricatives, or bone abrasion
Contagious: no

Cause of fracture

There are three main reasons for fractures:

Direct violence

Violence directly acts on a certain part of the bone and causes a fracture of the part, causing fractures to the injured part, often accompanied by soft tissue damage to varying degrees. If the wheel hits the lower leg, a fracture of the tibiofibular shaft occurs at the impact.

2. Indirect violence

Indirect violence causes longitudinal fractures, leverage, or torsion to cause distant fractures. For example, when the foot is dropped from a high place, the trunk flexes forward due to gravity, and the vertebrae at the thoracolumbar spinal column undergo compression or compression. Burst fracture.

3. Accumulated strain

Long-term, repetitive, minor direct or indirect injuries can cause fractures in a specific part of the limb, also known as fatigue fractures, such as long-distance walking, which can easily cause fractures of the second, third metatarsal bone and the lower 1/3 of the fibula.

Clinical manifestations of fractures

Whole body performance

(1) Shock For multiple fractures, pelvic fractures, femoral fractures, spinal fractures, and severe open fractures, patients often suffer shock from extensive soft tissue injury, extensive bleeding, severe pain, or concurrent visceral injury.

(2) Fever There is a large amount of internal bleeding at the fracture, and the body temperature slightly increases when the hematoma is absorbed, but generally does not exceed 38 ° C. When the temperature of the open fracture increases, the possibility of infection should be considered.

Local performance

Local manifestations of the fracture include the characteristic signs of the fracture and other manifestations.

3. Specific signs of fracture

(1) Malformation The displacement of the fracture end can change the shape of the affected limb, which is mainly shortened, angled and prolonged.

(2) Abnormal activity Normally, the limb cannot move, and abnormal movement occurs after the fracture.

(3) Bone fricative or abrasive feeling After the fracture, the two fracture ends rub against each other to produce a bone fricative or abrasive feeling.

As long as one of the above three signs is found, the diagnosis can be confirmed, but those who do not see these three signs can not rule out the possibility of fractures, such as impact fractures, fracture fractures. These signs should not normally be checked for diagnosis, as this can aggravate the injury.

Fracture examination

1. X-ray inspection

X-ray films should be routinely performed for those suspected of fractures, which can show incomplete fractures, deep fractures, intra-articular fractures, and small avulsion fractures that are difficult to find clinically, even if the clinical manifestations are obvious. , X-ray film examination is also necessary, you can understand the type and specific situation of the fracture, which has guiding significance for treatment.

X-rays should include front and side radiographs, which must include adjacent joints, and sometimes additional X-rays of oblique, tangential, or corresponding parts of the healthy side.

2.CT inspection

CT examination can be performed for those who have unclear fractures but cannot be ruled out, those with spinal fractures that may compress the spinal nerve roots, and those with complex fractures. Three-dimensional CT reconstruction can perform fracture classification more intuitively and conveniently, which is very helpful for the choice of treatment options. It is currently commonly used in clinical practice.

3.MRI examination

Although the fracture line display is not as good as CT examination, it has unique advantages for the display of spinal nerve root and soft tissue injury. It has been widely used in the examination of spinal fractures.

Fracture diagnosis

The diagnosis can be confirmed or excluded based on clinical manifestations and imaging studies.

Fracture treatment

The typical manifestations of fracture patients are local deformation after injury, abnormal movement of limbs, etc., and bone fricatives can be heard when moving limbs. In addition, the wound was severely painful, with local swelling and congestion, and dyskinesia occurred after the injury.

The ultimate goal of treating a fracture is to maximize the function of the injured limb. Therefore, in the treatment of fractures, the three basic principles of reduction, fixation and functional exercise are very important.

Reset

It is to restore the fractured stump that has been displaced after the fracture to normal or close to the original anatomical relationship to restore the stent effect of the bone. The reduction methods include closed reduction and surgical reduction.

2. fixed

After the reduction of the fracture, it is easy to reposition due to instability, so different methods should be used to fix it in a satisfactory position to gradually heal. Common fixing methods are: small splint, plaster bandage, external fixing bracket, traction brake fixing, etc. These fixing methods are called external fixing. If it is fixed by a surgical incision with a steel plate, steel needle, intramedullary needle, screw, etc., it is called internal fixation.

3. Functional exercise

By contracting the muscles of the injured limb, increasing blood circulation around the fracture, promoting fracture healing, preventing muscle atrophy, and actively or passively moving unfixed joints, preventing joint adhesion and joint capsule contracture, so that the function of the injured limb can be restored as soon as possible. Normal condition before fracture.