Open and closed fractured legs: symptoms

What is a closed fracture? Closed fracture with displacement. First aid for fractures

What is the difference between a closed fracture and an open fracture? The answer to this question will be found in the materials in this article. In addition, we will tell you what kinds of fractures exist, how they differ, what first aid should be given to the victim.

general information

A closed fracture is a partial or total violation of the integrity of the bone.

Typically, this occurs with a load that significantly exceeds the strength of the traumatized portion of the skeleton.

Such a pathological condition can be observed both as a result of trauma and as a result of various diseases accompanied by changes in the composition of bone tissues.

Severity of patient's condition

The health hazard of the patient with open and closed fractures is determined by the size of the damaged bones, as well as by their number.

If, as a result of the injury, large tubular bones are destroyed, this often leads to traumatic shock and heavy blood loss.

It should be noted that after such a fracture the patients recover very slowly. Their recovery may take several months.

Classification of fractures

In medical practice, fractures are classified according to several criteria. As a rule, they are associated with the localization of injuries, the cause of the occurrence, direction, shape, severity, etc.

However, immediately after the fracture, the first thing experts pay attention to is whether it is closed or open.

After all, it is the integrity of the skin that first of all catches the eye not only to the traumatologist, but also to the injured.

Open, closed fracture

There are two main types of fractures:

• Open. Such a fracture is accompanied by damage not only to the bones, but also to a violation of the integrity of the soft tissues that communicate with the external environment.
• Closed. This form is considered easier than open. This is due to the fact that damage to only bone tissue is characteristic for such a fracture. And the skin, ligaments, muscles, etc. remain intact.

Despite the fact that the closed fracture is considered an easy form of injury, it is mistaken to believe that it can not be treated. After all, the consequences for the victim can be extremely unpleasant.

Diagnostics

Diagnosing closed fracture is much more difficult than open.

It should also be noted that with minor trauma (for example, in the case of a crack without displacement), it is not immediately possible to detect pathology.

After all, injured people very often write off the pain caused by a fracture, for an ordinary bruise. That's why you should know the signs that are characteristic of such a trauma.

Symptoms of closed fracture

If you received a closed fracture of the ankle, brush, etc., then, most likely, you will exhibit the following symptoms:

• severe pain in the area of ​​injury;
• swelling;
• deformation in that part of the limb, where a fracture is suspected;
• characteristic crunch in the injured area;
• complete immobility or restriction in movement (in the event that the joint is damaged);
• hematomas;
• movement of bones where there is no joint.

It should be specially noted that with closed fractures, not all symptoms can be observed simultaneously. In this regard, for the final diagnosis, you must always consult a traumatologist and take an X-ray.

By the way, signs of closed fracture of the hands and feet are particularly prominent among the rest.

After all, in this case, the victim can almost immediately understand that serious damage has occurred.

This is due to the fact that, for example, with fractures of the bones of the lower extremities, the support to the injured leg is practically impossible.

Severity of defeat

The complexity of fractures can be:

• without bias;
• with offset.

Of course, a closed fracture without displacement is the easiest degree of damage. After all, with this form, the surrounding tissue is not destroyed by splinters of bones. Moreover, after receiving such an injury, the patient is restored in the shortest possible time.

Closed fracture with displacement occurs today very often. For such a deviation is typical displacement of fragments of bones in different planes.

It should be noted that such trauma is the most difficult.

After all, pointed bone pieces quite easily damage surrounding soft tissues (ligaments, muscles, vessels), which causes severe hemorrhage.

Especially dangerous is a fracture with a shift in the chest area. After all, fragments of ribs and other bones can attach to vital internal organs, which eventually leads to death.

Main symptoms of fracture with displacement

Closed fracture with displacement significantly differs from similar damage, but without the movement of fragments of bones in different planes. Thus the patient can observe at itself:

• growing dull or sharp pain;
• swelling at the site of injury;
• deformation of the joint;
• unusual position of the damaged part of the body;
• painful sensations during palpation;
• free sagging of the joint (for example, arms, legs, etc.).

Closed fracture: first aid for the injured

The main help to the injured with suspicion of a closed fracture is the immobilization of the damaged area of ​​the body. This is necessary to ensure that no complications arise in the process of transportation to the hospital.

So how should you act if your loved one supposedly has a closed fracture? The first help in obtaining such an injury should be the imposition of a temporary tire on the affected area.

In this case, your actions should be very cautious. After installation, the tire must be fixed using any fabric, and the bandage should not be tightened too tightly.

What can be used as a tire? In the absence of special medical devices, any suitable long hard objects (for example, a board, ruler, stick, etc.) can be used. It is desirable to impose tires on both sides of the damaged area.

As is known, closed fractures of bones are always accompanied by swelling. In this regard, experts recommend that for a while, apply a cold compress to the sore spot.

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If the injured person is injured at home, such a cooling agent may serve as a a piece of meat from the freezer or ordinary ice, which should be pre-wrapped in towel.

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In the event that the patient experiences severe pain, it is recommended that he give an anesthetic.

Treatment of closed fracture

Closed fracture fracture represents the most difficult degree of injury. Typically, this damage requires immediate surgical intervention to extract the fragments.

If, in case of severe trauma, there is no operation to remove the pointed bones that literally rupture soft tissues, then the patient can develop a severe hemorrhage, which in the future will lead to suppuration of internal wounds and, as a consequence, amputation.

If the injury is simple, but still there is a displacement, then parts of the bones necessarily combine. This procedure should be performed only by an experienced traumatologist.

Upon completion of the operation, a gypsum is applied to the damaged area of ​​the body, which will serve as a fixative for the fracture and significantly reduce the likelihood of additional trauma.

Very important in the rehabilitation period is the daily development of the damaged limb by means of metered loads. In addition, for the fastest fusion of the bones, the patient is prescribed drugs containing calcium and other macro- and microelements.

Let's sum up the results

A closed fracture with or without bias should be confirmed with objective data such as an X-ray. In addition, it is necessary to undergo a survey by a surgeon.

If the victim has a closed fracture with a displacement of fragments of bones, then this requires repositioning. As a rule, such a procedure is performed under local anesthesia.

It is extremely important that it be carried out by a professional. Otherwise, mismanagement will lead to such irreversible complications as loss of important limb functions.

A source: http://.ru/article/146405/chto-takoe-zakryityiy-perelom-zakryityiy-perelom-so-smescheniem-pervaya-pomosch-pri-perelomah

Signs of a fracture

A fracture occurs when the integrity of the bone is broken due to trauma.

Many types and signs of fractures are easy to detect on the spot, without the help of a specialist, however, some of them are cunning in that immediately the victim may not understand that he and medical help is urgently needed: he continues to lead the old way of life, experiencing insignificant pain and limited movement, believing that a strong injury.

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

Clinical signs of fractures

Depending on the type of fracture, its signs can be divided into reliable ones - those that leave no doubt that, that the bone is deformed from the impact, and the relative ones are those that can cause doubts: there is a fracture or injury.

Reliable signs of fractures:

1. Unnatural position of the arm or leg (if it is a sign of fracture of the limb).
2. Mobility of the broken part in the place where there is no joint.
3. Audibility of the crunch.
4. With an open fracture in the wound, bone fragments are visible.
5. Shortening or lengthening of the injured area.

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

Relative signs of fracture:

1. Painful sensations in the place of fracture when immobilized or during movements. Also, if you make an axial load, the pain increases (for example, if you knock on the heel with a shin fracture).
2. Puffiness at the site of the fracture can occur quickly (within 15 minutes after injury) or develop for several hours. Along with this, such a symptom has an insignificant role in determining the fracture, because it accompanies other types of damage.
3. Hematoma. It may be absent, but often still occurs at the site of the fracture, with not always right away. If it pulses, then the bleeding continues.
4. Limitation of mobility. As a rule, the damaged part can not function either completely or partially. If there was a fracture not of the limb, but, for example, of the coccyx, the person will feel difficulty walking, those. there is not only a restriction in the function of the damaged part, but also those that come into contact with it.

The presence of these signs can not speak with 100% probability of a fracture, but many of this category accompany any fracture (pain, swelling, restriction in movement).

Signs of closed fracture

All fractures are classified into open and closed fractures. The latter is diagnosed much easier than the first without an X-ray and the help of a specialist.

Closed fracture is not accompanied by soft tissue damage: in this case, the bones and joints that can change the position (the so-called fracture with displacement) or simply lose integrity: split (so-called comminuted fracture), while retaining the former position.

The first signs of a fracture are pain in the area of ​​damage and edema. Movements are limited, cause pain, and bone movement may not occur in the joint region (depending on the site of injury). Often formed a hematoma.

Finally, to make sure that there is a closed fracture can only be using X-rays.

Signs of an open fracture

An open fracture is a heavier injury than a closed one. in this case, in addition to damage to the bone tissue also lose integrity.

This can be due to external influences (in case of an accident, or a limb entering a moving mechanism in production) or because a broken bone itself damages the tissues.

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

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A source: http://WomanAdvice.ru/priznaki-pereloma

First aid: open and closed fracture, trauma

Fracturesconsider a complete or partial violation of the integrity of the bone.

The reasons are usually a fall from the height of their own growth, a fall from a great height (catatrauma), auto-trauma, less often blows by massive objects or compression by structural elements of a collapsed building.

Fracturesare open and closed.
Signs of closed fractures(Fig.

51) - pain, which is amplified by the movement of bruising in the fracture region, the disturbance of the functions of the damaged limb is not natural mobility at the fracture site partial deformation of the damaged limb crunch at the feeling of the fracture site change in length extremities.

Abnormal mobilityand a crunch can be detected with a careful feeling of the limb during the examination of the victim.

You can notpurposefully look for these signs, causing pain to the victim!
With open fracturesIn addition, there may be another wound at the fracture site, in which bone fragments can be seen (Fig. 52) bleeding from a wound with damage to blood vessels.

If there is any injury in the area of ​​the alleged injuryshould be considered a fracture open!

Signs of dislocations

Dislocationcalled the displacement of the joint ends of bones, which violates their mutual contact.

Dislocations and fractures have many common signs, so suspect the worst, hoping for the best: in the presence of pain and limb function after injury, you should consider that this is a turning point!

First aid

At the heart of the first aid is supposed transport immobilization -limb.

Immobilization is used not only for fractures of bones and joint damage, but also for extensive soft tissue damage, inflammatory processes of the extremities, injury of large vessels, extensive burns.

Transport immobilization- a temporary measure that is performed only to deliver the victim to the hospital, it is of great importance for the life of the victim and for the outcome of the injury.

Transport immobilization is carried out either by improvised means (board, cardboard).
In the absence of tires, it is possible to perform autoimmobilization, firmly pribintovav injured arm to the trunk, and the leg - to a healthy leg (photo 98).

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In addition to immobilization an important role is played by the simplestanesthesia in accessible ways. The intensity of pain is reduced both by immobilization itself, and by careful manipulation of the injured limb and local cooling.

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Absolute contraindicationsto the admission of any medicinal products inside are absence or confusion of consciousness, concomitant trauma of the abdomen. The task of the caregiver is to translate the severe pain into something that can be tolerated.

It should be remembered that whenopen fracturesin the first place, the bleeding stops, and immobilization is performed only when the bleeding is stopped and the wound is closed with a sterile bandage.

First aid for closed fractures:- call an ambulance. - See the victim. - evaluate the pulse. - try to inject finiteness of the least painful position. - perform transport immobilization with the help of improvised tires.

- Apply "cold" to the area of ​​injury. - Before the arrival of emergency medical care to monitor the condition of the victim.

First aid with open fractures:

- to call an ambulance. - to stop heavy bleeding by finger pressing of the artery above the wound, to apply a hemostatic tourniquet. - to impose a sterile bandage on the wound. - Evaluate the pulse. - Perform an examination to exclude other injuries. - Give the limb the least painful position. - If not determined or poorly defined pulse on the wrist: raise the end of the improvised stretcher (healthy leg with a fracture of the lower limb) to a height of 30-45 cm- perform transport immobilization with help of improvised tires. - Apply "cold" to the area of ​​trauma. - Before arrival of emergency medical services, monitor the condition the victim.

With open fracturesThe limb should be fixed in the position in which it is located!

Bony fragments sticking out of the wound, do not set!

Pressing bandageDo not apply on the wound!

A source: http://sajt-spasatel.ru/meditsinskaya-podgotoa/pervaya-pomoshch-pri-perelom-i-travma.html

Broken leg

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• Fracture of foot: important information
• Signs of fracture of the leg
• Diagnosis and treatment of fractures
• The process of rehabilitation during and after treatment

Fracture of the leg is a violation of the integrity of the bone when providing a load or a mechanical effect exceeding its strength.

The occurrence of fractures is caused both by trauma of a certain area, and by the presence various pathologies and diseases that can reduce the strength of bone tissue and make it more vulnerable.

The recovery process in such cases is rather slow and depends on the nature damage, the course of the disease and the general condition of the victim, including the ability of bone tissue to fuse.

Fracture of foot: important information

In fact, bone fractures are not rare in wildlife, and the methods of treatment and recovery are well studied and successfully applied in practice.

According to historical data, these diseases were cured even in primitive society.

As for the present time, traumatologists and surgeons have perfected their skills with the help of modern medical equipment, which makes it possible to see improperly fused bone tissue.

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In medical practice, there are several types of fractures, each of which is characterized by the area of ​​localization, the nature of the damage and the final presence of altered tissues. Among all types the most common:

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1. Compression fractures are those that are small cracks resulting from constant exposure to the feet. This type of fracture is the most characteristic for professional athletes.
2. Fracture of the leg without displacement. It is characterized by additional damage to tissues surrounding the broken bone without displacement.
3. Fractures with the presence of displacements. If damaged, the broken part of the bone is displaced relative to the second part.
4. Splintered fracture of the leg is characterized by the destruction of damaged bone into several parts - fragments.
5. An open fracture is a fracture of a complicated type with breakouts outward.

As for the foot, each of them consists of bones:

• femur;
• patella or patella;
• tibia;
• tibia small.

The appearance of fractures in the preparation of injuries of different origin is characterized by the following relative symptoms and signs:

1. Increased pain at the site of the fracture with an axial load on the leg.
2. The gradual appearance of puffiness on the foot in the affected area - this criterion is relative and, as a rule, does not carry clarifying information regarding the presence of a fracture.
3. Hematoma at the site of damage also occurs after a certain time. Each victim manifests itself in different ways. Hematoma of a pulsating nature indicates the presence of bleeding.
4. Limitation of mobility for violations of the functional characteristics of the legs in fractures, characterized by the temporary inability to provide any burden on the injured leg.

Depending on the degree of severity, in addition to the relative signs of fractures, absolute ones are added:

• The wrong position of the foot, which has obvious deviations from the natural appearance;
• mobility of the limb in the unintended legs of the skeleton without the use of joints;
• sensation of crunch when probing on the site of damage, which has a name in medical terminology - crepitation;
• The presence of fragments of bones, which can be seen with an open fracture.

The causes of leg fractures can be very different, but they all characterize the reception of bone injuries with their visible damage and a violation of the integrity of the structure.

Factors of the appearance of fractures include gunshot wounds, various household and industrial injuries, as well as injuries sustained as a result of playing sports.

Treatment of leg fractures, as a rule, is prescribed after the diagnosis of diseases.At the present stage, under ordinary circumstances, in almost every case, radiography is assigned.

When receiving pictures in the direct and lateral projections, the probability of establishing an incorrect diagnosis is reduced to a minimum, because they allow you to visually see the presence and nature of the fracture and decide on the adoption measures.

Conducting treatment involves bringing the damaged bones of the legs into the correct position with the obligatory subsequent fixation.

In most cases, as a first aid is the taking of pain medications through a dropper or inhalation mask, as well as providing limb immobility through a tire.

After determining the nature of the fracture, doctors are given the opportunity to take further measures. In the case when there is a fracture without the presence of displacements and edema, the treatment is limited to the imposition of a plaster bandage.

When the leg is swollen, a tire is applied.

When it is carried out, the patient may be assigned a local or general anesthesia, which completely lacks pain.

After the bones are brought to the correct position, the patient is obliged to impose a cast.

Some serious leg fractures require surgical intervention with subsequent internal fixation of the bone with the help of spokes, plates, screws or twigs.

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Metal structures can be subsequently removed or left in the foot in the event that they do not cause feelings of discomfort and are the main fixators and substitutes for lost or broken areas of bone tissue.

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In very rare cases, an external frame is used with the possibility of fixing bones in the desired position with the help of bolts, which are subject to mandatory removal after splicing.

Conducting a surgical operation provides for mandatory subsequent application of a plaster bandage to provide the possibility of proper splicing of the bones of the legs.

The splicing process will take place under the periodic supervision of an orthopedic traumatologist. Usually, the first examination is assigned to patients one or two weeks after the application of the gypsum.

However, after the removal of the bandage, many patients need further examinations during the control X-rays for some time.

Many people will be shown to use crutches or a wheelchair when moving to the healing of leg fractures. Use support equipment with safety.

Duration of treatment in each case is different. Small closed fractures without dislocations heal usually during 7 months.

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However, complicated damage may take more time to achieve full recovery.

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The rehabilitation process includes a number of physiotherapy procedures and exercise exercises, which can be shown to the patient before and after the removal of gypsum.

It is very important to follow the prescriptions of the attending physician and immediately apply to him in case of any issues related to the condition of the foot.

These measures are aimed at restoring the muscular activity, flexibility and mobility of the injured limb.

A source: http://ortopedia03.ru/perelomy/perelom-nogi.html

What is a closed fracture, its signs and methods of treatment

Closed fracture is the incomplete or complete destruction of any bone in the human skeleton without damaging the soft tissues.

Such damage happens because of the increased traumatic impact on the injured bone, with intense pressure on it or because of a disease that is called osteoporosis.

With its presence, the strength of bone tissue deteriorates significantly, and it breaks down even with a weak mechanical action. Most often, bone fractures occur in medical practice.

With the timely provision of first aid and fast follow-up hospitalization, there are enormous chances of a complete and complete rehabilitation of the injured bone.

Closed fractures of the bones can undergo conservative and operative treatment.

The choice of therapy is determined by the doctor and depends on the nature and severity of the damage.

Classification

Fracture of closed arm with displacement of fragments

A closed fracture can be with the displacement of bone fragments and without it. The causes of trauma can be mechanical and pathological, and the severity of such injuries can be severe, medium and light.

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

• transverse;
• oblique;
• longitudinal;
• screw-like;
• comminuted and multi-lobed;
• nailed;
• wedge shaped;
• compression.

Accompanied with an injury may be present:

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

The above signs of fracture indicate a complicated fracture.

Causes

The causes of the manifestation of trauma can be pathological and appear as a result of a minor impact on the area of ​​trauma. The reasons may be:

• tuberculosis of bone;
• tuberculosis;
• osteoporosis;
• osteomyelitis;
• The bone is more delicate because of surgical interventions;
• bone cyst;
• some chronic diseases of a severe degree.

In the case of a traumatic fracture, their occurrence is the result of increased impact. Most often, injuries occur in the winter season in people who have reached advanced age and in people engaged in extreme sports. Also the reasons can be:

• road accidents;
• direct or indirect impacts to the area of ​​damage;
• industrial injuries;
• strong pressure;
• non-compliance with all possible safety rules;
• falls on the upper or lower limbs.

First signs

Closed fractures have symptoms that indicate this type of injury:

• painful sensations in the area of ​​damage - more often during movement or load or palpation, they become worse;
• deformation of the injured place - in the case of broken limbs, they lengthen and acquire a different shape, if another trauma occurs - the bone can create an "bulging out" effect;
• reduced motor activity - a person with a fracture often can not perform ordinary functions, in case of severe fractures, the victim can not move at all;
• formation of hematomas - external manifestations of internal bleeding;
• the appearance of puffiness of the damaged area - occurs due to disruption of the local microcirculation and lymph drainage;
• hemarthrosis - occurs as a result of trauma to the joints and ligaments;
• crepitation - a crunch when the damaged bone moves.

Now you know what are the signs of a closed fracture of bones and at their first manifestations you need to seek help from medical institutions.

First emergency aid

Knowing what to do with a closed fracture, you can significantly improve the quality and effectiveness of subsequent treatment.

The first aid varies depending on the location of the injury, but first of all, you need to call an ambulance and take care of the immobilization of the victim.

To fix the upper limbs (picture on the right), use a bandage or a headscarf that fastens the arm relative to the torso.

In the case of more serious fractures, the first aid is as follows: the victim is placed on a firm and flat surface, and, without doing anything, wait until the doctors arrive and transport themselves patient.

If the circumstances do not allow and move the patient, then by their own efforts do the following-extremely cautious man fix bandages or any ropes around a hard surface and extremely gently carry it to the desired place.

In case of a fracture with a displacement, in no case should one try to independently compare the bone fragments.

Methods of diagnosis

Closed fracture is diagnosed in several ways. The first thing the doctor does is interview the patient. The essence of the survey is to understand the cause of the injury and an approximate determination of the nature of the damage, based on the first of its symptoms.

The next stage of diagnosis is palpation. Thanks to this procedure, a trauma doctor can understand if a displacement of fragments is present. Further, for an accurate diagnosis, radiography is used in two projections.

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After studying the pictures, the doctor can make a final diagnosis and prescribe the most suitable treatment.

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In some cases, diagnostics may be necessary using computed tomography, ultrasound and arthroscopy.

Therapeutic tactics

Closed fracture can be treated in two ways:

• conservative method;
• operative method.

If there was a fracture of the bones of mild severity, without displacement or the patient is contraindicated in surgical intervention - a conservative method of treatment is used. It consists in a strong repositioning of bone fragments and subsequent fixation of the injured area.

Bone comparison, for a less painful and effective result, is performed with local anesthesia.

After reposition, limbs or other damaged areas of the body are impregnated with gypsum, special bandages or other fixation items.

Operative method - this treatment is considered the most effective.

With its use, bone regenerates much faster, and physical exertion becomes possible much earlier than when treated conservatively.

The essence of surgical intervention is that bone fragments are fixed with the help of special metal objects. It can be:

• plates;
• screws;
• nails;
• pins;
• knitting needles.

Under local anesthesia, the surgeon fixes bone fragments with the help of the aforementioned devices and after the operation of the limb or other injured areas are also subjected to fixation. Light physical exertion is resolved earlier than when treated in a conservative way. The term fixing the injured part is prescribed by the doctor, relying on the diagnosis.

During the entire treatment period and after the beginning of the rehabilitation period, the victim must perform a number of special, developing exercises and attend the prescribed procedures of massage and physiotherapy. This will help make bones more mobile and prevent muscle atrophy.

Possible consequences

Injury of bones should be diagnosed and cured in a timely manner, otherwise a closed fracture may be accompanied by such complications:

• chronic pain in the area of ​​trauma;
• visual deformation of the damage site;
• incomplete fusion of bone fragments;
• complete or incomplete deterioration of working capacity;
• the onset of thrombosis;
• the appearance of decubitus;
• formation of false joints.

A source: https://PerelomaNet.ru/perelomy/priznaki-zakrytogo-pereloma.html

Fractures of the legs

Fracture of the foot is a common trauma to the lower limb. It is accompanied by a violation of the integrity of the bones under the influence of a traumatic force, which exceeds the strength of bone tissue.

Fracture of the hip occurs in road accidents and accidents at work, deformation of the bones of the shin and foot appears due to a fall from the height.

Damage to the knee joint is more often recorded in athletes, hip - in the elderly, ankle - with awkward foot movements.

Fractures in the area of ​​the lower extremities lead to impaired motor activity and, if untimely or inadequate treatment can lead to disability.

Causes

Fractures occur with the impact of a traumatic force that exceeds the strength of the bone. Deformation of healthy bones occurs as a result of the application of high-intensity force and is called a traumatic fracture.

Such injuries occur in 90% of cases. Pathological processes in the bones cause a weakening of strength and resistance to traumatic factors, which contributes to the appearance of pathological fractures.

Such injuries occur in 10% of cases due to low-intensity force.

The causes of traumatic fractures of the lower extremities:

• blow with a blunt object;
• falling to the feet from a distance above their own growth;
• unsuccessful landing during the jump;
• tucking in the leg;
• twisting of the foot with a fixed foot;
• road accidents;
• gunshot wounds;
• birth trauma in newborns.

Damage to the bones of the lower limbs often occurs when falls

Causes of pathological fractures:

• violation of osteogenesis during intrauterine development;
• osteomyelitis;
• tuberculosis of bones;
• osteoporosis;
• primary or metastatic tumors in the bones;
• fibrotic dysplasia.

Classification

Classification of fractures of the lower extremities was created to identify the specific trauma, the definition of therapeutic tactics and the prognosis of the disease.

According to the reports of bones with the external environment, fractures are distinguished:

• open - characterized by the formation of a skin defect (wound) over the area of ​​injury;
• closed - are not accompanied by damage to the skin.

An open fracture of the foot refers to a severe trauma and is accompanied by a primary infection of the wound, which can lead to the development of osteomyelitis and sepsis.

Fractures can occur with a hemorrhage into the joint, a lesion of the integument of the body, a displacement of bone fragments

By displacement of fragments of bone, a closed fracture is distinguished:

• with displacement - bone fragments move to the sides from the physiological longitudinal axis;
• without displacement - bone fragments do not change their physiological position.

An open fracture of the foot is always accompanied by a displacement of the ends of the damaged bone.

On the localization of the fracture line, fractures occur:

• diaphyseal (in the region of the middle part of the tubular bones);
• metaphyseal (near the joints);
• epiphyseal (in the joint cavity).

In the direction of the line of bone damage, fractures are distinguished:

• transverse,
• nailed,
• slanting,
• longitudinal,
• helical-shaped.

On the formation of fragments, fractures are distinguished:

• cloven (the formation of 1-3 fragments);
• fragmented (the formation of more than 3 fragments);
• shallow-furred;
• coarse-grained.

Splinter damage and fracture with a shift are attributed to severe bony injuries, which are often complicated by muscle contraction, damage to blood vessels and nerves of different calibers. The child develops fractures of the lower limbs as a "green branch".

They represent a crack in bone tissue without disrupting the integrity of the periosteum.

In childhood, bone lesions in the growth zone (epiphiseolysis) are characteristic, which can lead to a halt in the growth of the lower limb and its shortening compared to a healthy leg.

Clinical picture

Fractures of the legs, like other skeletal injuries, are characterized by clinical signs, which are divided into reliable (absolute) and probable (relative).

Reliable symptoms indicate a bone fracture without additional diagnostic methods.

Probable - can only be suspected fracture and occur in other types of injuries of the lower limbs (bruise, sprain and ligament rupture).

Deformation of the leg in case of damage to the lower leg bones

Reliable signs of fracture of the lower extremities:

• change in leg length as a result of bone displacement;
• the formation of a wound at the bottom of which the edges of the damaged bone are determined;
• pathological mobility of the leg or limb movement in an uncharacteristic location (outside the joint);
• crepitation (crunching of bone fragments) when feeling the area of ​​injury or movements of the injured limb.

Probable symptoms of fracture of the lower extremities:

• pain of high intensity at the time of injury;
• pain syndrome increases when trying to lean on the leg or when moving with the lower limb:
• deformation of the leg in the area of ​​injury (due to displacement of bone fragments, formation of edema or hematoma);
• edema and hematoma within an hour after injury;
• impaired sensitivity below the injury site in case of nerve damage;
• deterioration or cessation of motor function of the foot;
• hemorrhage in the joint (hemarthrosis) with violation of the integrity of the intraarticular surfaces of the bones.

Edema and hematoma with ankle injury

The first and permanent symptom is discomfort in the area of ​​bone damage. The leg hurts at rest and during movement, the intensity of the pain syndrome depends on the severity of the trauma and the development of complications. Inflammation in the fracture region leads to intoxication of the body.

The body temperature rises, there is a chill, there is weakness and drowsiness, muscle aches, appetite decreases. Swelling of the leg after fracture depends on the severity of soft tissue damage and the caliber of the damaged blood vessel, which leads to the formation of a hematoma.

First aid

First aid for a fractured leg should be given immediately after the injury to prevent blood loss, occurrence of hemorrhagic and traumatic shock, displacement of damaged bone ends and damage to soft tissues. After an injury, an ambulance team should be called urgently.

Treatment and prophylactic measures at the prehospital stage include:

• stop bleeding;
• aseptic treatment and application of a gauze dressing in the presence of a wound;
• general and local anesthesia;
• transport immobilization.

With external arterial bleeding, which is accompanied by the flow of scarlet blood "fountain put a tourniquet above the site of damage to the vessel.

For external venous bleeding with a weak jet of cherry color, a pressure bandage bandage is applied to the wound. A packet of ice is placed on the place of formation of the hematoma.

The limb swells much less when using cold.

Overlap of transport buses

With an open fracture of the edge, the wounds are treated with an antiseptic (iodine, hydrogen peroxide, chlorhexidine) and a sterile bandage is applied.

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Anesthesia is carried out with narcotic (omnopon, morphine hydrochloride) or non-narcotic (ketones, tempalgin, ketotifen) analgesics.

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When blood loss prescribed infusion therapy (Ringer's solution, glucose, saline).

Transport immobilization is carried out with the help of standard tires: Cramer, Diterichs, pneumatic, vacuum.

Transport immobilization fixes the injured limb in a stationary position and prevents the development of complications on the way to the hospital.

Diagnosis and treatment

To confirm the fracture, determine the nature of the lesion and identify fragments, assign a radiograph of the leg in a straight and lateral projection.

In doubtful cases, a computerized tomography is performed, primarily with intra-articular fractures.

Determine the damage to soft tissues (nerves, muscles, vessels, fascia) by means of magnetic resonance imaging.

Treatment of fracture of the leg is carried out conservatively and operatively. Conservative therapy includes the imposition of bandages from gypsum and skeletal traction.

Treatment with gypsum is used in the case of leg fractures without displacement or with a slight displacement (not more than a third of the width of the bone), in childhood.

Also, gypsum is used after skeletal traction and hardware osteosynthesis for effective consolidation of bone fragments.

Radiography of the shin bones prior to treatment and after internal osteosynthesis

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Before therapeutic immobilization, bone fragments are repositioned - they give a physiological position for the formation of bone callus. Gypsum is applied for a period of 3 to 12 weeks, depending on the severity of the injury. Fracture of the nail phalanx is fixed with a special orthosis.

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Skeletal traction is used in the case of leg fractures with significant bone displacement.

Comparison of bone fragments is achieved with the help of designs from staples, spokes, springs, cables, to which weights are weighed up to 2 kg.

The injured leg is placed on the physiological tire, the weight of the weights is reduced as the bone fragments are compared. Skeletal traction is carried out for 4-8 weeks.

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After the incision of the soft tissue over the site of the injury, the bone is fixed in the correct position by means of metal or titanium plates, screws, spokes.

Plates and other structures for osteosynthesis are removed one year after the operation.

External osteosynthesis is carried out with the Ilizarov apparatus for 3-12 weeks. It consists of metal staples and spokes, allows for fixation and extension of the bones of the lower extremities.

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External fixation devices do not restrict the motor activity of the leg, which prevents the development of muscle atrophy and ankylosis (immobility) of the joints.

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How much the fracture heals depends on the severity of the injury, the development of complications, the age of the patient and the general condition of the body.

Rehabilitation

Rehabilitation after a fracture of the foot has a weighty value for restoring the full function of the lower limb. It includes conducting physiotherapy, massage and physical therapy exercises (LFK).

After a long period of immobilization and removal of gypsum, joint stiffness is observed, a decrease in the strength of the muscles of the lower limb, edema in the area of ​​trauma.

The leg swells due to the squeezing of the tissues with a plaster dressing, the violation of the outflow of blood and lymph, and the slowing down of metabolic processes.

Skeletal tract stretching

Normalization of muscle tone is achieved with the help of therapeutic massage of the lower limb. Assign exercise exercise exercise with a gradual increase in physical activity and the duration of training.

Exercise exercise therapy should be done regularly until the full recovery of the motor and support function of the foot.

Fracture of the foot is a trauma that is accompanied by a violation of the integrity of the bones. Timely appeal for medical care, the right choice of treatment and rehabilitation methods improve the prognosis of the disease and prevent the development of complications.

A source: http://MoyaSpina.ru/bolezni/perelomy-nog