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Talk about a basic overview of fractures
A fracture is a break in the integrity or continuity of the phalanx. Many factors contribute to fracture, including direct violence, indirect violence, muscle strain, cumulative strain, bone disease and so on.
classification
According to whether the fracture is communicated with the outside world, it can be divided into closed fracture and open fracture. Incomplete fracture and complete fracture are classified according to the degree and morphology of fracture. According to the degree of stability after reduction can be divided into stable fracture and unstable fracture.Monitor manufacturers
Clinical manifestation and X-ray examination of fracture
Clinical manifestations systemic manifestations include shock and fever, local manifestations include pain and tenderness, local swelling and ecchymosis, and dysfunction. The specific characteristics of a fracture include deformity, abnormal movement, bone rubbing, or bone rubbing.
X-ray examination of fractures is of great value in the diagnosis and treatment of fractures. X - ray examination should be adjacent to a joint inside the positive and lateral film; X-rays of special positions when necessary; Attention should be paid to the comparison with the uninjured side; Negative patients with significant clinical symptoms were reexamined 2 weeks later.Monitor manufacturers
Healing of fracture
Hematoma organic progression (2 weeks) → primitive callus formation (4-8 weeks) → callus remodeling and shaping (8-12 weeks).
Clinical healing criteria of fracture: local no abnormal activity, tenderness, longitudinal percussion pain; X-ray showed blurred fracture lines with continuous callus passing through. Functionally, the injured limb meets the following requirements after the removal of external fixation: the upper limb can lift 1kg weight forward for 1 minute, the lower limb can walk flat for 3 minutes without turning and no less than 30 steps, and the fracture is not deformed after continuous observation for 2 weeks.
Factors affecting fracture healing
Systemic factors include age and health status; Local factors include the type and number of fractures, blood supply at the fracture site, infection, soft tissue injury, and soft tissue embedding. In terms of treatment methods, there are repeated manipulations of reduction, open reduction, excessive periosteum dissection, excessive traction, uncertain fixation, improper debridement and inappropriate functional exercise.
First aid for fractures
The purpose of first aid is to save the life, protect the affected limb and transfer quickly. General treatment measures include dressing the wound, hemostasis, trauma fracture end treatment; Properly fixed; Rapid transit.
Principles of fracture treatment
To restore a normal or nearly normal anatomic relationship. The rotatory and dissociative displacement of the fracture site must be completely corrected. The shortening displacement of lower limb fracture in adults is less than 1cm. Transverse fracture of long diaphysis should be at least 1/3 or so. Lateral displacement of the metaphyseal fracture should be at least about 3/4. Shortening of lower limb fractures in children should be controlled within 2cm.
Fixation maintains the fracture in its reduced position until it is firmly healed. External fixation methods include small splint fixation, plaster bandage fixation, abductor fixation, continuous traction, external fixator; Metal internal fixator and absorbable material can be used for internal fixation.
Functional exercise can restore soft tissue contraction activity as soon as possible, and prevent muscular atrophy, osteoporosis and other complications. Early stage: 1-2 weeks, promote blood circulation of affected limb, eliminate swelling, prevent muscular atrophy; Middle stage: over 2 weeks, the activity of the upper and lower joints of the fracture slowly increases in intensity and range; Late stage: the fracture has reached the standard of clinical healing. Reduce limb swelling, improve joint stiffness, and improve joint range of motion and muscle strength.