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Thursday, 28.03.2024, 18:37
Main » Traumatology » Bone fracture 
18:33
Bone fracture


Fracture - a violation of the integrity of the bone under the momentary influence of an external force that exceeds the margin of the bone.

Violation of the integrity of the bone may be incomplete in this case arises
  • fracture
  • fracture
  • perforated defect of bone tissue.

In children, due to incomplete maturation of the bony skeleton has its own characteristics of fractures. Subperiosteal fractures often occur when the bone breaks down the foundation, and the periosteum covering the bone remains intact, keeping the fragments in place.

It is also possible displacement and separation of bone fragments in the areas of growth, where the cartilage had not yet transformed into bone.

If the break is normal in structure and strength of bone - this is called a traumatic fracture.

Pathological fracture - a fracture at the site changed to any pathological process of bone tissue. The process, damaging the bone, most often a tumor, a cyst in the bone tissue. Often break bones in older women with bone loss - osteoporosis, in which bone tissue becomes brittle and breaks from small loads.

Fractures are:
  • open
  • closed.

Closed fracture - a fracture with intact skin integrity.


Open fracture associated with damage to the skin and soft tissues, and communicates with the external environment.

There are single and multiple fractures, as well as together, except when there are fractures and internal injuries.

The mechanism of traumatic injuries of the bones may be:
  • direct
  • indirect.

The direct mechanism of injury is when traumatic injury is produced directly at the effects of traumatic force.


The indirect mechanism of injury occurs when the traumatic force acts at a distance from the fracture site.

By the nature of traumatic forces speak of the action:
  • Bending
  • extension
  • compression
  • twisting.

In flexion and bones, she breaks down in the place of greatest curvature, or in the weakest spot. At the same time on the convex side of the bent bone is formed a transverse fracture, and the concave - a triangular piece. Most so-broken long bones of the limbs.


Compression of the bone leads to a compression fracture, for example, compression fracture of the vertebral body, or heel bone.

Under the influence of force, twisting the bone, it happens more often with limbs, there is a spiral fracture.

By the nature of fracture fragments formed can be varied:
  • fractures
  • marginal fractures
  • transverse
  • longitudinal
  • oblique
  • helical
  • comminuted fractures.

From the position of fracture fragments are:

without bias, if the bone fragments are in their usual place
offset.

The direction of displacement of fragments depends on the direction of, or traumatic force, either from the pull of the muscles that attach to a particular section of the bone.

The clinical picture characterized by fractures
  • pain
  • edema and swelling in the area of fracture
  • hemorrhage in the area of fracture
  • violation of the shape of the bones or joints
  • restriction of mobility of the limbs
  • abnormal mobility of the broken limb.


To clarify the diagnosis is always done X-rays. Executed at least two X-ray images in different projections. If the broken limb on radiographs must be submitted to the two nearest joint. X-ray study allows us to refine the location and nature of the fracture, the direction of displacement of bone fragments.

After performing surgery or conservative comparison of the fragments, holds a controlling X-ray - to check the correctness of the treatment.

The next x-ray produced in 10-12 days from the time of injury, since this term decreases tissue swelling and the risk of displacement of bone fragments have already mapped.

The results of fusion surgery, or fracture determined using X-ray after removal of plaster casts, taking into account the average time fusion of bones, which are different for each individual bone.



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