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Fracture of a bone occurs when the bone is exposed to constant pressure or impact. Fracture can also occur in cartilage, which are connective tissues that cover the bones. The fracture can be closed or exposed, located in only one place or multiple. The fracture can reach several bones, such as the femur, pelvis, arm, skull, facial bones, etc.
The general cause of fracture is severe damage to the bone or constant impact that wears down the bone. Diseases such as osteoporosis , cancer , osteomyelitis, etc. can wear down bones, making them more susceptible to breakage. The general symptom is severe pain at the fracture site. Other symptoms may accompany the fracture, such as difficulty breathing, loss of movement (due to nerve compression), hemorrhage (due to ruptured vessels), etc.
The diagnosis is made through conversation with the patient and analysis of his clinical history. Exams such as radiography and scintigraphy help to locate the fracture and the presence of other cracks in the bone. Sometimes, bone fragments can become dislodged and cause serious complications, such as stroke and pulmonary embolism.
Fracture treatment is done with analgesics (to relieve pain) and immobilization of the fractured limb, to allow the bone to heal and return to the site. Sometimes surgery is needed to put the broken pieces back together. Some homeopathic medicines, such as Arnica 15 CH, can be prescribed.
It is important not to handle the fractured victim and immediately call the emergency service, as any movement could worsen the patient’s condition.
Spine and neck fractures require the victim to be immobilized in place. If there is a need for evacuation, leave it to the specialized health team. Intake of vitamin D can help prevent fractures.
Definition
Fracture is a rupture or breakage of a bone or cartilage disc. Remember that bones are hard, solid organs that make up our skeleton. Cartilage is a connective tissue found on the surfaces of adult bones, particularly joints.
The fracture can be open or closed with wound, complete or incomplete, with or without displacement of the fragments. Breaking bone into multiple pieces is called a multiple fracture.
In addition, another name for a fracture, especially in children, is “green wood”. As its name suggests, bone breaks like green wood while bending.
The fracture usually affects the long bones, but it can also affect the skull, cheekbones and pelvis.
Causes
The fracture can be caused by a direct blow to the bone or by indirect shock. The first is associated with soft tissue injury at the point of impact and the second occurs after bone bending, compaction, crushing, stretching or torsion. Violent muscle contractions can also break bones.
In newborns, aggressive maneuvers during difficult births often create fractures of the clavicle or thigh, called obstetric fractures.
In some cases, patients’ bones weaken and break spontaneously or after minimal trauma. This type of pathological fracture itself can be due to tumors , bone cysts, osteoporosis or osteomyelitis. It’s the same for rickets, osteomalacia and menopause .
Unusual efforts, without prior training, such as in sports, and small repeated shocks can fracture the bone.
Symptoms
Upon impact, the victim may hear a bone cracking noise. And local pain appears and increases at the slightest movement or touch.
In all cases, the diagnosis shows functional impairment, with swelling, deformation, and sometimes a blue discoloration of the skin.
Other symptoms vary depending on the injured organ. Craniofacial or vertebral fractures are associated with disturbances of consciousness, tingling in the limbs and paralysis. Pectoral fractures can result in difficulty breathing and bleeding from the mouth. Also, abnormal urination may accompany pelvic fractures.
Pathological fractures are painful and interfere with walking.
Diagnosis
The doctor looks for signs of a fracture by examining the patient. He also asks for information about the natural history of the disease and the nature of the accident.
The diagnosis is confirmed through radiographs. Sometimes more advanced explorations such as scintigraphy or can help discover cracks and possible complications.
Complications
Fractures can be complicated when they are exposed or opened and when the fragments displace, which can cause blood vessel cleavage. Fractures can also cause nerve damage, which leads to paralysis or impaired sensation. Cerebral or pulmonary embolism and thrombophlebitis are part of the serious complications of fractures.
The wound from an open fracture is susceptible to infection and can become gangrenous. In addition, acute pain weakens the patient and can interfere with activities such as eating and moving.
Treatment disadvantages, such as immobilization, can cause stiffness and contractures of muscles and tendons. If immobilization devices are installed incorrectly, it may injure the skin or impair circulation in the immobilized limb.
Another problem is pressure ulcers, phlebitis, constipation or urinary and respiratory tract infections, which can appear after prolonged rest.
Treatments
At the accident site, it is important to move the patient as little as possible. In this case, two situations can occur:
– If you move the victim there is a risk of further damage. You must leave the person immobile until help arrives.
– If you need to do an emergency evacuation, the fracture must be immobilized before evacuation.
Immobilization techniques at the crash site vary depending on the broken bone. Limbs can be immobilized with splints, for example.
Before fixing an open fracture, the wound must be protected from any source of infection covered with a clean cloth or gauze protected by a bandage.
If the victim loses consciousness, the lateral position, that is, laying the victim on his side, is indicated to prevent obstruction of the airways, but must ensure that the axis of the head is aligned with that of the trunk.
Cervical collars and hard surfaces are used for fractures of the skull, pelvis and spine.
The goal of hospital treatment is to restore the fractured bone to its normal anatomical location. To do this, the fragments are joined into place, either by manual techniques or surgery. The region is then immobilized by plaster, traction or special tools designed for this purpose (screws, plates, nails, etc.).
For pathological fractures, the treatment is the cause of the disease ( treatment of osteoporosis , tumor, etc).
Joint stiffness and musculotendinous contractures can be corrected with physical therapy. This will help the patient regain normal joint function and promote healing.
Tips
– Before taking any action, always call the emergency service.
– Avoid handling, as this aggravates the injury.
– Do not attempt to reduce the fracture.
– If you suspect a spinal injury, and in the absence of removal of the victim, leave the patient as it is, without moving him.
– Try to remove objects that could affect the injured limb (rings, bracelets, ties, etc.).
– Regularly check the patient’s heat, color and pulse status.
– If you are exposed to situations that can weaken bones:
> Regularly monitor your condition;
> Strictly follow your doctor’s requirements;
> Use suitable sports equipment, such as good quality cushioned shoes;
> Train yourself enough, while being aware of your limits;
> Keep your vitamin D levels always adequate (therapeutic and preventive);
– First aid training will help you save lives.
Prevention
Take vitamin D. According to a study published in 2009, vitamin D preparations reduce the total fracture risk by 14% for hip fractures, and by 9% for fractures caused by falling.
Critical Study on the Use of Vitamin D or Calcium for Fractures in People Over 50
– Dietary supplements containing calcium , vitamin D , or both do not appear to protect against hip fractures and other bone fractures in older people , according to a Chinese study published December 26, 2017 in the scientific journal JAMA (DOI: 10.1001 / jama.2017.19344).
– This study, a meta-analysis (review of studies), took into account 51,145 adults over 50 who did not live in an institution or community such as a nursing home, they lived at home. These adults participated in 33 randomized clinical trials comparing the use of dietary supplements (calcium, vitamin D, or both) with a placebo or no treatment and the risk of new fractures. The results of this research work go against other studies published in the past. Therefore, Chinese scientists who released a statement about the study in December 2017 discouraged the regular use of dietary supplements containing calcium, vitamin D or both in adults over 50 years of age for the prevention of fractures.
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