bone fractures constitute a violation of the integrity of the bone caused by violence or pathological process (swelling, inflammation, and others.) Is broken.When
fractures are almost always more or less damaged tissue surrounding the bone at the fracture site.Fractures may occur as a result of direct exposure to mechanical force, ie,by direct injury (eg, fracture from impact with a heavy object, in the fall and bruise on the curb).They can come and indirect injury when a mechanical force is applied not in the same place of the fracture (for example, basal skull fracture when falling on the buttocks).How to use folk remedies for fractures, see here.
At the turn is often a displacement of bone fragments.It arises as a consequence of a traumatic factor application and under the influence of muscle traction, is attached to fragments of bone.Attached to the ends of a fractured bone muscles are reduced in an effort to bring together the ends of the bone fragments, displace them and held in the wrong posi
If the skin over the fracture site is intact, the fracture is called closed.If simultaneously with bone fractures occurred violation of integrity of the skin and the wound is formed in communication with the fracture site, it is an open fracture.
Depending on the positions of the body at the time of the injury and the direction of the traumatic factor are different types of fracture: transverse, longitudinal, oblique, helical, comminuted and tear.
fracture may occur as a result of uncoordinated contraction of muscles that are attached to the ends of the various bones, such as unsuccessful or unexpected sharp movements in throwing stones or try to retain the lost balance.
• damage to the sharp ends of fragments of large vessels, which leads to the development or external bleeding with an open fracture or
intraarticular hemorrhage (with closed fractures) with the development of hemarthrosis (blood in the joint);
• trauma of the nerve trunks splinter of bone that can cause shock or paralysis;
• infection and cellulitis development fracture, osteomyelitis, or sepsis;
• damage to vital organs (brain, liver, lungs, spleen, etc.).
to fracture characteristic: sharp pain, aggravated by any movement and the load on the limb, change position and shape of limbs, disturbance of its function, swelling at the site of the fracture, shortening of the limbs, pathological (abnormal) rolling the dice.
sharp local pain at the rib fracture, the inability to take a deep breath (leading symptom).The sharp pain and crepitus of bone at the fracture site, shortness of breath.
On palpation the field of crisis - a sharp pain, often bone crepitus (crunching broken bones).To conduct palpation of the limb should be very carefully with both hands, being careful not to cause unnecessary pain and especially not cause complications (damage to the fragments of vessels, muscles, skin and nerves).
With an open fracture in the wound can be seen fragments of bone, often one or more of their projects outward.In this case, to carry out palpation prohibited.
1) traumatic and pathological;
2) The condition of the skin and mucous membranes at the fracture site - open and closed;offset fragments without displacement (the width, angle, length, etc.);
3) localization - in the epiphyseal, metaphyseal and diaphyseal;
4) features a line of fracture - on the transverse, oblique, helical, comminuted, impacted;
5) primary and secondary.
Rib fractures are single and multiple.The reason - a drop in the protruding object, hitting the car, the train.Multiple rib fractures can lead to acute respiratory failure, especially in the elderly.
Proper and timely first aid is one of the most important moments in the treatment of fractures.
Immobilization of limb fracture reduces pain and is one of the most important moments in shock prevention, displacement of fragments, wounding vessels, nerves, muscles.Immobilization is achieved by applying standard tires (Cramer, Ditrihsa, Abolin) or using improvised tires from scrap materials (boards, skis, sticks, cardboard, etc.).
Overlay tires should be carried out directly on the spot, and only then to transport the patient.Any corrections, matching fragments are not recommended.Wrap the patient should be cautious, limb and trunk should be raised at the same time, all the while holding at the same level.
With an open fracture immobilization before the skin around the wound to be treated with an alcoholic solution of iodine or other antiseptics and impose aseptic bandage.
for solid immobilization of limbs must have at least two tires, which is applied to the limbs on two opposite sides.In the absence of tires and auxiliary material immobilization should be made pribintovyvaniem injured limb to a healthy part of the body: upper extremity - to the body using a bandage or gussets, bottom - a good leg.
In severe, complicated fractures need to anesthetize the victim promedola intravenous administration of solutions (2% - 1-2 ml);morphine (1% - 1.2 ml of 40% glucose solution -s - 10 ml), and isotonic sodium chloride solution (0.9% - 10 ml).In simple fractures we can restrict solutions intramuscular dipyrone with diphenhydramine.If there is no damage to the abdominal cavity, it should be given plenty of drink.In severe fractures administered in / in polyglukin 400 ml or 400 ml reopoligljukin that is the beginning of the treatment of developing traumatic shock.
Transportation bone fractures of the lower limbs, gas, spine - lying down;upper extremities - sitting or in a hospital casualty department or the injury-point.
Emergency care: pain management solution dipyrone 50% - 2.0 intramuscularly, at multiple fractures can introduce 1-2 ml of 2% promedola, elevated body position, oxygen.
Hospitalization: isolated fractures of the ribs are treated on an outpatient basis;fractures to two ribs - in a surgical hospital, preferably in the thoracic department, as should promptly identify fractures often associated pneumonia and hemothorax, and for fractures of the lower ribs - damage to the liver and spleen.
skull fractures occur mostly at street or traffic injury.The greatest danger in this case is not so much damage to the bones of the skull, but in the possibility of damage to the contents, especially the brain and its membranes and blood vessels.Especially dangerous is the opening penetrating the skull fractures in which injury to the skin and meninges creates particularly favorable conditions for the penetration of the infection to the surface or in the depths of the brain and the development of serious and even fatal complications (meningitis, encephalitis, brain abscess, and others.).
depending on the fracture location distinguish fractures vault and skull base.
In recognition of the cranial vault fractures should be borne in mind as signs, depending on the damage to the bones of the skull (pain, bleeding, painful points at palpation, sometimes - the feeling of depressions or gaps in bones), and the signs, due to the simultaneous damage to the brain tissue,meninges, blood vessels (loss of consciousness, vomiting, slow heart rate, worsening headache, loss of speech, paralysis of limbs, respiratory disorders, and so on.).
to fracture of the skull base is characterized by the following features: damage of the auditory nerve (hearing disorders), impaired function of the facial nerve (paralysis of the facial muscles on one side of the face - the face "harvested" in a healthy way), the emergence of extensive bleeding in the eyes, throat, nose, ear one day after injury, bleeding or discharge of blood and cerebrospinal fluid through the transparent nose or ears.
When fractures of the skull first aid should be provided at the site of injury.You must perform thorough immobilization followed by immediate transport of the victim to a medical facility.Move, move affected even for a short distance is strictly prohibited in order to avoid irreversible damage to the brain and spinal cord.
no washes should not do in the allocation of blood or cerebrospinal fluid from the ear, and is only necessary to apply a sterile bandage.With the decline of cardiac patients into kordiamina give 20-25 drops, or korvalola valokordin.To enhance the effects of drugs is necessary to resort to the available skin irritants: hot bottles, heating pads, or mustard to the legs and the heart.
Transport immobilization in fractures of the skull is best achieved by imposing on the head, neck and shoulders of two or even three-wire bus (Cramer or mesh), and in their absence - bundles of flexible rods or beams of aluminum wire.The head, neck and shoulders need to impose a thick layer of cotton wool.
one longitudinal rail impose on the forehead on the head, neck, back of the neck and along the spine.To her tied two transverse tire.One of them, attached above the crown, bent along the contours of the side surfaces of the head, neck and shoulder girdle.Another bus encircle the chest and at the bottom corners of the blades fastened at its rear with a longitudinal rail.Interconnected pribintovyvayut tire tightly to his head, neck and torso.
In the absence of tires, including improvised, the victim with a fractured skull placed on a stretcher, to which it is tied to avoid any whatsoever movements.Under the head and neck, put a big soft pillow or a bed and around the head of blankets or clothes make the roller.
Transporting such patients should be under close monitoring of their condition (pulse, respiration, etc.) Entourage, which should provide a gentle, quiet transportation.
jaw fractures occur, usually during direct trauma (a blow, drop, etc.).Most of these fractures is open, ie,accompanied by damage to skin or mucosa.For fractures of the jaw in the absence of timely and proper first aid further treatment the victim may have a number of serious complications and severe consequences (violation of chewing function, swallowing and speech, facial disfigurement).
Recognition jaw fractures typically does not cause much difficulty.In addition to the common features characteristic of all fractures (pain, pain points, the mobility of the fragments with a particular sound of rubbing bone ends), with fractures of jaws observed a number of very specific symptoms.These include primarily the displacement of teeth or incorrect closure of the teeth, bite disruption and difficulty or inability to chew, difficulty in swallowing, painful drooling, slurred speech, and others. Fractures of the jaws are often accompanied by fractures of the teeth.
should be borne in mind that in some (difficult) fractures of the lower jaw can occur the tongue, which can cause choking.
When fractures of jaws first aid is as follows.If there is a fracture of the lower jaw the tongue, causing difficulty in breathing, you need to fix the language with the help of pins.
To do this, take an ordinary safety pin and the middle tongue pierced through, departing from the tip by 1.5-2 cm. After fastening pins are tied to it a piece of thick string or bandage, which strengthens to toggle or another part of the patient's clothes.If the victim is unconscious, and strengthen the language is not possible, in order to avoid suffocation of the patient's head is turned to one side.Even better in such cases to lay down a sick person, i.e.on the stomach, and under the brow and chest put a bundle of clothes or any dense object.With any method of fixing the language and placing the victim of such patients who are in critical condition requires constant monitoring.
Temporary fixation of fractures of the jaws is achieved by imposing sling bandage, which should bring the damaged jaw close to healthy, to use the latter as a splint to immobilize the bone fragments.
spine fractures are among the very heavy damage.Special severity of vertebral fractures is that they may be accompanied by compression or spinal cord injury, and this in turn causes paralysis of the limbs, the pelvic organs.
cause of spinal fractures is often indirect trauma (fall from a height, jumps into the water, squeezing by heavy objects, etc.).Recognition
spine, usually not cause any difficulties.Apart from the usual signs of a fracture (pain, etc.) Is characterized by symptoms such as a protrusion, and a sharp pain the spinous processes of the vertebrae damaged, sharp pain, and sometimes even complete impossibility of any movement in the spine.
If there is compression of the spinal cord injury or paralysis observed (immobilization) of extremities, loss of sensation below the area of the body fracture, disturbance of pelvic organs (urinary and fecal retention).
When fractures of the spine to provide first aid should be carried out with the utmost care.Be aware of the particular gravity of these injuries and non-spine flexion or any movement in it, so as not to cause or enhance the compression of (damage) of the spinal cord.
special temporary fixation in these severe fractures are not required, as the spine and unloading some of its immobilization is best achieved by carefully laying the victim on a stretcher in the prone position, and under the shoulders and enclose the head cushion or rollers.
patient Lifting off the ground and laying it on the stretcher as follows: the patient lying on the ground gently turn down the belly, and then in this position 3-4 carefully lifted and placed him on a stretcher.
When the patient is still on the back, it can not be lifted by the hands and feet because of the danger of bending of the spine and spinal cord compression.Less dangerous to take the patient's shoulders and legs when he turned on his stomach, as this spine is in extension, but in this case should be closely monitored so as not to bend his spine when lifting the patient.
best to sum up their hands at the upper half of the breast and under the patient's pelvis, while others are preparing to lift his head and feet.Lift and put this victim on a stretcher on board and others. Hard surface to be all at the same time on the pitch.
If a patient with a fracture of the spine is placed on his back, then to the usual soft stretcher is necessary to put a wooden board, plywood, wide boards and other items with a hard, flat surface to again prevent dangerous spinal flexion.So come with the most common fractures in the thoracic and lumbar vertebrae.
If there is a fracture of the cervical vertebrae, the victim lay on a stretcher in the back and under the neck (sometimes under the shoulders) enclose a pillow or a bundle of clothes.Very good at the same time impose on the neck "collar".To this end, the neck wrapped with a thick layer of cotton wool, which pribintovyvayut gauze bandage.
Rib fractures are very frequent and occur from both direct (in the place of application of force, such as shock) or by indirect trauma (for example, in place of the ribs bend when compression of the chest).There are single and multiple rib fractures.Fractures often occur in the elderly, and preferably in the IX-X ribs.
Recognition ribs fracture is usually straightforward, since it observed very characteristic features: sharp local pain, aggravated by palpation, breath, coughing, sneezing, and when you try to squeeze the chest in the transverse direction or the other.Due to increased pain during deep breathing and movements of patients with fractures of the ribs surface breathe, afraid to cough, and retain a forced situation.