Reliable and relative signs of fractures. Signs of a fracture - absolute and relative

In a closed fracture, the bone is broken or cracked but the skin is intact. With an open fracture, the bone is not only damaged, but also visible on the surface. An open fracture is often accompanied by a strong one. Infections are also common with open fractures.

Causes

• bad fall or fall from high altitude;
• road accidents;
• swipe;
• excessive stress, for example during physical exercise, can lead to fractures of the bones of the feet, ankle, shin, tibia, etc.

Symptoms of a bone fracture

If, after a fall, you notice a visible deformity of the bone, severe pain in the area of ​​​​the bone, shooting pain, restriction of movement, or severe pain with movement, then you should immediately seek medical attention. medical care.

What can you do

If you suspect a fracture, try not to touch the damaged area. For open fractures, use clean, dry dressings.

Immobilize the injured limb until you receive medical attention.

In order to fix the limb, it is best to apply a splint. It is not necessary to wrap the damaged area too tightly so as not to cut off blood circulation.

Apply ice to the injured area.

Applying ice to the injured area can help reduce inflammation and pain.

Frequent fractures, especially in people over 60 years of age, require additional visits to the doctor to rule out (a disease in which the bones become brittle).

What can a doctor do?

The doctor should take an x-ray, if necessary under control x-rays set the fracture (reposition), apply plaster.

In some cases, with complex fractures, osteosynthesis is performed and the bones are connected using special metal parts. This is usually done in a hospital in a specialized department.

The doctor monitors the healing process. In some cases, after the removal of the cast, a recovery period may be required. This is necessary so that you fully restore all movements. The doctor will prescribe a massage, therapeutic exercises and physical therapy.

Prevention of fractures

While skating, roller skating, cycling, etc. use protective equipment: helmet, elbow pads, knee pads, shin guards. Provide necessary measures safety for children. Supervise small children closely. Teach children to follow traffic rules.

Symptoms of a fracture - an injury characterized by a violation of integrity bone tissue, often appear as severe pain, as well as in the form of other signs that will be discussed in this article.

Regardless of where in the body the fracture occurs, there are variations of the same group of symptoms.

The manifestations of fractures depend, first of all, on the nature of the injury, which can be open or closed. Based on the location of the wound on the body, the number of broken bones, the presence or absence of displacement, pain symptom has different intensity. There are often cases when the victim, not feeling severe pain, thinks that he has simply dislocated a limb and does not seek help. medical assistance, which leads to worsening clinical case and the development of complications.

Put accurate diagnosis only a doctor can, so after an injury you need to go to the hospital mandatory. When injured, symptomatic picture may include absolute and relative signs of fracture. An absolute sign of a bone fracture does not require clarification of the diagnosis; in this case, an x-ray is performed only to identify the exact location of the bone fragment and to conduct a study for the possible presence of displacement.

The relative symptomatic picture requires medical examination, since this type of signs can be observed both with a fracture and with a strong sprain or dislocation.

Signs of a limb fracture are as follows:

Absolute signs of a fracture are characteristic of open wounds. Based on the wound, from which bone fragments are visible, and bleeding, the doctor immediately determines the complexity of a particular case.

Symptomatic picture

The symptoms of a bone fracture depend on the type of injury - closed type, without violating the integrity of the skin, and open when a piece of bone breaks soft cloth and skin. At closed injury signs of a fracture are:

• Pain of varying intensity;
• Increased pain when the limb moves during palpation;
• Violation motor functions(or complete absence, or excessive, pathological mobility);
• Extensive hematoma;
• Bleeding under the skin.

Open bone fractures are characterized by the following manifestations:

• Open wound;
• Bleeding;
• Strong pain;
• Swelling of the soft tissues around the injured area;
• Bone fragments are noticeable in the wound;
• Traumatic shock condition.

Such a symptom of bone fractures as swelling of soft tissues does not appear immediately; it develops gradually. Pain appears immediately upon injury and increases in intensity over time. The first signs of an open fracture - a wound and bleeding - appear immediately after the injury.

What kind of pain could it be?

Pain is a relative sign. Its nature may vary depending on the type of injury and location on the body. When the bones of the spinal column are injured, the integrity of the joints is compromised, or a tubular bone is broken, the pain can be very severe. Often, due to pain, a person cannot move a limb, or cannot move at all if the spine has been damaged.

Often, severe pain causes traumatic shock, resulting in the victim losing consciousness. Pain will be felt least of all in cases where the person was under the influence of drugs or used drugs when the injury occurred. a large number of alcoholic drinks. Regardless of the type of injury, children feel the most pain, while older people feel it less.

How much pain will be felt also depends on the pain threshold of each person. In case of bone cracks, closed injury without displacement, the pain symptom will be moderate, the nature of the pain will be aching. Strengthening of the sign is noted when trying to move the limb or if the damaged area is palpated.

Pain can be a sign that accompanies the entire process of bone fusion, and can also occur after recovery and removal of the plaster; especially, aching pain appears when weather conditions change.

Characteristics of edema

The main signs are swelling, hemorrhage under the skin, and the appearance of a hematoma. These symptoms may appear immediately or over time, depending on the severity of the injury. Swelling and hematomas are signs that tend to appear not only at the time of bone injury, but also after fusion of the bones and removal of the plaster.

Swelling occurs due to impaired blood circulation in the area where the bone was broken. A hematoma under the skin begins to form several hours after injury, localizing directly in the area of ​​the wound, or if the fracture is open, around the wound.

If the victim does not seek medical help in a timely manner, a hematoma may form at the site of a hematoma due to poor lymph drainage. purulent focus. This will significantly complicate the treatment process and cause a deterioration in the patient’s general condition.

The most severe type of edema and hematoma is hemarthrosis - a hematoma that appears when joints are damaged. Hemarthrosis is usually caused by stretching of the joint capsule. As a result, the joint greatly increases in size and becomes damaged. physical activity damaged area.

How does bias manifest itself?

When injured, limbs are often deformed, becoming shorter or longer. Types of fractures accompanied by deformation may include open and closed injuries, during which bone fragments were displaced.

Displaced fractures are the most severe because bone fragments can put pressure on nerve endings or tear the walls of blood vessels. What are the signs of displacement of bone fragments?

1. Loss of sensation resulting from damage to the nerve roots.
2. Development of ischemia - damage lymph nodes and blood vessels, which leads to stagnant pathological processes.

TO common features offsets include the following:

• Pale color at the site of bone damage;
• Coldness in the injured limb;
• A sharp decrease in pain (due to damage to the nerve roots);
• Changes in the structure and color of the nail plates;
• Excessive dryness and flaking of the skin;
• Poorly palpable pulse.

If damaged blood vessels, and seeking medical help was not timely, blood poisoning and gangrene may develop.

Symptoms on X-ray

Determine the exact type of injury (exception: open injury), the nature of the bone fracture can only be determined by x-ray. Signs of a fracture based on the type of broken bone tissue are:

1. Transverse fracture - the fracture line runs perpendicular to the direction of the bone axis.
2. Longitudinal - the fracture line runs along the entire bone.
3. Oblique - the fracture line makes an acute angle in relation to the axis of the bone.
4. Helical fracture - displacement of fragments in a circle, outside of their usual location.
5. Wedge-shaped - bone fragments are deformed, pressed into each other. This type of fracture occurs when the integrity of the bone tissue of the spinal column is damaged.
6. An impacted fracture is a displacement of the bones along the axis.

In cases where the injured person has absolute signs which do not cast doubt on the correctness of the initial diagnosis, x-rays are performed in any case to determine the exact location of the bone fracture:

1. Injury of the epiphyseal type - with damage to the joint, affecting the muscles and tendons, joint capsules. Most often accompanied by displacement of bone fragments.
2. Periarticular - this type of injury is impacted, displacement is rarely observed.
3. Diaphyseal type injury - a violation of the middle part of the bone, this type of fracture occurs most often.

A bone fracture, regardless of the location of the fracture, can be aggravated. For this type of fracture characteristic feature is the development of painful shock. In this case, the person is most often in unconscious. General state the victim is rapidly deteriorating as a result of damage by bone fragments internal organs, internal bleeding opens.

The appearance of fat embolism is observed, often this species Injuries join the infection, especially if the fracture was open and the wound was not treated correctly. It is only possible to determine the exact signs of fractures and diagnose the type of injury qualified specialist after an X-ray examination.

Quite often, having twisted your ankle, you decide that you have a normal sprain. Apply a bandage and forget about the injury. But to determine the nature of the injury, it is still worth knowing the signs closed fracture.

Before helping the victim, you need to carefully examine the injured area. If a bone is visible through the tissues at the site of the injury, then everything is clear here - an open fracture, but when nothing is visible, it is necessary to determine whether the victim has closed fracture.

The main symptoms of a closed fracture considered sharp pain at the site of injury, the limb became a little shorter, swelling of the joint and all adjacent tissues quickly develops. It is also worth paying attention to whether the patient can move: the inability to move or the wrong range of motion should suggest that this is a closed fracture. No less often, with a fracture, one can detect a change in the shape of the joint, and an increase in temperature. And another symptom is traumatic shock, which is expressed differently in each person, but it always manifests itself with fractures.

If you find at least one of these closed symptoms, then you need to immediately provide first aid to the patient. Pre-medical care is quite simple and consists of steps such as

1. Give the victim an anesthetic medicine that will help to avoid pain shock. The patient should drink as much fluid as possible, but in no case alcohol. It dulls feelings and prevents you from adequately assessing the situation.
2. it is imperative to put a splint on the joint that is above or below it. If the shoulder or shoulder is broken, then the splint should be applied to three joints. This is necessary so that the pain does not increase during the transportation of the patient, because pain shock can lead to death. Absolutely any material at hand can serve as a tire, and it should be fixed under the natural position of the limb.
3. Be sure to apply cold to the damaged area and change it until the victim is taken to the hospital.

What are the treatment methods for a closed fracture?

The first and main thing is to immediately consult a doctor who will make an accurate diagnosis. It is the specialist who will be able to determine the severity of the injury and prescribe treatment. A plaster cast may be applied or surgery may be performed.

The time to treat a fracture depends primarily on how severe the injury is.. And after the bone has healed, you will be prescribed a course of special gymnastics and physiotherapy. All recommendations should be followed quite strictly; this will help you recover faster from injury.

It is forbidden to adjust a dislocation yourself. This may cause more serious problems– damage to blood vessels and increased pain shock. So, with the slightest suspicion of a closed fracture, the victim should be left in exactly the position in which he was injured and called " ambulance" If it needs to be moved, then the surface must certainly be hard and smooth, and the patient’s body must maintain its previous position.

It must be remembered that if a collarbone fracture occurs or humerus, then the symptoms of a closed fracture will be much weaker. There may be no pain at all, and movement of the hand is practically not difficult, which is why such a fracture is discovered mainly after some time has passed, when calluses have already formed.

So, if you have discovered at least one of the signs of a closed fracture, then contact a specialist immediately - this will help avoid further complications and lead to a speedy recovery.

Traumatic bone fractures— violation of their integrity due to the influence of any force. Bone fractures can occur when direct influence traumatic factor or indirectly.

In the first case, a bone fracture occurs due to a direct blow to it. In the second case, a high axial load on the bone occurs. Depending on their structure, bones are divided into tubular and spongy. Tubular ones can withstand greater loads, but they are less elastic than sponge ones. Tubular bones are represented by long bones upper and lower limbs.

Signs of a fracture

Depending on the direction of the damaging force, multidirectional fracture lines. They can go transversely, spirally, multiple multidirectional fractures are possible due to splintered injuries, etc. Sometimes a bone fracture occurs without changing its axis and in the absence of displacement of the fragments among themselves. Sometimes, with a sufficiently high force of impact, a bone fracture occurs with significant displacement of the fragments or even several lines of fractures appear.

Such fractures lead to visible deformities of the parts of the body that are supported by the broken bone. The most severe are comminuted, fragmentary fractures, crushed bones, and they occur when exposed to excessively high traumatic factors. Most common reasons- these are road traffic accidents, falls from heights.

Fractures may be complicated bleeding when the sharp edge of a fragment injures a nearby vessel. Possible damage from fragments of nerve trunks, spinal cord for spinal fractures. Rib fractures may be accompanied by damage to the pleura and lungs; fractures of the skull bones - severe traumatic brain injuries, etc. Damage to other anatomical structures can occur primarily or secondary. Primary damage occurs at the moment of exposure to force, and secondary damage occurs after an impact, when, during movement or improper transportation, moving bone fragments injure nearby organs, blood vessels, and nerve trunks. Therefore, correct primary fixation (immobilization) of bone fragments during fractures is very important.

If damage occurs when a bone is broken skin, then they talk about an open fracture; If the skin is not injured, then the fracture is closed.

Open fractures They are also primary and secondary, depending on whether the skin injury occurred immediately or after the injury. Signs of a fracture are:

• intense pain; pain on exertion;
• increasing swelling;
• inability to support the damaged area;
• creaking when feeling the fracture site;
• unnatural mobility.

First aid for fractures

Initially necessary inspect possible place fracture Visualize the mechanism of injury in detail. This allows one to suspect a fracture of one or another section. bone skeleton. If the effect of the damaging agent continues, it must be eliminated. It is important that there is no or minimal movement in the damaged area.

If the fracture is open and there is dangerous bleeding, then stopping it is a priority in first aid.

All efforts must be given up to stop bleeding. Bleeding and ways to eliminate it were discussed above. When the bleeding has stopped, a sterile or clean bandage must be applied to the wound surface. Treatment with antiseptics, as a rule, is impossible at such moments, but if there is such a possibility and the threat to life is small, then you can spend a few seconds treating the wound, but at the same time try not to move or pull out the fragments. After applying a bandage to the wound, further assistance for closed and open fractures is carried out in the same way.

The next step will be pain relief as a prevention of traumatic shock and prevention of possible pain during immobilization. However, pain relief is not always possible due to the lack of such funds at the site of injury.

Any available painkillers are suitable: analgin (2-4 tablets or 4 ml of solution by injection or orally), ketorol and its analogues (2 tablets or 2 ml by injection), baralgin (5 ml by injection), etc. The main thing is not to exceed a single dose dose (always indicated in the instructions; if not, limit yourself to 1-2 tablets or one ampoule). Before performing an injection, ask if the victim has allergic reaction on this drug.

If a person is unconscious, then anesthesia can be omitted, but immobility can be immediately immobilized and the victim urgently evacuated to medical institution.

Immobilization is necessary to fix bone fragments in order to prevent secondary complications and reduce pain when transporting the victim.

Objects for fixation are called splints, so immobilization is also called splinting. To do this, use both special tires (metal, wood, pneumatic) and any available means (sticks, fittings, tools, skis, etc.).

Important rule is to ensure that the length of the splint is sufficient to fix movements in two joints adjacent to the fracture. For example, for a fracture of the forearm, a splint is applied that extends from the fingers to the middle or upper third of the shoulder; for a hip fracture - from the middle of the lower leg, or better yet, from the foot to the lower back or chest.

Don't be afraid to take a longer tire. After application, it is fixed along its entire length with even rounds of bandage or rags, ropes. Sometimes you can fix the injured arm to the body, and the broken leg to the healthy leg. Never try to fix a fracture yourself; fix it as it is, even if it seems unnatural to you. Otherwise, secondary damage to nearby structures may occur.

For spinal fractures the victim is carefully transferred by three or four to a shield and transported on it; In this case, it is important to secure the neck with a special collar or with cardboard and wrapped clothing.

For pelvic fractures the victim is transported in a frog position - on his back with his knees apart and his feet brought to the pelvis.

At a fracture lower jaw You can use a jaw-fixing bandage over your head.

If the fracture is open, and the opportunity to get into medical institution is absent earlier than 3 hours later, then you can give the victim an antibiotic, as if injured.