What causes a fracture? Different types of fractures

Bone fractures have been a prominent problem throughout the medical community throughout human history. Even at the dawn of human civilization, people encountered this phenomenon and tried to deal with the consequences. No person is immune from this misfortune - it always happens unexpectedly and brings a lot of suffering and inconvenience.

Bone fractures take a person out of his usual way of life for a long time and partially deprive him of his ability to work. Based on this alone, accelerating the recovery of the body and returning a person to a normal state are becoming an important task for orthopedists around the world.

The essence of a bone fracture

In essence, a bone fracture is a complete or partial destruction of the bone, i.e. loss of integrity of bone tissue when a force is applied that exceeds the tensile strength of the substance. This phenomenon may result from the direct application of excessive stress or be a consequence of a decrease in the strength of the bone structure in the course of certain diseases.

In general, bone is made up of mineral (calcium, phosphorus and trace elements) and organic (collagen) ingredients. The mineral component provides the necessary strength, and the organic composition provides the elasticity of the structure.

Any fracture is accompanied by damage to blood vessels, nerve processes and surrounding tissues, incl. muscles, joints, ligaments, tendons. The most typical fracture is with displacement of the destroyed bone, which is determined by the direction of the load and the reflexive reaction of the muscles. The human body ensures independent restoration of damaged tissues. The active process of fusion of the bone structure begins with the formation of new tissue, the so-called callus. The duration of bone restoration depends on the individual characteristics of the person (health status, age, etc.) and the type of damage. Fractures in children heal much faster than in adults. The mechanism of formation of new bone composition is based on cell division of the periosteum, endosteum, bone marrow and vascular adventitia.

Classification of pathologies

Classification of bone fractures is made according to several basic parameters. The main types of pathologies include traumatic and pathological. Traumatic is caused by the impact of extreme load on a normally formed skeletal system. Pathological is characterized by a decrease in the strength of bone tissue as a result of internal processes, which causes bone destruction under light load.

According to the degree of damage, complete and incomplete (partial) fractures are distinguished. In turn, complete destruction is divided into a fracture without displacement and with displacement of fragments. Incomplete types include partial fractures and cracks in the bone.

Taking into account the direction and type of destruction, the following types of fractures are classified:

Transverse type: the direction of destruction is perpendicular to the bone axis.
Longitudinal type: the fracture is directed along the bone body.
Oblique variety: the fracture is directed at an acute angle to the bone axis.
Helical variety: the load had a rotational moment, as a result of which the bone fragments are displaced in a circle relative to their normal location.
Comminuted type: a clear fracture line cannot be traced - the bone is simply crushed.
Wedge-shaped type: A wedge-shaped deformity occurs as a result of one bone pressing into another (most often a vertebral fracture).
Impacted version: fragments of a broken bone are displaced along the bone axis.

Types of bone fractures

The following main types are distinguished: closed and open. Closed damage is isolated from the external environment, i.e. do not cause destruction of the skin. Such injuries can be single (only one segment of the support system is destroyed) or multiple. The open version implies a violation of the integrity of the skin and the presence of direct contact of the destruction site with air. Among such processes are combined fractures, which are accompanied by damage to internal organs.

Taking into account the localization of the process, it is customary to distinguish between the following fractures:

Epiphyseal fracture: refers to the intra-articular variety, causes destruction of the ligaments, joint, capsule, as well as displacement of bones and damage to the surface of the joints: most typical for children.
Metaphyseal type (periarticular): manifests itself in the cortical region; A typical representative is the impacted type; no displacement of the fragments is observed.
Shaft fracture: The most common type of bone fracture, it occurs in the middle portion of the bone body.

According to the severity of the manifestation, uncomplicated (typical) and complicated fractures are noted. The main complicating factors include: painful shock, damage to internal organs, profuse hemorrhage, fat embolism, concomitant infection, the presence of osteomyelitis and seasis.

Among injuries to various parts of the skeleton, fractures most often occur in the following elements: fractures of the bones of the extremities - lower and upper (including the radius, shin bones, foot), spine, femoral neck, coccyx, collarbone, shoulder region, jaw, nose , pelvis, skull, tibia.

Causes of fractures

The etiology of fractures is divided into two groups - traumatic and pathological factors. A traumatic fracture occurs under the influence of excessive mechanical load of a static or kinetic nature. Most often, bone destruction occurs as a result of extreme kinetic (moving) load applied perpendicularly or at an angle to the bone axis. Such a load occurs when there is a strong blow, a fall, or an unsuccessful jump. One of the most common causes of our time is road accidents. Longitudinal bone rupture is less common and is usually caused by pinching of the limb under the action of an axial force. Static load manifests itself, for example, when there are rubble.

The pathological factor reduces the strength of the tissue to such an extent that the bone is destroyed under light loads - a sharp rise from a chair, squatting, and even when walking. The main diseases leading to such consequences are tissue tumors, osteoporosis, and osteomyelitis. It is because of the weakening of the bone structure that the risk of fractures in older people increases during icy conditions.

Main signs of fractures

Bone fractures have characteristic symptoms that make it possible to identify pathology when it occurs, which is very important to exclude complications. The following main relative signs of a fracture can be distinguished:

Pain syndrome: sharp pain when a bone ruptures and aching pain in the future, which intensifies with longitudinal load or its imitation.
Swelling: Swelling in the affected area develops gradually.
Hematoma: of different sizes on the affected area; in this case, a hematoma with pulsation indicates continued bleeding.

The absolute sign of a fracture occurs as a result of direct destruction of the bone and indicates the completion of the process. These signs of a fracture are:

A characteristic crunching sound (crepitus): occurs when bone tissue ruptures, and is subsequently audible with a phonendoscope due to the friction of the fragments.
Unnatural direction of a limb or other bone.
Increased mobility when a joint is torn.
Bone fragments are visible visually.
Shortening of the limb when fragments are displaced, protrusion of the broken bone.

Some signs of a fracture without displacement or an incomplete fracture may not appear, which will complicate the diagnosis. The symptoms of a fracture are clearly determined by radiography - the location, type and degree of destruction are recorded.

Regeneration process

The fusion of bone tissue and restoration of the entire structure is a natural reflexive process, which usually proceeds according to the chondroblastic scenario (due to the activation of chondroblasts). The regeneration process is divided into the following stages:

Catabolic phase: duration 8-10 days; all the symptoms of fractures appear, an inflammatory reaction develops, heavy bleeding, blood supply to tissues is disrupted, and intoxication of the body occurs; In the rupture zone, cellular enzymes are activated, necrosis develops on the surface of the area, and fusion has not yet occurred.
Differential phase: 15-30 days after fracture; the process of new cells appearing, which leads to the formation of callus on a fibrocartilaginous basis; the synthesis of glycosamyglycans develops; the basic basis of the callus begins to form - the metric; collagen production is activated.
Primary accumulative phase: 15-40 days; a vascular system of small capillaries is gradually formed; chondroitin sulfate combines with phosphate and calcium ions to form bone tissue; the synthesis of calcium phosphate is activated; with the participation of silicon and magnesium ions, primary callus is formed.
Mineralization phase: up to 4 months; crystalline hydroxyapatite is formed; their complex with collagen appears; crystallization nuclei are formed—primary mineralization; intercrystalline bonds are created, completing the secondary mineralization of the callus.

Treatment of fractures

When fractures are recorded, treatment must immediately begin with first aid, and then immobilization, anesthesia, conservative and restorative therapy, and other methods of treating fractures are applied, and, if necessary, surgical treatment is performed.

In order to accurately understand the nature of the injury, radiography is required.

First aid. The main task when providing treatment before the doctor arrives is to relieve pain shock, provide peace to the victim, minimize damage to soft tissues, and ensure immobility of the damaged area.

In case of an open fracture, it is necessary to stop the bleeding by applying a bandage. For pain relief, analgin or promedol is used. Immobilization for fractures is carried out by securing a homemade splint.

Immobilization measures. The main principle of fracture treatment is complete immobilization of the damaged area. Immobilization is ensured by layer-by-layer application of bandages impregnated with plaster or modern synthetic compounds. The plaster splint has a different number of layers depending on the location of the fracture (for example, shoulder - 6, lower leg - up to 10, thigh - 12 layers). Before applying a splint, the damaged area is treated with an antiseptic and lined with cotton wool to prevent bedsores.

Restoration activities. Restoring a damaged area is a fairly lengthy process. Exercise therapy is widely used for fractures; in addition, physiotherapy, therapeutic massage, CRM therapy, and treatment of bone fractures with folk remedies are used for full functional rehabilitation. If for some reason there is a fracture that has healed incorrectly, the resulting callus is carefully destroyed and immobilized again; More often, surgery is used to correct an improperly healed fracture.

Gelatin is an effective remedy. It is used for home treatment by oral administration and as a compress. Among other folk remedies, the most popular is mumiyo in various combinations. Folk remedies from comfrey root or in the form of mixtures of rose hips and currants, budra and plantain, lemon and spinach, and many other folk recipes are also used.

No one is immune from fractures during their lifetime. Despite the fact that the bones of our skeleton are quite strong, under certain conditions they may not withstand the load, and then a fracture occurs. The possibility of a fracture also depends on the individual characteristics of the human body and the strength of its bones. This is primarily influenced by nutrition, metabolic characteristics, and various pathologies.

Classification of fractures

When approaching this issue, it is necessary to take into account several signs by which the classification of fractures is carried out. If we consider the reason that provoked the fracture, they can be divided into:

Traumatic.
Pathological.

Pathological damage to the skeleton can be caused by various processes occurring in the human body. For example, they can often be provoked by benign or malignant tumors in the bones and degenerative changes. Bone fractures can be caused by osteogenesis imperfecta or other diseases of the skeletal system.

Traumatic fractures

These fractures most often occur as a result of a fall or as a consequence of a car accident. Based on whether damage to the skin occurs as a result of a fracture, the types of fractures can be distinguished as follows:

Closed.
Open.

Both the first and second varieties may have different severity of damage, based on this they can also be divided into the following types:

Signs of a fracture

Almost all types of fractures have similar symptoms:

The appearance of swelling at the site of injury.
Presence of bruising.
If bone fractures occur in the limbs, mobility is limited.
The slightest movement causes severe pain.
Limb deformity.
Change in limb length.
The appearance of unusual mobility.

With different locations and types of fracture, these signs may differ. For example, with a fracture of the spine, the victim may not feel pain at the site of injury; it may appear in the legs. If the fractures are displaced, then deformation is definitely visible, mobility appears where there should not be any.

A joint fracture usually does not lead to deformation, but the patient feels very severe pain. Thus, only after an X-ray examination can a doctor diagnose a fracture and its type with complete confidence.

Diagnosis of fractures

Since the symptoms of fractures can vary, it is not always possible to accurately diagnose a fracture in a person. Sometimes similar symptoms can accompany severe bruises. In order to provide qualified and correct assistance to the victim, it is necessary to ensure that there is a fracture.

When first aid has been provided, the injured person must be taken to the hospital, where he will undergo all the necessary tests. The most accurate is x-ray. It must be prescribed by a doctor if a fracture is suspected. This is especially important when there are no reliable signs, for example, with a spinal fracture.

The photographs must be taken in different projections in order not only to see the location of the fracture, but also to study it in detail. Only after examining the images will the doctor be able to recognize the type of fracture, its complexity and direction.

After applying a cast, if possible, or completely fixing the broken bone, the patient has repeat images to ensure that the bones are properly connected. This procedure will then be performed approximately every two weeks to monitor the bone healing process.

Closed fracture

This kind of fracture is quite easy to get; sometimes too much force on the arm or leg can cause such an injury. Bones can break in different ways, depending on which a fracture occurs:

As with any fracture, a closed one can be diagnosed by certain reliable signs:

Unnatural position of the limb.
A crunch appears.
A leg or arm becomes shorter or longer.

Treatment of a closed fracture

After examining the victim, the doctor will prescribe appropriate treatment.

Treatment for any type of fracture is to restore the integrity of the bones and the mobility of the limb or joint. For a closed fracture, several stages of treatment can be distinguished:

Ensuring complete immobility of the damaged bone.
Post-immobilization.
Recovery process.

Only when all these stages have been completed can you guarantee that the closed fracture has passed without complications for you.

Open fractures

This type of fracture is quite easy to distinguish from others; the skin is damaged and the bone sticks out. The danger of such damage is that pathogenic microorganisms can easily penetrate through an open wound and cause inflammatory processes.

The victim must be given first aid as quickly as possible and taken to the hospital. Since open fractures of the limbs are more serious, all first aid measures should be limited to the following:

It is necessary to stop the bleeding, which, as a rule, always accompanies open fractures. It is necessary to apply a tourniquet above the injury site if the bleeding is arterial. Just keep in mind that it cannot be left on the limb for more than 1.5 hours. With minor blood loss, you can get rid of it with a bandage.
Treat the wound and apply a napkin.
Since you will have to wait some time for the ambulance to arrive, you should apply a splint yourself to immobilize the limb. To do this, you can use any available means. The splint must be applied directly to clothing.
Do not try to set protruding bones; this may cause painful shock in the victim and lead to even more undesirable consequences.
After providing first aid, you must wait for the ambulance to arrive or take the person to the hospital yourself.

Treatment of closed fractures takes more time and necessarily includes surgery. It is necessary not only to align the bones with each other and put them in their place, but also to remove all foreign bodies from the wound and prevent the spread of infection.

Then the doctor must stabilize the fracture. This procedure is aimed at restoring blood circulation and stopping vascular spasm. Caring for the victim becomes easier and recovery will be faster.

When choosing a stabilization method, the severity of the fracture, its location, and the patient’s condition are taken into account.

The most commonly used devices are rod-based devices; they are easy to use and provide good bone stability. Before this, the bones are given the correct position, and then the wound is sutured.

Displacement of bones during a fracture

An experienced doctor will be able to identify such a fracture even before an x-ray. In children, they can occur without damaging the periosteum, but in adults, due to the fact that the bones are already more fragile and not so elastic, the bones can form fragments when fractured. It is their displacement that causes the appearance of a displaced fracture.

The displacement can be different, most often they are:

Longitudinal.
Lateral.
Axis offset.

It’s good if the periosteum is not damaged, then it at least somehow holds back the fragments and prevents them from damaging neighboring tissues. When the periosteum is destroyed, pieces of bone penetrate into muscles, nerves or blood vessels.

As a rule, with such a fracture, the length of the limb changes and unusual mobility appears. Of course, if you see bone fragments protruding from the wound, then there is no doubt that you have a displaced fracture.

Treatment of a displaced fracture

There are only two ways to treat such injuries:

Traction.
Plaster application.

It is worth noting that before using these methods, the doctor must combine all the fragments and give the bone its original appearance. This can be done by hand or using a special apparatus with knitting needles.

Since this process is quite painful, the patient undergoes this entire procedure under general anesthesia. This not only relieves him of pain, but also allows him to relax his muscles.

Some doctors are of the opinion that it is advisable to treat such a fracture without using casting, so as not to impair blood circulation.

First aid for fractures

It is very important when a person suffers a fracture as a result of an injury, to provide him with timely assistance. It consists of the following manipulations:

Complications of fractures

With fractures, there is always a possibility that healing will occur poorly or the bones will not heal at all. In this case, you will have to resort to surgical intervention. Quite often, the cause of nonunion can be various complications that cause some consequences of fractures. These consequences include:

Bleeding, which means severe blood loss. In this case, the supply of nutrients to the injured area is disrupted.
Damage to internal organs. For example, with a skull fracture, there is a possibility of brain damage. A fracture without displacement is safer in this regard.
Infections. This is often observed with open fractures, when pathogens penetrate through the wound and provoke an inflammatory process.
Some problems with bone growth. This can often be seen in children when the bone simply fails to grow to the desired size, especially if the damage occurs near a joint.
Painful sensations. Almost all types of fractures are accompanied by severe pain. Therefore, you cannot do without painkillers.

If all these symptoms are not eliminated in time, this can lead to more serious complications, then healing of the broken bone will occur with great difficulty. Any type of fracture after healing can cause swelling, pain at the site of the former injury, and impaired movement.

In order to avoid this, it is necessary to undergo a rehabilitation course after complete fusion of the bones. Physical therapy, physiotherapy, massage will help you quickly return to normal after a fracture.

Fracture is the main clinical manifestation of metabolic bone diseases.

Causes of bone fractures

Violations of bone integrity due to increased bone fragility occur spontaneously or as a result of relatively mild traumatic effects; Such fractures are typical for osteoporosis

Pathological bone fractures occur due to structural abnormalities of the bones, for example due to Paget's disease, osteomalacia, bone metastases, parathyroid osteodystrophy. Like fractures due to increased bone fragility, pathological fractures occur spontaneously or due to minor traumatic effects.

High-energy bone fractures are caused by serious damaging effects (in a car accident, fall from a height) and affect bones of normal structure. The same can be said for stress (fatigue) fractures in healthy people, such as athletes and military personnel, who are exposed to repetitive traumatic exposure.

Symptoms of bone fractures

Violation of the integrity of long tubular bones is characterized by acute pain syndrome in combination with swelling of the limb; symptoms are preceded by traumatic exposure. The main condition that needs to be differentially diagnosed is soft tissue damage, but a fracture is characterized by severe pain, swelling of the limb, pathological mobility, bone crepitus and deformation of the limb. A fracture of the femoral neck in typical cases leads to shortening of the leg and its external rotation; movements cause .

Symptoms of spinal fractures are more varied; sometimes a spinal fracture causes severe back pain radiating to the anterior chest, simulating myocardial infarction or pulmonary embolism. In other cases, symptoms are absent or insignificant, for example, in the form of transient back pain, a decrease in the overall height of the spine. Differential diagnosis for back pain should be carried out with a large number of diseases, however, a significant decrease in the height of the spine and acquired kyphosis indicate an osteoporotic fracture.

Rib fractures often cause pleuritic pain; in this case, chest disease can be suspected, especially in patients with chronic pulmonary disease and osteoporosis due to the use of glucocorticoids. However, rib injuries are characterized by increased pain with movement, pain on palpation, and pain with springy pressure on the chest wall.

Examination for bone fractures

If a fracture is suspected, it is necessary to take x-rays of the injured area in at least two mutually perpendicular projections; the images should be carefully examined for continuity of the bony contour. If radiographs do not reveal signs of bone disruption, but doubts remain, other imaging studies are indicated, such as radioisotope bone scanning for osteoporotic and scaphoid fractures, CT or MPT for pelvic or spinal fractures. CT and MRI also help differentiate osteoporotic fractures from pathological vertebral fractures with metastases.

Treatment of bone fractures

Therapeutic measures for violations of bone integrity include adequate pain relief (if necessary, with the use of narcotic analgesics; reposition of bone fragments with restoration of anatomical relationships and immobilization to promote fusion of bone fragments, which is carried out using adhesive bandages or other fixation methods.

A fracture of the femoral neck is a separate problem, since it often causes complications in the form of fracture nonunion and avascular necrosis. Complications are especially common with intracapsular fractures - then surgical treatment consists of prosthetics with replacement of the femoral head.

Rehabilitation and observation after fractures

From the point of view of prognosis, rehabilitation measures are no less important than repositioning bone fragments and immobilization. The program allows you to prevent muscle weakness and the occurrence of joint contractures, which in the future can adversely affect the patient’s motor activity, especially in old age. In old people with femur fractures during hospital stay, a positive effect was noted from nutritional support (replenishment of missing nutrients with the help of special biological supplements); In general, nutritional support for fractures in elderly patients should be implemented everywhere.

Patients with high-energy fractures and bone loss due to osteoporosis, after diagnosis and initial reduction and immobilization, are simply monitored until union. Patients with compromised bone integrity due to increased bone fragility or vertebral fractures require additional evaluation to identify secondary causes that can be treated, such as Paget's disease, osteomalacia, malignant diseases, and secondary hyperparathyroidism. In addition, bone mineral density should be measured as part of the osteoporosis screening test.

The article was prepared and edited by: surgeon

Experts distinguish different types of fractures. The classification of fractures depends on a large number of characteristics.

It is a complete or partial destruction of the integrity of bone tissue when excessive physical load is placed on it, exceeding the strength limits of skeletal tissue in the area of injury. Damage occurs both in the event of exposure to a traumatic factor and during the development of various ailments leading to pathological changes in the strength characteristics of skeletal tissue.

The severity of the condition is determined by the size of the damaged bone, the number of lesions and bones affected. Multiple lesions received by tubular bones provoke the occurrence of heavy blood loss and lead to the development of trauma shock. Patients with such lesions slowly restore their health, and recovery sometimes lasts several months.

Criteria for classification of injuries, characteristics of open and closed types of bone injuries

All types of bone fractures are classified according to several criteria, which is associated with a wide variety of causes leading to the occurrence of lesions and areas of localization of injuries.

In modern medical classifications of bone fractures, experts distinguish different types depending on the following signs:

causes of injury;
severity of the lesion;
shape and direction of the injury line;
degree of skin damage;
localization of the wound area;
the likelihood of complications.

The most common classification is the division of various types of fractures into two groups: closed and open. The main difference between open types and closed ones is that a violation of the integrity of a skeletal element is accompanied by damage to the skin and the presence of an open wound. In the open type, the area of damage to the skeletal element communicates with the external environment, as a result of which all bone injuries are primarily infected.

Skeletal elements can be primary and secondary open. In the case of a primary open injury to a skeletal element, a trauma-forming force affects the affected area, resulting in injury to soft tissue, skin and bone tissue. When this type of injury occurs, the resulting extensive skin wound is characterized not only by a large area of soft tissue damage, but also by splintered bone damage. In the case of a secondary open injury, soft tissue injury occurs from the inside as a result of a puncture of fragments of a skeletal element with sharp ends. This type of injury is accompanied by the appearance of a wound and a small affected area.

Classification of bone lesions

Based on the reason for their occurrence, skeletal bone fractures are divided into two groups by experts:

traumatic;
pathological.

The formation of traumatic injuries is caused by excessive external forces in the area of injury.

Appear as a result of minimal impact on the bone. Such exposure leads to the appearance of damage in the presence of ailments in the body that contribute to the destruction of tissue of skeletal elements. Such ailments can be tuberculosis and tumors of various natures.

Depending on the severity of the resulting lesion, there are the following types of damage:

full;
incomplete.

Complete fractures can occur with or without displacement. Incomplete bone injuries are cracks or fractures.

Depending on the shape and direction of the line of damage, the classification of fractures includes several types of bone injuries.

Medical specialists distinguish the following types of bone fractures:

transverse;
longitudinal;
oblique;
helical;
splintered;
wedge-shaped;
driven in;
compression

Based on the location of the injury, lesions of the diaphysis, epiphysis and metaphysis are distinguished. During the development of the disease, various complications can develop; therefore, injuries are divided into complicated and uncomplicated. When the growth zone of a skeletal element is injured, a special type of injury occurs - epiphysiolysis.

Characteristics of bone injuries depending on the form and direction of injury

Transverse injuries to skeletal elements are characterized by the presence of a fracture line that is perpendicular to the longitudinal axis of the bone element.

Longitudinal damage has a line of tissue destruction, which is directed parallel to the longitudinal axis of the skeletal element.

Oblique injuries are distinguished by the presence of a line of injury, which is located at an acute angle to the longitudinal axis of the bone element.

A helical fracture differs from other types of injury in that during the injury process, rotation of the fragments relative to their normal position is observed.

Splintered injuries of bone tissue do not have a single line of injury; the bone at the site of injury has a crushed appearance and consists of individual fragments.

Wedge-shaped fractures are lesions characteristic of fractures of the vertebral column. This type of lesion is characterized by pressing one bone into another. When this process occurs, a wedge-shaped deformation is formed.

Features of impacted lesions are the displacement of the proximals along the longitudinal axis or their location outside the main axis of the bone element.

Compression lesions are characterized by the absence of a single line of injury and the presence of small bone fragments in the affected area.

Diagnosis of bone injuries

Each type of injury has characteristic signs that allow specialists to diagnose it.

During the examination, traumatologists identify characteristic symptoms that allow an accurate diagnosis of the victim. All symptoms are divided into absolute and relative.

Medical experts include the following as absolute symptoms:

the appearance of a characteristic deformation consisting in a change in the configuration and axis of the bone element of the skeleton;
the appearance of pathological mobility (the appearance of limb mobility outside the joint zone or restrictions in mobility);
the appearance of crepitus (a phenomenon characterized by the occurrence of a bone crunch in the area of damage as a result of friction of bone fragments);
the occurrence of shortening of the limb in the event of displacement of fragments along the longitudinal axis.

All these symptoms are a direct indication of the presence of trauma to a bone element of the skeleton.

Relative symptoms include:

pain at the site of injury, which intensifies with movement;
the occurrence of local painful sensations during palpation;
increased pain at the site of injury when a load is applied in the direction of the longitudinal axis of the bone element;
the appearance of a hematoma in the area of injury; the hematoma can be of significant size;
motor dysfunction.

Relative symptoms can signal the occurrence of not only fractures, but also dislocations and bruises. However, if there are several relative symptoms that occur in a person, it can simultaneously assume the presence of injury to a skeletal element in the form of a fracture. To confirm the diagnosis, the area of injury is examined using radiography in two planes.

Consequences of injury

After an injury, a violation of the integrity of the bone tissue appears, provoking the development of severe bleeding and the occurrence of severe pain. With complete fractures of the tubular elements of the skeleton, displacement of the fragments relative to the longitudinal axis occurs. The displacement of the fragments is caused by the occurrence of uncontrollable pain pulsation in the muscle tissue that surrounds the area of injury. The muscles that are attached to bone fragments, as a result of a reflex contraction, displace the fragments relative to the normal position of the bone. This displacement leads to additional injury, aggravating the severity of the lesion. In the area of injury, an extensive hematoma forms in the closed type and heavy bleeding in the open type.

Bleeding resulting from injury is very difficult to stop, since the blood vessels of the bone tissue do not have the ability to collapse. The vessels are located in the mineral part of the bone, which prevents them from blocking. The amount of blood loss depends on the type of injury received and location, as well as on the type of bone element that was injured.

In the area of bleeding, tissue swelling occurs and fibrin threads are formed, which later form the basis for the formation of the protein base of the bone tissue of the damaged element. Stopping bleeding is a difficult task and in most cases is only possible in a specially equipped operating room.

If injured, the person should be taken to a hospital for treatment.

The life of a modern person differs in many ways from that which was characteristic of, say, the inhabitants of the Middle Ages. However, events such as injuries, which include bruises, sprains and fractures, still occur. This article is about bone fractures. In it we will try to briefly consider the reasons for their appearance, as well as the main types.

Definition of bone fracture in medicine

First, it’s worth figuring out what fractures are? What is included in the concept of “fracture” among specialists? In simple terms, fractures include any injuries that are characterized by the destruction of any bone of the human skeleton. In medicine, this term sounds like this: a fracture is the complete or partial destruction of a bone as a single, monolithic fragment of the body, a violation of its integrity under conditions where the traumatic effect exceeds its strength.

The main reasons why a bone can break, experts include the following:

Injuries during which there is strong compression over the entire surface of the bone or a targeted impact on it with a high degree of intensity.
Stress fractures, which are systematic microtrauma to a specific joint or bone.
Diseases that cause a decrease in the strength of the entire skeleton or individual bones in it.

According to statistics, the most common fractures that occur in a person are the limbs: arms and legs. In second place are fractures of the bones of the skull and spinal column.

Types of fractures

So, we move on to another, no less important issue, which concerns such a phenomenon as a fracture. This type of injury, depending on the causes that caused it, is divided into several types. Firstly, fractures can be acquired and congenital, traumatic and pathological. Traumatic fractures most often occur as a result of falls, blows and other mechanical impacts on the skeleton. Pathological fractures can appear even in a state of complete rest in diseases such as osteomyelitis, osteogenesis imperfecta, osteoporosis and others.

Since a fracture is, first of all, an injury, there are two types of it, depending on how damaged the tissue surrounding the bone is. If there is a rupture of muscle fibers and skin, we are talking about an open fracture. If the skeletal bone that has lost its integrity does not damage the skin, then such a fracture is classified as closed. Open fractures, in turn, are divided into primary and secondary: the former are characterized by a large wound surface with bone fragments coming out, while the secondary is characterized by a small wound on the skin caused by a puncture of the skin by bone fragments from the inside.

The nature of the fracture of the skeleton bones also gave rise to several groups of bone fractures: helical, oblique, transverse and longitudinal, crushed, fragmented and splintered, impacted, avulsion and compression.

For example, or the hips are most often oblique, transverse or longitudinal. First of all, this is due to the structure of these particular bones, as well as their increased vulnerability. Often, when limbs are injured, dislocation and fracture occur. This phenomenon in medicine is called fracture-dislocation. They are most often diagnosed with injuries to the elbow and ankle.

Symptoms and signs of fractures

The occurrence of a fracture of any bone can be easily diagnosed. Common symptoms of bone tissue disorders are: sharp or dull pain, swelling of adjacent tissues, atypical mobility, impaired motor function, hematoma formation.

A fracture of the humerus or femur may also be accompanied by the appearance of a characteristic protrusion and blue discoloration of the fingers. When the bone is displaced, shortening of the limb is observed, and severe pain appears when trying to move it. When a joint is fractured, the patient’s contours of the damaged part of the body are smoothed out, and noticeable swelling appears due to the blood accumulated in it. Open fractures are characterized by the presence of a bleeding wound in which bone fragments are visible.

Diagnosis of bone fractures

The first diagnostic measure if a fracture is suspected is, of course, external examination and palpation. With their help, you can detect signs such as the appearance of a tumor and increased tissue sensitivity, as well as the inability to move the injured part of the body.

The clearest idea of the type and type of fracture can be obtained by radiographic examination. This type of diagnosis allows you to determine the location of bone fragments and their number. As a rule, X-rays are taken in two projections, since this is what allows one to confirm or refute the presence of displacement of bone fragments.

First aid for a fracture

If a fracture is suspected, it is important to immobilize a limb or other injured part of the body as soon as possible using special devices or improvised means. In case of a fracture, the splint should fix not only the fracture itself, but also the nearby joints. It is important to avoid excessive compression of soft tissues. If there is an open fracture, an insulating (if possible sterile) bandage is applied to the wound.

Severe pain can be relieved with medications. You should also place something cold at the fracture site: an ice pack, a bottle of water, etc. When the patient exhales, the chest is bandaged with elastic material. After these procedures, you can transport the victim to the nearest hospital.