FRACTURES

Disease information

FRACTURES

Fractures.

The fractures are the breakage, partisan or total, of the bones.

In the human body there are 206 bones that, articulated to each other, form the skeleton.

The bones not only serve to lend a handle and support to our movements, but that also constitute a protective frame of organs and delicate apparatuses:

The skull and raquis protect encéfalo and the spinal marrow.

The orbit locks up and protects the ocular globe.

The torácica box defends of traumatic violences the heart and the lungs.

Bones, joints and muscles constitute a functional unit, and in this one, the bone has as main mission the one of support.

Complications.

Given the great variety of possible fractures, it is impossible to list all the possible complications.

Most specific they are:

Greasy Embolia (by fracture of fémur)

Collapse (shock) neurogénico (by back fractures)

Loss of extremities.

Prognosis.

Very variable.

Diagnosis and treatment.

Diagnosis.

After any accident, it is necessary to consider, until the opposite does not demonstrate itself, that he can have bony fractures.

Suspect a fracture when it appreciates abnormal swelling, angles, lack of symmetry (comparing both) or impossibility to move an extremity.

Suspect a fracture when the victim complains intense or present pain an important wound on a bony zone.

If the patient is unconscious, we will have to estimate that she has some fracture in the back or head until these discard.

The simple x - rays are the method diagnosis par excellence.

In some special circumstances, it must resort to other techniques of imaginería to need the injuries, mainly in pelvis, neck and head, like escáner (T. A. C. and the R. M. N.

Treatment.

The treatment of the fractures, consisting of reduction (relocation of the pieces in its site) and immobilization, is all a medical specialty, the traumatología, and can be very complex.

Here we will give norms for the initial attention of the patients who will facilitate the later definitive treatment:

We must act with serenity without exposing to the victim or we ourself to a new danger.

Before the suspicion of a fracture, it is necessary to warn the medical services as rapidly as possible.

Always consider that, although so that takes place a fracture in a young person makes lack an important force, in a old person a fall can be enough or tropezón.

The treatment must be made in the place in which is the victim, unless an immediate danger exists:

In such case, we must retire before maintaining it the part injured with both hands ahead and behind or by above and under the injury, avoiding any unnecessary movement.

This provisional immobilization will be sufficient while another person transfers it.

If one is an opened fracture, we must cover it with a sterile dressing or a clean handkerchief before immobilizing it.

The immobilization of the injured zone must include the broken bone and the adjacent joints: we will use the parts of the body that are healthy (the trunk, the other leg) or rigid objects (cardboard small boards, tubes, branches) and we will hold it by means of bandage, strips of rag or belts, having taken care of of not tightening too much the bandage.

The subjection must be firm without jeopardizing the circulation below the injury.

We will pay attention to the color of the skin and in if he is hot.

If it wanes or one cools off (in members, in comparison with the other) we will have to relax it.

The transfer of the wounded must be made in a suitable vehicle since, if not outside thus, we could aggravate the fracture or originate internal injuries of very serious character.

It is very important to consider that if the fracture is in the skull or the spine, we do not have to move to the victim:

In opposite case, we could cause injuries in the brain or the spinal marrow.

If it is not left more remedy than to move it, one will become "in block" with the aid of several people who mobilize to unisonous the different parts from the body so that this she moves like a table.

If it is not essential, waits for the services of aid, since they take rigid tables ("shovels") to intention for these maneuvers.

Some fractures will require immediate surgical treatment, other deferred surgical treatment, others only ortopédico treatment.

Factors of risk.

Driving of vehicles (the pedestrians undergo proportionally many fractures less, although they are more serious when they are run over)

Sports of risk or contact.

Labor activity.

The postmenopáusicas women and very greater men, offer a very disminuída resistance in their bones, reason why little intense traumatismos can produce important fractures to them.

Prevention.

To lead with precaution, using the defenses to our reach (what in addition it is obligatory) Lap belt and helmet.

To fit the head rests and to lead with the head supported in them.

To respect the signals of traffic and the norms of road security, specially the limitations of speed.

The pedestrians will have to circulate always around the left and taking care of the traffic in highway, and they will not be entrusted in the reactions of the conductors.

To use the specific protections of each sport of risk or contact (helmets, espinilleras.

In labor means, to respect the indications of security, not to annul the safeties (interrupting, railings. to use the individual protective equipment precise (helmets, harnesses. and to maintain the order and the cleaning in the work place.

The postmenopáusicas women will carry far the care.

Signs and symptoms.

The specific signals that they make suspect a fracture us are:

Intense pain in the zone of the injury.

Swelling or deformity, more apparent in the extremities.

Difficulty or impossibility to move the injured part.

Also they can appear signs and symptoms by the injury of other structures, either by the traumatismo or by the bone when moving its pieces:

Collapse (shock) circulatory, before the injury of an important glass.

Collapse (shock) neurogénico in the affectations of the spinal marrow.

Anesthesias or paresias (partial lack of sensitivity) when a sensitive nervous trunk is injured; or paralysis when he is motor.

Causes.

The bones offer resistance to all the classes of forces that on him act (pressure, traction or torsion)

When some of them exceeds the elastic properties of the bone the fracture takes place.

If it must to a direct force, the fracture in the point of the impact takes place. On the contrary if the force is indirect, the fracture takes place to certain distance.

Supported in the bones or their proximities, there are blood vessels, vital nerves and organs. Therefore, before a fracture we must act with precaution, to prevent other damages that could take place when making unnecessary movements.

Even though multiple forms exist to classify the fractures, we are going to remember the one that divides them in:

Closed fractures: the skin that surrounds the injury is complete; when closed being, it protects against a possible infection.

Open fractures: the solution of continuity of the skin is lost, by where it can excel the fractured end of the bone or present / display a deep wound that arrives until the fracture.

The manipulation of the fracture returns to receive a great importance, since badly a movement, in addition to being able to injure to the glasses and the nerves, can transform a closed fracture into open, originating an additional damage.

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