What to do in case of a fracture. What to do if your leg is broken? What not to do for fractures

Fracture is called a partial or complete violation of the integrity of the bone as a result of its impact, compression, compression, bending. After a complete fracture, the bone fragments are displaced. With an incomplete fracture, the bone is partially damaged - a fracture or crack is formed. Fractures happen closed(without damaging the skin), open(with violation of skin integrity) and complicated(bleeding, crushing of surrounding tissues).

Signs of a fracture: pain, swelling, change in shape and shortening of the limb, the appearance of mobility at the site of injury, “crunching” of fragments. A fracture is always accompanied by damage to soft tissues. Particularly dangerous are injuries to large vessels and nerve trunks, the formidable companions of which are acute blood loss and traumatic shock. In the case of an open fracture, there is a risk of wound infection.

In case of fractures, when providing first aid, you should under no circumstances try to compare bone fragments - eliminate the curvature of the limb in a closed fracture or straighten the protruding bone in an open one, because The fragments, when displaced, often damage blood vessels, nerves and internal organs. For fractures and joint injuries, the main thing in first aid is reliable and timely immobilization of the damaged part of the body, which leads to a reduction in pain and prevents the development of traumatic shock, eliminates the risk of additional damage and reduces the possibility of infected complications.

Temporary immobilization for bone fractures is usually carried out using various types of splints made of various materials: wood, plastic, metal, rubber. The splints must ensure the immobility of the two joints adjacent to the fracture site. In the absence of standard means, you can use available means: boards, sticks, plywood, cardboard, etc. In exceptional cases, transport immobilization is allowed by bandaging the injured limb to a healthy part of the body: the upper one to the torso, the lower one to the healthy leg.

Fracture of the skull bones. Broken bones often damage the brain, which is compressed as a result of hemorrhage. Signs of a fracture are: violation of the shape of the skull; break (dent); leakage of cranial fluid and blood from the nose and ears; loss of consciousness.

To fix the neck and head, a soft fabric collar is placed on the neck. To transport the victim, they are placed on a stretcher, a soft bedding with a recess is placed under the head, and soft cushions rolled up from clothing or other available material are placed on the sides.

For fractures of the upper jaw The simplest method of immobilization is a circular bandage or scarf. When applying it, the lower jaw is pulled towards the upper jaw until the teeth are closed and fixed in this position with vertical moves of the bandage around the head or with a scarf. In cases where the teeth do not close together, a strip of plywood or a piece of ruler is inserted between the jaws and pressed against the upper jaw.

Fracture of the lower jaw may lead to asphyxia (suffocation). If a person loses consciousness as a result of an injury and lies on his back, the tongue may retract and immediately suffocate. It is necessary to give the victim a sitting position with his head tilted or put him on his stomach with his head turned to the side. Sometimes they resort to stitching the tongue with a pin and provide immobilization of the lower jaw.

With a fracture of the humerus the forearm is bent at a right angle at the elbow joint, and two splints are applied to the broken bone of the shoulder: one on the outside of the shoulder, and the other from the armpit to the elbow joint. Then both splints are bandaged to the shoulder and the bent forearm is suspended on a belt or scarf.

In the absence of a service splint (Fig. 12, a) or available means, the arm bent at the elbow is suspended on a scarf, belt and bandaged to the body (Fig. 12, b).

Rice. 12. Immobilization for a humerus fracture

Clavicle fracture more often occurs when falling on an outstretched arm. Medical care should be aimed at immobilizing the belt of the upper limbs (Fig. 13, a).

Rice. 13. Fixation of hands in case of a clavicle fracture

A ball of cotton wool is placed in the armpit on the injured side and the shoulder is tightly bandaged to the body, and the forearm is suspended on a scarf, and the arm is attached to the body with a second scarf. The injured hand can be placed on the raised hem of the jacket (Fig. 13, b).

Rib fractures accompanied by pain when breathing. Immobilization - a tight bandage on the chest. The first passes of the bandage are made while the victim is exhaling.

Spinal fracture – the most severe and painful injury. Even minor displacements of bone fragments can lead to death. Therefore, it is strictly forbidden to sit or stand a victim with a spinal injury. He should first be given an anesthetic (morphine, promedol, analgin, etc.), and then placed on a flat, hard board or board (Fig. 14).

Rice. 14. Splints made from boards for a spinal fracture

It is necessary to lift a victim with a spinal fracture very carefully, in one step, so as not to cause displacement of fragments and more severe destruction of the spinal cord and pelvic organs. Several people can lift the victim by holding his clothes and acting in concert, on command (Fig. 15).

Rice. 15. Placing the victim on a stretcher

In the absence of such a shield, the victim is placed lying on his stomach on a regular stretcher, with pads or bolsters placed under his shoulders and head (Fig. 16).

Rice. 16. Position of the patient with a spinal fracture

A person with a fracture of the cervical spine should be left on his back with a bolster under his shoulder blades, and his head and neck should be supported by placing soft objects around their sides.

Fracture of the pelvic bones. It is impossible to place the victim on a soft stretcher, only on a shield (wide board, plywood) or on a stretcher with plywood placed on it (Fig. 17). The victim is placed on his back, his legs are spread apart (“frog position”) and a thick pad made of a folded blanket or rolled-up clothing is placed under his knees: In this position, the limbs are fixed with a spacer and bandages.

Rice. 17. Position of the patient with a fracture of the pelvic bones

For a fracture of the forearm bones the arm at the elbow joint is bent at a right angle with the palm facing the body. The splint is taken such a length that one end covers the fingers, and the other extends beyond the elbow joint. In this position, the splint is secured with a bandage, and the hand is suspended on a scarf or belt.

Fractures of the bones of the hand andfingers. Damaged bent fingers (giving a “grasping” position to the hand) are bandaged to a cotton roll, hung on a scarf or splinted.

For fractures of the lower extremities The transport splint is usually applied to the straightened leg (Fig. 18). In this case, you must have at least two large tires. One of them is applied along the outer surface of the limb, with one end of it being under the armpit and the other protruding slightly beyond the foot. The second splint is applied along the inner surface of the leg so that one end reaches the perineum and the other protrudes beyond the edge of the foot. In this position, the splints are bandaged to the body.

Rice. 18. Methods of immobilization

for fractures of the lower extremities.

If there are no service splints or available means, the injured leg should be bandaged to the healthy leg.

In case of fractures of the foot bones, a plank is bandaged to the sole.

All methods of immobilizing bandage should provide good fixation of the fracture site and not disrupt the blood supply to the injured limb. Therefore, when applying a transport splint, it is necessary to ensure immobility in the joints above and below the fracture site.

To prevent strong compression and pain, the splint is wrapped with cotton wool and a bandage. In case of an open fracture, stop the bleeding, apply an aseptic bandage to the wound, and only then begin immobilization.

Questions at the beginning of the paragraph.

Question 1. What are the goals of first aid for trauma?

The goal of first aid for trauma is to ensure gentle transportation of the patient to the emergency room, reduce pain, and exclude infection. A serious injury will be treated by a doctor.

Question 2. What should be done in case of bruises, fractures, sprains and joint dislocations?

First aid measures for bruises are aimed primarily at reducing pain and internal bleeding. Cold is used for this purpose. It is not recommended to apply a bottle of cold water or ice directly to the body: it must be wrapped in cloth.

For open fractures, you must first stop the bleeding and treat the wound and apply a bandage. You should not try to force the bones into their natural position, as broken ends of the bones can damage soft tissue, rupture a blood vessel, or damage a nerve. The affected part of the body must be immobilized, that is, it must be fixed.

If the leg is twisted, the foot is placed perpendicular to the shin and a fixing bandage is applied in this position. They bandage with a figure of eight, that is, after the next move, the bandage is turned over to the other side and applied alternately to the foot and shin. The foot should be fixed perpendicular to the shin.

Questions at the end of the paragraph.

Question 1. What should be done if a limb is fractured?

Ensure complete rest of the damaged bone by applying a splint using available means.

If you fracture the bones of the forearm, bend your arm at the elbow at a right angle, bend your fingers halfway, placing a roll of gauze or cotton wool under them. Apply a splint, covering two joints (above and below the fracture - elbow and wrist).

If the humerus is fractured, fix the shoulder and elbow joints.

If the bones of the leg and thigh are fractured, apply splints to the entire damaged leg from the outside and inside, directly onto the clothes.

Give the victim an analgin tablet. Apply cold (snow or ice in a plastic bag) to the injury site for 15–20 minutes. For open fractures and bleeding, apply a sterile bandage to the wound. Stop the bleeding.

Question 2. What first aid measures are used for chest injuries?

In case of chest injuries, the victim is asked to hold his breath during the exhalation phase and apply a tight bandage. After this, he is allowed to breathe shallowly and taken to the emergency room.

Question 3. What should be done in case of spinal injuries?

In case of spinal injuries, the victim must be placed face down on a flat floor. It is strictly forbidden to seat the victim. It is impossible to transport or carry the victim in a sitting position. Next you need to call an ambulance.

Question 4. In what cases should a splint be used, and how to apply it correctly?

The splint is applied mainly when the limbs and their belts are damaged. To apply the splint correctly, the following requirements must be taken into account:

Use a hard flat object (a board, a ruler, a stick, a rolled-up magazine) as a splint. You can use a healthy leg (in case of a broken leg) or a finger (in case of a broken finger) of the victim as a splint.

If the splint is too rough, wrap it with a piece of cloth or towel before applying it.

Make sure the splint grips the joints above and below the fracture.

Tape the splint to the injured part of the body with a bandage, tape, or belt. Make sure that the bandage is not too tight; If the fingers of a bandaged hand or foot turn pale and cold, make the bandage looser. The nodes should not put pressure on the damaged areas.

Figure 41 schematically shows two types of injuries. Determine what letters indicate fracture and dislocation.

Figure A shows a dislocation, Figure B shows a fracture.

A fracture is a complete or partial disruption of the integrity of a bone resulting from trauma. Fractures can be open or closed. With an open fracture, there is a violation of the integrity of the skin. A wound surface is formed and infection can occur. Naturally, this leads to various complications and slower recovery. Injuries can also cause bone cracks and tears of the bone tubercles to which the muscles are attached. A combination of fracture and dislocation is possible.

As people age, their bones become lighter and thinner. Thus, a seventy-year-old person has a skeleton that is about a third lighter than a forty-year-old person. This decrease in bone density, or osteoporosis, occurs when the balance between natural bone breakdown and repair is disrupted. Almost all older people suffer from osteoporosis, but in different forms: the disease is more severe in people who are thin and sedentary, especially if their relatives are also affected by osteoporosis. Many people do not realize they have osteoporosis until they break a wrist or femur in a simple fall. Such a fracture can leave an elderly person bedridden and even be fatal.

The younger and stronger the body, the faster bone healing occurs during fractures. Therefore, in children and young people everything returns to normal much faster than in old people. There are no standards for bone healing after fractures. For some, the bones heal in a few weeks (3-4 weeks), for others in 2 months, and for others with the same fracture, the bones will heal for 1.5 years.

For fractures without bone displacement, outpatient conservative treatment is usually prescribed. The principles of fracture treatment are simple, with restoration of bone integrity being the most important. The patient is given a fixing bandage, usually a plaster cast. This allows you to reduce pain and ensure limb immobility. For fractures with complications, for severe fractures with bone fragments, with displacement, surgical intervention is performed. In the most severe cases, fixation with metal knitting needles is used.

Is it possible to speed up bone healing during fractures?

Is it possible to somehow speed up the process of bone fusion? Yes, it can be influenced. Below are some useful tips:

• Follow all doctor's instructions. If he said to wear a cast for a month, you shouldn’t think that after 2 weeks it will be possible to remove it.
• Try not to move or put pressure on the injured limb and avoid excessive strain. Otherwise, the bones will shift, or the fragile callus will break.
• Calcium is needed to strengthen bones. You can get it from sesame seeds, dairy products and small fish, which can be eaten with bones. Cottage cheese is especially rich in this microelement, so lean heavily on it.
• Vitamin D 3 is also necessary, which allows calcium to be properly absorbed. It is found in fish oil and fatty fish (herring, trout).
• You can’t do without vitamin C either, as it promotes collagen synthesis. Collagen, in turn, is the basis of many tissues. Eat citrus fruits, kiwi, greens, sauerkraut.
• Many doctors advise patients with fractures to use gelatin. Jellied meats are especially useful, as they are also very nutritious.
• If fusion is very slow, then the doctor may recommend a certain drug that has a positive effect on this process.

Physiotherapy for bone fractures

To speed up the process of bone fusion, physiotherapy is prescribed. Physiotherapy should begin on the 2-5th day after the injury. For pain relief, elimination of edema, resorption of hemorrhages and acceleration of bone regeneration, the following are used: UHF therapy, which has an analgesic effect, reduces tissue edema, low-frequency magnetic therapy, and interference currents.

For a long time, bone tissue was viewed as a very passive substance, incapable of generating electrical potentials. And only in the middle of our century, researchers discovered that electrical processes take place in bones, as well as in other organs. A change in the nature of electrical signals was also observed when metal screws were introduced into the bone, which are usually used to fix metal structures used to treat fractures.

Interestingly, the property of producing biopotentials under load was also preserved in bones removed from the body, and even in specially treated bone, in which only the “bare” crystalline base, the so-called matrix, remained. Analyzing these data, experts came to the conclusion that bone tissue contains structures that act as unique piezocrystals.

Weak currents can have a noticeable effect on bone tissue regeneration; available information allows specialists to use electrical stimulation in the clinic to target bone tissue.

Doctors know that the lack of load on the injured limb and its long-term inactivity slow down the formation of a full-fledged bone adhesion after a fracture. Therefore, it is recommended to move the injured limb, naturally, within reasonable, permissible limits. But there are times when even minimal movement is impossible. If in such a situation the damaged limb is exposed to an electric current, the frequency of oscillations of which coincides with the frequency of oscillations of the biocurrents that arise in the bone during physical activity, positive dynamics are observed. At the same time, immobility is maintained and the bones receive the load they need. As a result, the process of bone adhesion formation occurs faster.

Domestic scientists, back in the Soviet period, developed methods that make it possible to use directed electric current in fresh fractures, when for some reason the fusion of bone fragments is disrupted, as well as in cases of formed non-united fractures, false joints, and some bone defects. Clinical observations have shown that in many cases that doctors call difficult, electrical stimulation gives good results.

What to do to make your bones heal faster

Currently, there is a tendency to prolong the healing time of fractures. This is associated, first of all, with the widespread insufficient consumption of elements such as calcium, phosphorus, etc. And also, the spread among the population, especially in people over 50 years of age, of vitamin D deficiency, which ensures the flow of calcium from the intestines into the blood and then into the bone .

In addition, vitamin D enhances the formation of a number of substances that are necessary for normal fracture healing.

Preparations based on calcium carbonate (purified chalk) + Colecalciferol (vitamin D3) will help speed up the healing of damaged bones. In this case, an acceleration of fracture healing by 30% is observed.

Calcium is also involved in the regulation of nerve conduction, muscle contractions and is a component of the blood coagulation system. Vitamin D3 regulates the exchange of calcium and phosphorus in the body (bones, teeth, nails, hair, muscles). Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium in the body, necessary for the mineralization of teeth.

Vitamin D3 increases calcium absorption in the intestines. The use of calcium and vitamin D3 interferes with the production of parathyroid hormone (PTH), which is a stimulator of increased bone resorption (leaching of calcium from the bones).

During the recovery period after a fracture, a full set of vitamins and microelements is necessary.

Nutrition for fractures

To help bones heal faster, your diet should have enough calcium, vitamin D and protein. Every day it is advisable to drink a glass of any fermented milk drink - kefir, yogurt and eat 100 grams of low-fat soft cottage cheese. In order for calcium to be better absorbed, the food must also contain vitamin D. There is a lot of it in cod liver and fatty fish. During fractures, the body needs protein, because it is one of the building materials of bone. Hard, low-fat cheese, lean poultry, meat, fish, and eggs are rich in protein. It is healthier to eat poultry and meat boiled.

For fractures, you need to eat products with gelatin (jellied meat).

If you have broken bones, you don’t need to limit sweets. The human body cannot do without sweets. Sugar contains sucrose, which promotes rapid healing of bones after fractures.

Physical activity for fractures

Physical activity is necessary for bones to heal faster. However, thinning bones require a number of restrictions in the exercise program.

You will need to consult an exercise specialist and a physiotherapist. You can try doing exercise in a group.

You can walk for half an hour 3-5 times a week. During the recovery period after fractures, it is important to speed up recovery and relieve pain associated with the fracture.

Exercise will not only speed up the recovery process, but will also help reduce the risk of subsequent injury (fracture) in the event of a fall, and will also improve balance, posture, flexibility and coordination.

Make walking a mandatory part of your daily life. Bad weather or slippery streets don't have to be an obstacle: you can walk at home, in large stores or other indoor areas. If physical exercise is difficult for you, you can do it every other day. Always listen to your body.

Physical activity improves physical well-being: Physically active people have more energy and don't get tired as quickly as less active people. In other words, physical activity helps you feel better and get more out of life.

To summarize, we can say that bone fusion is a complex process that is influenced by many factors. But our tips will help your bones heal faster.

We continue the joint project of our newspaper and the Moscow Ambulance and Emergency Medical Service, begun in previous issues.

The floor goes to the anesthesiologist-resuscitator of the 18th ambulance substation in Moscow, traumatologist of the highest category, candidate of medical sciences Sergei Ryabtsev.

Theoretically, anything can be broken. However, in everyday walking life, doctors most often deal with ankle injuries. It can sometimes be quite difficult to distinguish a fracture from a sprain or dislocation. And yet they have some characteristic features.

Stretching

When sprained, the ligaments of the joints (most often the ankle) are damaged, up to their rupture - complete or partial.

Characteristic features:pain in the joint area, swelling, and if the ligament ruptures - hematoma. However, unlike a fracture, movement in the damaged joint is possible.

What is dangerous: When sprained, the main thing is not to miss the rupture of the ligaments, which over time can lead to the damaged ligament weakening - and the leg will constantly twist, as they say, out of the blue.

What to do: provide the injured leg with complete rest for a day, or preferably three;To prevent swelling from increasing, apply cold to the sore spot for 15-20 minutes as quickly as possible (avoiding frostbite in the affected area), repeat cold lotions 2-3 times a day for the first two days. From the third day after the injury, you can use thermal procedures (semi-alcohol, vodka compresses, warming ointments);Apply a tight bandage to the affected joint, which should not be removed for the next 5-7 days.

Where to go:to the emergency room or district clinic.

Dislocation

A dislocation is a displacement of bones in joints. Most often it is accompanied by damage or even rupture of the joint capsule. The most common dislocations of the shoulder, elbow, and ankle joints.

Characteristic features:In addition to pain and swelling, characteristic signs of a dislocation are abnormal movements of the joint, displacement of the bones that make up the joint, and a change in its normal shape.

What is dangerous:If a fresh dislocation is not corrected soon after the injury, an intractable old dislocation develops, which in the future can only be corrected on the operating table.

What to do: You absolutely cannot correct a dislocation yourself, otherwise you may end up with a fracture in addition to the dislocation! The most that can be done before visiting a doctor is to “fix” the injured limb, as if there was a fracture, give the victim a painkiller and take him to the doctor as quickly as possible.

Where to go:to the nearest emergency room.

In case of an open fracture, it is important to stop the bleeding promptly and competently by applying a tight pressure bandage to the wound, but without interfering with blood circulation. If the skin of the injured limb turns blue or numb, you can loosen the bandage. You can also apply pressure to the wound with your hand.

Fracture

When a fracture occurs, a complete or partial disruption of the integrity of the bone occurs under a load exceeding the strength of the injured area. The most vulnerable places on the hands are the wrist and forearm. On the legs are the ankles, shin bones and femoral neck.

Characteristic features: an open fracture is visible to the naked eye. A closed one will result in severe pain (such that it is impossible to move the affected limb), deformation of the affected area of ​​the bone, rapidly increasing swelling and hematoma.

What is dangerous:improper fusion or non-fusion of the bone of the limb, damage to surrounding soft tissues, nerve endings, infection of the wound at the site of the open fracture.

What to do:using a special splint, stick, board, or piece of plywood, fix and immobilize the injured limb. If the bones of the forearm are broken, the wrist and elbow joints are immobilized. If the humerus is damaged - the elbow and shoulder joints. In case of a fracture of the femur, the hip and knee joints are fixed (the splint is attached with one end to the body along the side surface, the other - to the lower leg and foot), the lower leg - the knee and ankle. If nothing is at hand, the injured leg can be bandaged to the healthy one, and the broken arm to the torso; apply cold to the fracture site; in case of an open fracture, treat the wound with an antiseptic (iodine, brilliant green, vodka) and apply a sterile bandage. Pre-treat the contaminated wound with hydrogen peroxide.

Where to go:to the ambulance or the nearest emergency room. Do not step on the injured leg under any circumstances, so as not to complicate the fracture.