Cracked or fractured bone: distinguishing features

Bone integrity is compromised when the load exceeds the limit of their strength. In professional terminology, there is no such thing as a "fracture", but a complete or incomplete fracture, the latter corresponds to the widely accepted term "fracture", i.e. Partial bone damage.

Which is worse, a fracture or a crack? A crack, of course, heals faster and is easier to treat, but not everything is so unambiguous, as a fracture of the little finger, for example, is less painful than a leg crack. It all depends on the location of the injury.

Epidemiology

Researchers from a number of Ukrainian medical institutes specializing in traumatism and orthopedics developed a questionnaire that included 17 blocks of questions providing extensive information about the mechanism of injury, its localization, severity, applied treatment methodology, its effectiveness, etc. The questionnaire was used in the analysis of fractures. In total, about 3 thousand fractures were analyzed. This analytical work gave the following data: 51% of all traumatized were women and 49% were men; domestic traumas prevailed (51%), the second place was taken by street traumas (30%); the largest age group of the injured was in the range of 40-59 years (40%), followed by the range of 20-39 years (37%).

Causes of the a cracked or fractured bone

One of the criteria for classifying fracture types is the cause of the fracture. Two are distinguished:

• traumatic (occurring under external influence);
• pathological (tuberculosis, bone tumors, osteoporosis and other pathologies), for which minor loads are sufficient.

Risk factors

Bone strength depends largely on bone density, which in turn is directly proportional to the content of minerals (phosphorus, boron, calcium, etc.) in bone tissue. Their deficiency is one of the serious risk factors leading to fractures. Genetic factors, nutrition, environmental conditions, and lack of physical activity cannot be discounted.

An important role is played by a person's age (elderly people gradually lose bone mass), gender (osteoporosis in women is much more common than in men), ethnicity (Europeans and Southeast Asians are more susceptible), weight (thin people have more fragile bones), bad habits (smoking, alcoholism), certain medications (hormones, anabolic steroids).

Pathogenesis

Bone tissue consists of 60% minerals, which determine its strength, 30% collagen, which is responsible for its elasticity, and 10% water. Vessels are concentrated in the mineral part. Fracture of bone tissue leads to their rupture, which leads to bleeding, hematomas and swelling.

Symptoms of the a cracked or fractured bone

The first signs of a fracture or fracture make themselves known by a strong pain that increases with touching and palpation. Traumatization of the extremities: arms or legs responds with painful movements, at rest the pain is dull, muffled. Symptoms of fracture or fracture of the rib, chest is expressed by pain during deep breathing, coughing, talking. Multiple rib fractures can cause increased pulse rate, pallor, sometimes lividity of the skin.

The next evidence of violation of the integrity of the bone is the appearance of swelling at the site of injury, often hematoma (the latter is more characteristic of fractures).

Complications and consequences

Displaced fractures have the most possible consequences, as they may not heal properly, resulting in loss of organ function. Other complications include blood loss, hyperemia, and inflammation.

But the most dangerous fractures of the femur bones, as they entail the development of fat embolism from the yellow bone marrow - blockage of the vessel with subsequent circulatory failure, fraught with even lethal outcome.

Diagnostics of the a cracked or fractured bone

A fracture is indicated by characteristic symptoms. The orthopedic surgeon examines the history, conducts a physical examination, palpates the damaged area. Absolute signs of fracture are unnatural position of the limb, abnormal mobility, a peculiar crunch formed by pressure, the presence of bone fragments in the open wound.

The most accurate confirmatory diagnosis is instrumental, carried out through radiography. X-rays are taken in two projections, straight and lateral. It is the X-ray examination that makes it possible to recognize the fracture. There are many varieties of images of fractures on the image, but the classic one is a linear area of lumen, displacement of fragments, if any.

Cracks are sometimes not visualized, so CT scans come to the rescue.

Differential diagnosis

In the absence of obvious evidence of bone fractures, they are differentiated with contusions, dislocations, sprains, fractures. The accuracy of the diagnosis determines the treatment tactics.

Treatment of the a cracked or fractured bone

Fractures require an immediate response, as the complications that accompany them can be more dangerous than the injury itself. First, it is necessary to provide the injured person with first aid: to determine the location and severity of injuries, if bleeding is present, to stop it, in case of isolated trauma to splint, to give painkillers, sedatives, to call an ambulance or take the patient to a trauma center.

Medical treatment depends on the severity of the condition and can be either conservative or operative.

Conservative consists of anesthesia and analgesia if necessary, application of a fixation plaster cast, traction methods - traction to neutralize the action of muscles attached to bone fragments and to improve bone tissue regeneration. In addition, immobility of the affected areas is provided according to the indications.

Surgical treatment

Where conservative treatment is not possible (fractures of spongy (short) bones, skull vault, jaws) or after improper bone fusion, surgical treatment is used. This can be fixation of bone fragments with spokes, plates, pins, staples. The surgeon determines the method based on the localization of the injury, its severity, the general condition of the patient, etc.

Prevention

It is impossible to anticipate all possible situations that could lead to injury, but you should try to avoid injury hazards. Other preventive measures include minimizing the person-dependent risk factors listed above.

Forecast

Timely treatment of fractures in combination with rehabilitation measures, including massage, therapeutic exercises, physical therapy, gives a favorable prognosis. Usually the recovery time ranges from several weeks to several months.