Open leg fracture

An injury with an open wound is always more dangerous to health, since such a violation results in severe damage to both bones and tissues. An open leg fracture is very easy to distinguish from a closed one, since the broken bone protruding outward is clearly visible.

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Epidemiology

About 30% of all bone fractures in the human skeleton occur in the shins. Such fractures are mainly combined with knee ligament injuries (approximately 10-33% of all cases), which lead to instability in the knee joint. Also, fractures sometimes involve injuries to the meniscus (external - 13%, internal - 2.5%) and neurovascular trunks. They can also be accompanied by injuries inside the joint, which disrupts its congruence and leads to the development of compression syndrome.

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Causes open leg fracture

The following factors may cause an open leg fracture:

• As a result of a fall from a height, due to an accident, as a result of a criminal incident or being in a traffic accident;
• Some pathologies that can lead to a fracture of the limb even as a result of a small load on it. Such a disease is, for example, osteoporosis.

Athletes, because of their profession, are often at risk of getting a fracture; children, because they are less careful and more active than adults; and pensioners, because age-related changes in bone structure make them more fragile.

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Pathogenesis

Traumas such as fractures usually occur as a result of some traumatic force. In the case of a fall or a jump, the tibia is too abducted, resulting in a fracture of the lateral condyle. In the case of adduction of the tibia due to trauma, a fracture of the medial condyle occurs. If the traumatic force is directed from below along the axis of the tibia, fractures in the proximal tibial bone are T- or V-shaped. In the case of direct blows to this part of the leg, fractures of the corresponding condyles occur.

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Symptoms open leg fracture

An open fracture can be easily identified, as it is accompanied by noticeable damage to the skin and soft tissues. In addition, open fractures cause injury to nerves and blood vessels, pain and bleeding occur, and swelling appears. Bone fragments are observed in the open wound.

Open fracture of the finger

Often, a fracture occurs as a result of direct trauma - as a result of a blow with a finger, twisting, squeezing the foot, falling on the foot with a heavy object or tripping. Open fractures of the toes are less common than on the hands. When an injury occurs, a person feels sharp pain, the finger begins to swell, and its movements become difficult. Sometimes there is bleeding under the skin or nail. In case of displacement, deformation may occur. In some cases, the crunching of bones may be heard.

Open fracture of the big toe

When a big toe is broken, the main symptom is a sharp, severe pain that is felt continuously. The injured person cannot step on the foot. Swelling immediately appears at the fracture site, which quickly spreads to other toes and the foot. An open fracture is diagnosed if, along with other symptoms, there is damage to the skin - a wound with a bone sticking out of it is clearly visible.

Open fracture of the leg with displacement

A displaced leg fracture often occurs as a result of a direct blow to the shin, performed in a transverse direction. As a result of the injury, bone fragments are formed that can shift in any direction - the displacement can be angular, lateral or peripheral; with wedging, divergence or overlap of the broken pieces. In some cases, these fragments shift excessively, breaking through the skin and soft tissue, which causes an open fracture.

Complications and consequences

Open leg fractures usually occur as a result of combined and multiple injuries – in these cases, the incidence of purulent complications is approximately 57.4%. Wound suppuration can be both superficial and deep.

Osteomyelitis is a frequent complication of open fractures, and in some cases, anaerobic infection may occur. Some victims develop pain shock as a result of the injury, which is sometimes combined with fat embolism.

An open fracture can result in disability (in 17.6% of cases), which occurs as a result of improper treatment – as a result of the appearance of false joints, non-union, and bone tissue disorders.

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Diagnostics open leg fracture

In case of open fractures, the main instrumental diagnostic method is considered to be an X-ray procedure of the injured part of the leg. In some cases, the doctor may prescribe an additional MRI examination to assess the condition of the soft tissue structure.

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Treatment open leg fracture

In case of an open leg fracture, immediate treatment is required. It is very important to provide the victim with first aid correctly and competently. First, the pain should be reduced, for which you can use any available analgesic. After that, it is necessary to immobilize the injured leg, using a hard long board or stick. The limb should be securely fixed so that the bone does not move from its place during the patient's movement. Sterile or, in extreme cases, clean material should be used as a fastener - this is necessary so that infection does not get into the wound (the area around which should be treated with a disinfectant). In no case should you reset the bone yourself.

With an open wound there is always bleeding. When it is arterial, the blood turns bright red and comes out of the wound pulsating. In this case, a tight tourniquet must be applied over the injured artery. In the case of venous bleeding (in which case there is no pulsation and the blood is darker in color), simply bandaging the leg below the wound is sufficient.

Surgical treatment

Surgical treatment may be necessary, for example, in the case of a fracture of the femur with obvious displacement. In this case, the damaged bones are fastened with nails or special metal plates. In the case of an open fracture, surgical intervention is performed using the so-called Berger method - the bone fragments are brought together, after which the torn ligaments, muscles, and skin are sutured.

Recovery time

The final stage in the process of treating a leg fracture is the recovery period. At this stage, rehabilitation is carried out, which is necessary to return the mobility of the leg. Also during this period, it is important to fully restore all the basic functions of the injured limb. At this time, it is important to perform training exercises that help develop the leg, as well as massage the injured area.

If swelling occurs, it is necessary to use a special ointment against swelling. Also, during the rehabilitation period, the patient should take painkillers and use herbal medicine. Effective remedies are decoctions of pine needles, cornflower, and rose hips.

Prevention

Sometimes, a high susceptibility to fractures is a consequence of the fact that the strength of bone tissue decreases due to osteoporosis (bone loosening occurs). In this case, in order to strengthen weakened bone tissue, you can take medications containing calcium as a preventive measure, as well as take multivitamin complexes.

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Forecast

An open leg fracture heals safely and without complications if the correct treatment was carried out and, first of all, competent primary antibacterial and disinfectant treatment of the wound was provided. It is also very important to properly immobilize the injured leg. But it should be taken into account that the healing of open fractures is a longer process compared to recovery from a closed injury.

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