Open fracture of the leg

Injury with an open wound is always more dangerous to health, because as a result of such a violation, serious damage occurs both to bones and tissues. An open fracture of the foot is very easy to distinguish from a closed one, as when it is visibly seen the outwardly breaking broken bone.

[1], [2]

Epidemiology

About 30% of all bone fractures in the human skeleton are on the lower leg. In general, these fractures are combined with knee ligament injuries (approximately 10-33% of all cases), in which instability in the knee joint develops. Also, fractures sometimes show meniscus injuries (external - 13%, internal - 2.5%), and neurovascular trunks. They can also be accompanied by injuries inside the joint, in which its congruence is impaired, and the development of the compression syndrome.

[3], [4], [5], [6], [7],

Causes of the open fracture of the leg

The causes of open fracture of the leg can be such factors:

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

Get a fracture is often at risk athletes, because of their profession; children, because they are less cautious and more mobile than adults; as well as pensioners, because the changes in the structure of bones that occur because of age make them more fragile.

[8], [9]

Pathogenesis

Injuries, such as fractures, usually result from the impact of any traumatic force. In case of a fall or jump, too much tibia is observed, resulting in a fracture of the external condyle. In the case of adduction of the tibia due to trauma, a fracture of the inner condyle occurs. If the traumatic force is directed downward along the axis of the tibia, the fractures in the proximal part of the tibial bone are T-shaped or V-shaped. In the case of direct attacks on this part of the foot, fractures of the corresponding condyles occur.

[10], [11], [12], [13], [14], [15], [16]

Symptoms of the open fracture of the leg

Determine an open fracture can be easily, because with it there is a noticeable damage to the skin and soft tissues. In addition, with open fractures, nerve and vessel trauma occurs, pain and bleeding occur, and swelling occurs. In the opened wound there are bone fragments.

Open fracture of the finger

Often, the fracture occurs as a result of direct injury - as a result of a finger blow, tucking, squeezing the foot, falling on the leg of a heavy object or stumbling. Open fractures of the toes are less frequent than in the arms. When a person is injured, the person feels a sharp pain, the finger begins to swell, and his movements become difficult. Sometimes there is a hemorrhage under the skin or fingernail. In the case of displacement, deformation may occur. In some cases, a crunch of bones can be heard.

Open fracture of the big toe

With a fracture of the thumb on the leg, the main symptom is a sharp severe pain that is felt continuously. A person injured can not step on his foot. At the site of the fracture immediately appears edema, which quickly passes to the other fingers and feet. An open fracture is diagnosed if, along with other symptoms, skin damage is observed - a wound with a bone protruding from it is clearly visible.

Open fracture of leg with displacement

Fracture of the leg with displacement often occurs as a result of a direct impact on the shin, carried out in the transverse direction. Due to damage, bone fragments are formed, which can move in any direction - the displacement is angular, lateral or peripheral; with wedging, divergence or the desire for breakaway pieces. In some cases, these fragments shift excessively strongly, breaking through the skin and soft tissues, because of which an open fracture is formed.

Complications and consequences

Open fractures of the legs usually occur as a result of combined and multiple injuries - in these cases, the incidence of purulent complications is approximately 57.4%. Suppuration of the wound can be both superficial and deep.

Often the complication of open fractures becomes osteomyelitis, and in some cases an anaerobic infection may occur. Some injured patients develop a pain shock, which is sometimes combined with fat embolism.

The consequence of an open fracture may be a disability (in 17.6% of cases), which arises from improper treatment - as a result of the appearance of false joints, nonunion, and bone disorders.

[17], [18], [19], [20]

Diagnostics of the open fracture of the leg

With open fractures, the main instrumental method of diagnosis is the procedure of the X-ray of the injured leg part. In some cases, the doctor may prescribe an additional MRI scan to assess the state of the soft tissue structure.

[21]

Treatment of the open fracture of the leg

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

When an open wound is always present, bleeding. When it is arterial, the blood becomes bright red and exits the wound, pulsating. In this case, the application of a tight tourniquet over the injured artery is required. In the case of venous bleeding (with no pulsation, and blood having a darker color), simply pulling the leg with a bandage below the wound is sufficient.

Operative treatment

Surgical treatment may be needed, for example, with a fracture of the femur with a clear bias. In this case, the damaged bones are fastened by means of nails or special metal plates. When the fracture is open, surgical intervention is performed by the so-called method of Berger - bone fragments are brought together, and then the ligament ligaments, muscles, and also the skin are sewed.

Recovery time

The final stage in the treatment of fracture of the leg is the recovery period. At this stage, the rehabilitation necessary to return the leg mobility is carried out. Also during this period it is important to completely restore all the basic functions of the injured limb. At this time, it is important to perform training exercises that help the development of the foot, and also to massage the injured area.

In the case of puffiness, a special ointment should be used against edema. Also during the rehabilitation period, the patient should take painkillers and use phytotherapy. Effective means are decoctions of needles, a cornflower, and also a dog rose.

Prevention

Sometimes a strong susceptibility to fractures is a consequence of the fact that the strength of bone tissue is reduced due to osteoporosis (bone loosening occurs). In this case, in order to strengthen the weakened bone tissue, it is possible, as a preventive measure, to take medicines that contain calcium, and also use multivitamin complexes.

[22], [23], [24], [25]

Forecast

An open fracture of the leg can be cured safely and without complications in the event that the right treatment was performed and, first of all, a competent primary antibacterial and disinfecting wound treatment was provided. It is also very important to properly immobilize the injured leg. But it should be borne in mind that the healing of open fractures is a longer process in comparison with recovery with closed trauma.

[26], [27]