Fracture

Fracture - damage to the bone with a violation of its integrity.

There are traumatic and pathological fractures. The latter are caused by pathological processes in the bone tissue( tumors, tuberculosis or osteomyelitis), in which even the usual load at a certain stage of the course of these diseases leads to a fracture.

There are open fractures( with damage to the skin in the zone of bone integrity) and closed( without damaging the skin).Open fractures are more dangerous due to possible infection and abundant( and even life-threatening) bleeding.

Fracture may be complete or incomplete. With incomplete fracture, only a part of the bone is broken, most often in the form of a longitudinal slit-a crack in the bone.

The shape of the fracture depends on the mechanism of injury and the features of the fracture zone. There are transverse, oblique, spiral, longitudinal fractures. With gunshot wounds and some other types of damage, there are comminuted fractures - when the bone is damaged in several pla

ces and has several fragments. A fracture resulting from compression or flattening is called compression fracture.

Depending on the direction and strength of the mechanical force that caused the fracture, and muscular traction in the damaged part of the body, the fracture may be with or without bone fragments displacement. The displacement can be at an angle, along the length, lateral.

There are also punctured fractures when one of the fragments is injected into another.

Signs of fracture:

Swelling and sharp pain in the fracture zone, changes in the shape of the limb, often - shortening of the limb, violation of the movements of the damaged part of the body. Also, with a fracture, there is evidence of a victim or eyewitnesses of a previous injury or the presence of a bone disease that can lead to a fracture.

First aid for fracture.

The first aid for a fracture should begin with the release of the victim from the action of the injured object.

The lack of response of a victim to a cry may indicate a fainting, and a sharp pallor, a quiet voice, a weak pulse or his absence - about shock, a large amount of blood - about a life-threatening bleeding. If the victim has no pulse and no breathing, resuscitation should be started immediately.

In the provision of first aid for fractures and dislocations, temporary( transport) immobilization is used. For this purpose, special tires are used, and in the absence of them you can use any improvised means( wooden slats, sticks, bunches of brushwood, dense cardboard, plywood), which are imposed on the fracture area.

The basic principle of immobilization is the creation of immobility of bones in the area of ​​damage, for which the tire should fix a total of two or three adjacent joints above and below the fracture site.

If the injured person has a fracture of the shoulder, two tires should be placed on the inner and outer sides of the shoulder, place the soft tissue roller in the armpit and fix the arm in a bent state with a bandage bandage.

With a fracture of the bones of the forearm and the hand, the tire should begin with the elbow joint and protrude somewhat beyond the fingers. Apply it to the back-palm surface. In the bent fingers, you need to put a roller.

In fractures of the bones of the shoulder girdle( clavicle, scapula, humerus, forearm bones and brushes) as the final stage of immobilization, the arm is suspended on a kerchief or belt in a bent at the elbow position.

If the victim has a hip fracture, the ankle, knee and hip joints should be immobilized with transport tires. For this you can use 2 ordinary boards. A long board is placed on the outer surface of the body from the foot to the axillary cavity, the short one is placed on the inner surface( from the foot to the perineum).If there is no improvised material and tires, then the damaged leg is tied to a healthy one.

First aid in case of knee joint damage - apply a pressure bandage to the injury site, immobilize the limb, put a cold on the joint.

If the injured person has a fracture of the bones of the middle part of the tibia, it is necessary to apply tires with fixation of the ankle and knee joints. You can attach a damaged leg to a healthy leg, then a healthy leg will act as a tire.

If the fracture is open or bleeding occurs, first stop the bleeding and apply a sterile bandage on the wound, and a tire on top of it.

Tires are superimposed on clothes and shoes. Between the tire and the limb, it is necessary to lay a layer of cotton or soft matter. If there are bone protrusions on the limb, they are protected from pressure by a gasket of cotton wool.

Clothing from the injured must be removed, starting with the healthy side( legs, hands).The tissue attached to the wound should not be torn off, it is necessary to cut it around.

If a rib fracture should be applied bandage on the chest.

In the case of a spinal injury, the injured person should be placed with his back on a solid shield and attach the trunk and legs to this surface. If there is no shield, then the victim is put belly down on a stretcher.

The injured with a fracture of the pelvic bones are put back on a firm, level surface, and rollers are placed under the knees of the half-bent and divorced legs.

Algorithm for rendering assistance to a victim with open fracture and arterial bleeding: apply a tourniquet, apply an aseptic bandage to the wound, and immobilize the limb.

Algorithm for rendering assistance to a victim with an open fracture of the shin bones without heavy bleeding: anesthetize, apply an aseptic bandage on the wound, carry out transport immobilization.

Find out if the injured person received any injuries other than a fracture, and provide, respectively, first aid.

Call an ambulance or arrange for the victim to be taken to the hospital by road.

  • In case of a chest injury, the injured person should be transported in a semi-sitting position.
  • In case of fracture of the clavicle - in the sitting position.
  • With closed abdominal injury - in the supine position on the back with a cold on the abdomen.
  • In case of injury to the face or jaws - in the prone position with the head turned on its side.
  • When the trauma of the lumbar spine - in the supine position on a rigid basis.
  • In case of craniocerebral trauma, the patient should be transported only by ambulance and in a lying position with his head turned on his side. This will prevent the sinking of the tongue( a sunken tongue will block the airways and cause breathing problems, up to the need for resuscitation) and, in the event of vomiting, will not allow the vomit and saliva to get into the respiratory tract, which is also unsafe for the life of the victim. It is advisable to place around the head a roller from a towel folded in the form of a donut. The injured person is prohibited from moving independently.
  • When injured, the pelvis of the injured person should be transported in the "frog" position.

That it is impossible to do or make at breakage.

  • Leave the victim alone.
  • Without the need to move the injured person without immobilizing the fracture area.
  • In no case should the injured limb be pulled and tried to correct by itself.
  • In case of injury to the spine, the injured person should not be put in any way, put on his feet( as this can cause displacement in the place of fracture and damage to the spinal cord).

All actions should be extremely cautious, since inept shifting and carrying the patient can cause serious additional trauma.

Do not apply the tire with an open fracture, without previously stopping bleeding, since severe bleeding can lead to death.