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Fractures Definition, Types, Risks, Causes, prevention and treatments

Definition of bone fracture

A fracture is defined by the discontinuity or breakage of bones of the human body. We distinguish closed fractures (without wound) open fractures (with wound and risk of infection). All the bones may be involved at all stages of life. The causal mechanism of injury determines the type of fracture: compaction, avulsion if ligament injury, fracture of the femoral neck geared for example ...

There are three types of fractures:

Bone fracture

It is most often due to trauma after a fall or blow, but a vicarious trauma is also possible (excessive twisting of the leg). In children, the bone can be incompletely fractured (one side of the remaining intact bone) fractures talking about "green wood".

The stress fracture

It occurs when repeated efforts imposed on a bone (sports with excessive training).

The so-called pathological fractures

It occurs in the absence of trauma or for a minimal blow; they reveal usually an already fragile bones (tumor ...).

Risks and health issues fractures

All bones can be achieved, but some fractures are most common in function of the age and location. The fracture of the wrist is the most common fracture in children (20 to 35% of fractures). Compaction is characteristic of the vertebrae and mainly occurs in osteoporosis. Similarly, the femoral neck fracture occurs in a special way in the elderly.

Fracture risk factors are now identified: personal history of fracture fragility, age> 60 years, corticosteroids, history of fracture of the proximal femur in a first-degree relative, body mass index (weight / height square) <19, early menopause (before age 40), smoking, alcohol abuse, decreased visual acuity and neuromuscular and orthopedic disorders.

Causes and treatments of fractures

A fracture occurs most often after trauma, more or less violent to break the bone. More bone density, the greater the shock will be significant. For example, the bones of the infant is mechanically less resistant than adults and therefore fracture more easily.

In closed fractures, the skin is intact; in open fractures, bone fragments pierce the skin with a high risk of infection.

Bone fragments can be moved or not; in the latter case, a single asset or longer (plaster, resin ...) will be enough to consolidate with callus formation will recover and strengthen the fractured bone.

How is he clear?

Fractures of the bones or joints are common and can affect the upper limbs, lower limbs, head, neck or back. The victim usually complains of severe pain, difficulty or inability to move, and the affected area is often of swelling and / or visible deformation. In case of compaction, often vertebral pain is located in the back but no deformation is visible.

In an open fracture, the bone fragment creates a wound with a risk of bleeding.

Fracture of the nasal bone is fractured nasal cartilage. It is manifested by deformation of the nasal septum and usually a nosebleed (or epistaxis).

With what should we be confused?

It should not be confused with other bone fractures fractures such as fracture of a solid organ (spleen, liver ...) for example. A violent abdominal trauma can indeed come to break the spleen or liver with a risk of internal bleeding. In case of shock with severe abdominal pain or malaise, emergency consultation is necessary.

Furthermore, it should not be confused sprain or strain, affecting the joints and ligaments. Sometimes only the radiograph will remove a bone fracture.

Will it possible prevention?

Prudence, good physical preparation and proper warm are safety pledges to prevent fractures.

Some equipment such as knee, shin guard or headphones are used to limit the consequences of direct trauma. They are particularly recommended for children at high-risk activities.

Power must be balanced to avoid excess weight but also fight against deficiencies (lack of calcium and / or vitamin D). Tobacco and alcohol are two enemies of the bones and weaning is recommended. If demineralization proven bone densitometry (osteoporosis) treatment may be proposed in postmenopausal women, and drugs fighting against bone destruction are available to all.

When to consult?

In case of suspected fracture, emergency you should call and do not mobilize the affected area. If the injured has fallen, is lying on the ground and complained of back, neck and / or head, immobilize the head maintaining constantly awaiting rescue.

What does the doctor?

Interview (history, risk factors for fracture, mechanism of trauma and violence) and clinical examination (palpation of bony prominences, mobilization and clinical tests) allow the fracture to suspect and ask indication of an X-ray. Deformation or painful point is very suggestive of a fracture or avulsion, but only the radiographic support or refute the diagnosis. Plain radiographs are usually sufficient to diagnose a fracture of a limb or the nose. However, settlements or complex fractures may require other tests to clarify the extent and consequences of the broken bone. For example, an MRI may specify any neurological compression in case of settlement.

The treatment of all fractures is immobilisation, which helps to fight against the pain and allows consolidation. Complex fractures (femur, open ...) or displaced require surgery by an orthopedic surgeon. There are several techniques under general or regional anesthesia, such as pinning, screwing with pins or external fixators. For other fractures, called conservative methods are preferred, with cast immobilization with or without reduction or continuous traction.

For open fractures, including nasal fracture with bleeding, early antibiotic treatment prevents the risk of infection.

How to prepare for my next visit?

If cast immobilization, any pain should be reported to the doctor to check that the cast is not too tight and not impeding traffic (called compartment syndrome with pain, numbness ...). If anticoagulant therapy is prescribed (bites), it must follow carefully to prevent phlebitis, and make the necessary blood tests to monitor treatment.

Wounds and sutures should be monitored; if they turn red, inflammatory with fever, a consultation is needed quickly.

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