Fractures of the lower limb: types, symptoms and methods of treatment. How to treat bone fractures with fixation? Reposition in the healing of bone fractures

You should know that first aid for fractures will help to avoid complications, and in some cases save the life of the victim. Before you get acquainted with how first aid is provided for fractures of the limbs, it is necessary to study the classification of the injury, the signs of a fracture, and whether there are complications.

Limb fracture classification

The main cause of bone fracture is trauma from a blow received under various circumstances. This may be a fall at work, an accident or the consequences of a natural disaster.

Fracture or violation of the integrity of the bone are closed, open. The reason that led to such a pathology may be traumatic or pathological. The last factor is associated with the internal problem of a person - bone tuberculosis, oncology and other diseases.

types of fractures

Limb injuries may be incomplete, with or without displacement of debris. Great importance when providing the first first aid in fractures, it is necessary to know the direction and shape of the injury.

transverse- in this form, the fracture line is located perpendicular to the axis of the tubular bone.
Longitudinal- the fracture runs parallel to the axis of the bone.
Oblique- the line is under acute angle to the axis.
Helical- bone fragments are rotated or turned in opposite side from his usual position
splintered- the bone is shattered into small pieces at the site of injury.
wedge-shaped- formed with fractures of the spine and is a deformation in the form of a wedge - one bone penetrates another.
Impacted- fragments of bone are displaced into the nearest tubular bone or are placed outside the main plane of the cancellous bone.
Compression- a clear fracture line is not observed, the fragments are small.

Important! When providing first aid for a fracture of the limbs, it is necessary to be very careful and careful. For whatever harm the patient observe general rules first aid for fractures, the main of which is not to try to return the bone fragments to their place.

Fracture symptoms

All symptoms of a fracture of the limbs are divided into absolute and reliable. First aid for bone fractures without this knowledge can be harmful.

Absolute

With an open fracture, bone fragments can be seen in depth or protrude outward.
Due to the displacement along the bone of its fragments, the limb is significantly shortened.
Due to the displacement of bone fragments at an angle, deformation appears, this symptom is characteristic of an injury to the forearm, lower leg.
Abnormal mobility of bone fragments at the site of injury. A symptom is detected by raising and shifting its peripheral part to the side, and the central part is kept - if mobility is observed, that is, a fracture.
A certain crunch of bone fragments - like snow underfoot - also indicates a fracture, is checked in the above way.

Relative

In the place of impact, in case of damage small bones arises strong pain, which increases with the slightest load, movement and any other manipulations. Pain may be the only symptom.
Violation in the work of the limbs.
Swelling in the area of injury.
Hematoma, like edema, does not appear immediately, but quickly increases in size due to heavy bleeding.

Important! The presence of one of the absolute signs confirms the diagnosis, which means that the provision of first aid should correspond to the injury or cause an ambulance for first aid for fractures. With absence reliable signs(fuzziness of their manifestation) the presence of the whole complex of relative signs can serve as the basis for the diagnosis.

With fractures of tubular bones, complications may occur - damage to nearby organs, traumatic shock, fat embolism, sepsis, osteomyelitis, bleeding.

First aid for fractures of limbs

A fracture of a limb is one of the most common injuries, and before providing any assistance, it is necessary to know its entire algorithm.

The provision of any assistance lies primarily in the understanding that the victim cannot independently hold the injured limb, and the slightest movement causes severe pain. Therefore, the provision of first aid begins with an examination of the patient and, if necessary, he is given an analgesic.

Shoulder limb

What to do with a fracture of the humerus or a fracture with bleeding?

The assisting person must fix the arm to the body in any way possible.
Give painkillers, non-narcotics.
Apply a cold compress to the injury site.
When bleeding, a tourniquet is first applied to stop the blood, and then a special bandage is made on the wound.
After stopping the bleeding, the injured limb is fixed with a scarf or a special splint.

Forearm fracture

First aid for a fracture of the forearm is as follows:

Put a splint on your hand and fix it with a scarf.
If the victim is not allergic to analgesics, the drug should be given.
Cold to the point.

Ankle fracture

Emergency care for ankle fractures in the form of splinting is performed only when it is impossible to call an ambulance to the victim.

First aid for an ankle fracture is anesthesia, a cold compress and a special splint.

Important! The tire is applied by two people, one fixes the leg, while the second imposes it under the raised limb. Next, the first one presses the tire tightly to the leg, and the other fixes it with straps. The rules of first aid must be observed in any conditions in order to avoid complications.

Fracture of the femur

First aid for hip fractures comes down to the fact that the following order must be observed:

Analgesic three tablets, after clarifying that there is no allergy.
Apply ice to the fracture site.
Place a roller between your legs.
Tires are fixed first on the chest, then on the feet.
In the case when there is bleeding, the first thing that is done is a tourniquet is applied, an analgesic is given, only after that a bandage is made on the wound and the splint.

The axiom of providing first aid for fractures is not only the application of a bandage or splint, but also the correct transportation of the victim.

Putting the patient on a stretcher

The procedure for assisting with bone fractures should be in 1st place.

The required number of helpers should not be less than four people.
The fabric of clothing in the chest area, the abdomen should be twisted into a roller, the victim’s legs are treated in the same way - they are twisted into one roller in the thighs and lower legs.
The transfer command is given by the participant who supports the person’s head.

Important! This method transfer, which is called "twisting" is allowed only if there is tight clothes in the patient and taking into account that he does not lie on his stomach. If tires are put on his legs, then the legs are picked up and held until the moment when the body does not touch the stretcher.

Transporting the patient on a stretcher up the stairs or horizontally

At the time of first aid for fractures of the limbs, it is important to properly carry the stretcher with the victim.

Representatives of the medical staff carry the head of the stretcher, in case of first aid for fractures of the limbs.
Those in front should report any obstacle in their path of stones, rebars, steps and more.

Transportation down stairs

Help, be the first health care in case of fractures of the limbs, it is also based on the correct transportation of the victim.

The descent of the stretcher with the patient down the stairs occurs exactly the opposite, from the rise up.

Carrying stretchers in front notify those walking behind of any slightest obstacle.
Behind walking medical worker monitors the patient's condition and, if necessary, report an emergency stop.

Important! The transfer of victims for further transportation is not allowed without observing the rules of transport immobilization.

First aid for fractures or first aid is provided at the site of injury, and then the victims are taken to the emergency room. For this, the patient must be immobilized.

Transport immobilization refers to one of important measures in the provision of PMP fractures, dislocations. It is not allowed to transfer and transport the patient without immobilization, even for short distances. This is due to the fact that this can cause an increase in the displacement of bone fragments, injury to blood vessels and nerves located in the immediate vicinity of the injury. With open fractures, immobilization of the damaged part of the human body prevents the rapid spread of infection. Transport immobilization carried out in accordance with all the rules prevents the occurrence of traumatic shock.

Immobilization can be done with the help of improvised means, in cases of fracture of the collarbone, lower leg, forearm, thigh.

Tires to be used:

Staircase.
Lubkova.
Tire Dieterichs.
Kramer.
Tires from improvised material - boards, skis, sticks, branches.

Tires are divided into several types:

Wooden, flat shape for immobilization of simple fractures.
Wire, having a transformable surface for immobilization of combined fractures.
Vacuum, pneumatic allow you to quickly prepare the patient for transportation.

All actions must be carried out very carefully so as not to worsen the condition of the victim. Rough manipulations can lead to complications up to traumatic shock.

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" . My name is Albert Sagradyan , I am an orthopedic traumatologist, and part-time co-founder of this site. From today I will lead the section "THE MEDICINE", and I'll start, perhaps, with my professional activity. Today we're talking about bone fractures!

Traumatology - introduction

Traumatology- This is the oldest branch of medicine, which has become the basis of surgery. History knows archaeological finds, when back in Ancient Rome signs of consolidation of bone fragments were found on the bones of the fallen soldiers. For the first time about traumatology described in the writings of the ancient Greek physician Hippocrates. It was at the time of Hippocrates that the types of treatment for fractures were already described.

Wars of the 20th century played a big role in the formation of traumatology, the one we see now. They not only claimed the lives of people, but also made them physically broken. It was then that traumatology stood out from general discipline as a separate industry.

Categories of injuries in traumatology

Let's look at the main types damage, which are included in traumatology:

fractures - full or partial destruction bone tissue.
dislocations - change in the shape of the joint with or without damage to the joint capsule.
breaks and sprains - partial or complete rupture of ligaments and muscles with the formation of a hematoma.

Today we will talk about fractures.

What are bone fractures?

bone fracture - this is a violation of the integrity of bone tissue caused by mechanical action. Such a breach could be complete, and partial.

And a similar violation is caused under such a load, which is clearly exceeds strength that part of the bone tissue, which, in fact, accounts for the same mechanical effect.

By the way, if we compare bone fractures in primates Homo Sapiens (human) and bone fractures in all other vertebrates, then fundamental differences in these fractures no!

Types of bone fractures:

We will classify the main types of bone fractures according to several criteria:

According to the etiology
According to the severity of bone damage
By type of form and direction
The integrity of the skin

Let's look at each in more detail!

Types of fractures etiology of occurrence

According to this criterion, all fractures can be divided into traumatic and pathological.

traumatic are fractures caused by impact external factors
Pathological are fractures that occur due to the influence of pathological factors(for example, tuberculosis, oncology, etc.), and the impact of external factors, at the same time, is minimal!

Types of fractures severity of bone loss

By given feature allocate full and incomplete fractures.

Incomplete fractures, as a rule, are cracks or fractures.
Full fractures, in turn, are divided into:
- fractures without displacement(subperiosteal) - most often found in children in whom the bone tissue is not yet fully formed.
- displaced fractures- in this case, the bone fragments move away from each other and change the axis of the bone

Types of fractures type of shape and direction

Here are the following types of fractures:

transverse ,
oblique ,
longitudinal ,
helical ,
ringed ,
wedge-shaped

All these fractures are illustrated in the picture below:

In addition to the types shown in the figure, there are:

Compression fractures - this is when the bone fragments are so small that there is no clear fracture line
Impacted fractures - these are fractures in which one of the fragments of the bone is embedded in another

By integrity of the skin

According to this criterion, open and closed fractures.

open- these are those fractures in which damage to the skin and communication with the external environment occurs. Open fractures, in turn, can be gunshot and non-firearms.
Closed- fractures in which there is no damage to the bones.

In addition to the classification given above, fractures are distinguished:

Combined- this is when a fracture is combined with trauma to internal organs, or the skull
Combined- damage to bone tissue in one anatomical region

Diagnosis and treatment of bone fractures

Bone regeneration occurs through the formation bone marol. The terms of formation range from several weeks to several months, depending on the regenerative characteristics of the organism.

Fracture diagnosis

When diagnosing fractures, absolute and indirect fracture signs.

Indirect is pain, swelling, hematoma, dysfunction if we are talking about a limb.
Absolute- unnatural shape and position of the limb, crepitation of fragments.

Treatment of bone fractures

Treatment can be divided into:

Treatment for prehospital stage
Treatment in the hospital.

under treatment for prehospital stage should be understood first aid. It is very important to remember here that improper first aid can lead to bleeding and traumatic shock!

The first thing to do is:

Assess the severity of the victim's condition and localization of injuries.
In case of bleeding, stop it with a tourniquet.
Decide if the victim can move. In case of spinal injuries, it is forbidden to transfer the patient.
Immobilize the damaged area, apply a splint. As a tire, you can use any object that excludes movement at the fracture site.
If there are contraindications to changing the position of the victim, provide, if possible, complete or partial immobilization of the damaged areas

Immobilization (fixation) treatment technique - the most common treatment technique without surgery. This technique is based on fixing the injured limb with plaster bandages or its analogues.

Surgical treatment:

Percutaneous metal osteosynthesis . Fixation of bone fragments through the skin with pins

Minimally invasive metal osteosynthesis . Type of fixation in which the plate is fixed to the bone with screws

Open reduction . Manual repositioning of fragments for their further fixation with metal plates, screws and knitting needles.

With external fixation device ChKDS - for example, the Ilizarov apparatus.

Video of operations for the treatment of bone fractures

*IMPORTANT! The following videos contain recordings of real operations, so The faint of heart, please do not watch!

1. Osteosynthesis of the distal segment of the humerus

Original :

2. Osteosynthesis femur with the use of clamps with thermomechanical memory

Original:https://www.youtube.com/watch?v=56di2COy5F8

3. Osteosynthesis of the distal segment of the humerus

Original: www.youtube.com/watch?v=bohOTzWhBWU

Fractures of the lower extremities are an extensive group of injuries, including fractures of various parts of the legs. Injuries to the bones of the limbs occur as a result of playing sports, falling or car accidents. Also, people often face the fact that it is necessary to provide first aid to the victim.

A fracture in the leg is a severe injury, accompanied by a violation of the integrity of the bones of the limb.

The nature of the fracture depends on the area of the skeleton of the limb in which the bone tissue was damaged.

For convenience, the bones of the lower extremities are divided into sections:

hip;
knee;
shin;
foot.

You can also find separate information about the skeleton knee joint, how important element responsible for the mobility of the legs.

Hip

The thigh is formed by a large tubular bone, also referred to as the "thigh bone".

The main characteristics of the femur:

It has a cylindrical shape bent in the forward direction.
Expands at the bottom.
In the upper region of the bone, the head and neck of the femur stand out, which are at an angle of 130 degrees with respect to the main body of the bone. The femoral head serves to form hip joint and the implementation of the mobility of the organ of movement ().
Due to the expansion of the lower part, the femur is able to form the knee joint, together with the patella and articular ligaments.

A large number of muscles are attached to the thigh bone, which perform the motor functions of the organ. In the case when the muscles and ligaments of a person are in good condition, the risk of injury is significantly reduced.

Knee

The knee joint is formed:

condyles of the femur;
upper surface tibia;
patella (patella).

The joint has great mobility and is actively involved in the motor work of the limb skeleton.

The danger is intra-articular injuries of the thigh.

Shin

If the fracture line is located in the shin area, using a radiograph, you can determine which of the bones was damaged. Unlike the thigh zone, the lower leg includes several bones:

Tibia - large segment locomotive system. characteristic feature bone is an extension in the upper part, in the area of formation of the knee joint with the femur. The body of the bone is represented as a prism with three faces. At the bottom of the bone is the articular surface for interaction with the talus of the foot.
The fibula is a thin, laterally located part of the skeleton of the lower leg. The fibula, unlike the tibia, has an expansion in the lower region, but narrows in the upper part. Also in the upper region, the bone has a pronounced head, through which interaction with the tibia occurs, a thickening in the lower region forms an articulating surface with the lateral malleolus.
Joints of the bones of the leg. Between the tibia and fibula the lower leg has an interosseous membrane and articulation in the upper region and a syndesmosis in the lower part.

The joints between the bones of the skeleton of the lower leg are inactive. Also, a large number of muscles and ligaments are attached to the bones, which provide mobility and stability of the motor apparatus.

Foot

The foot has the largest number of segments of all areas of the skeleton of the lower extremities.

Conventionally, the skeleton is divided into:

Tarsus ( , - back department, navicular, cuboid and three cuneiform bones - anterior).
Metatarsus (five tubular bones that form the arch of the foot).
(two phalanges at the first finger, fingers 2-5 have three phalanges each).

The skeleton of the foot, although it has a modified shape, differs slightly from the mechanism of the hand. One of these features is the greater prominence of the sesamoid bone, which forms the arch of the foot in the anterior part.

Classification

Fractures of various parts of the skeleton lower limb dangerous in their own way, since in most cases the area of the fracture affects the ability to move the leg. decline motor activity makes it very difficult or impossible for the victim to move independently.

Due to the large number of bones and complex mechanism work of the lower limb, there is no single type of classification, however, in medicine it is customary to divide injuries into categories depending on the qualities that the damage has.

Types of leg fractures depending on the severity of the injury:

complete fracture with displacement;
complete fracture without displacement and bone fragments;
incomplete;
open fracture of the leg (violation of the integrity of the skin and the exit of the bone outside the wound);
closed fracture of the leg (injury without breaking the integrity of the skin);
complicated (during an injury, a person experiences a strong shock, a violation of the integrity muscle tissue, fat embolism or infection of an open wound);
trauma without complications.

Note!

"What is consolidation?" - consolidated fracture, this is an injury that grows together to form callus; the consolidating process of accretion is a natural mechanism; if the injury began to consolidate, the danger manifests itself in the absence of preliminary diagnosis and detection of damage.

Typical fracture sites are divided into:

(damage to the proximal end of the bone, diaphyseal injuries, fractures of the condyles);
lower leg (trauma of the condyles, damage to the ankles - the lower part);
foot (trauma of the tarsus, metatarsus or phalanges of the fingers, marginal fracture of the phalanx of the fingers, fracture of the cuboid and scaphoid, proximal or distal phalanx).

Also depending on characteristic features there are several varieties:

transverse fracture;
oblique (the fracture line is at an angle);
longitudinal;
screw fracture (the line of damage is in a spiral direction).

Except general classification fractures, separation of injuries with fragments of bone tissue is distinguished:

polyfocal damage - during the injury, 2 or more large fragments were separated;
impacted damage - one of the bone fragments enters the adjacent fragment;
comminuted damage;
crushed damage - the formation of a large number of small fragments;
compression fracture - the injury is usually formed as a result of a strong compression of the bones of the limb.

Often in the case closed fracture there are difficulties in distinguishing and recognizing injuries. This is due to the pronounced pain and impaired mobility of the musculoskeletal system (also characteristic signs for dislocations and cracks), confusion is possible. However, in order not to worsen the patient's condition, it is necessary to treat the injury very carefully and provide first aid as soon as possible.

« Radius" - what it is? The skeleton of the upper and lower extremities has the same structure, however, a fracture of the ulna and radius of the forearm is treated faster. The radius is an analogue of the fibula of the lower leg, but a fracture of the lower limb heals more difficult due to the possible loads and support of the human body.

ICD 10 injury code

According to international classification ICD 10, adopted in 2016, fractures of the lower limb belong to the extensive class "Injuries, poisoning and some other consequences of external causes (S00-T98)".

A large number of bones in the skeleton of the lower extremities is the reason for the division of leg injuries into different subclasses:

A fracture of the hip is combined with some injuries of the girdle of the lower extremities into a block - "and the hip (S70-S79)". Within the block, a fracture of the femur is coded S72 - Fracture of the femur.
combined with injuries of the joints in the block "and lower legs (S80-S89)". Within the block, fractures in the region of the tibia and joints are coded "S82 - Fracture of the tibia, including the ankle joint".
refer to the block "S90-S99 - Injuries of the ankle and foot." Within the block, foot fractures are coded "S92 - Fracture of foot excluding".

Each of the above blocks has a large number of subcategories related to injuries. individual bones included in a particular region of the skeleton of the lower extremities.

Symptoms

There are common signs of a leg fracture that appear in more cases:

the appearance of dull, aching and persistent pain during a fracture;
sharp, throbbing pain when you try to step on or lean on your leg;
decreased mobility;
the skin in the area with broken bones turns blue, signs of hematoma and edema appear;
crepitus, resulting from the friction of the fragments against each other;
a characteristic sound resembling a crunch that occurs at the time of damage;
the appearance of unnatural mobility in the area of the fracture (occurs with an injury to the tubular bones - the femur, tibia, metatarsal bones);
if an open fracture occurs, a wound appears at the site of injury and bone tissue is visible;
if after a leg injury a displacement is formed, then the broken fragments are palpated;
the position of the legs looks unnatural;
fever after a fracture;
after a fracture, the leg becomes shorter than healthy;
the appearance of edema in case of damage to the patella, a complete disruption of the knee joint;
with an injury to the bones of the foot, the leg does not swell much, the functions are partially impaired.

Symptoms of a broken leg are also characteristic of others. mechanical damage such as or cracked bones. If, after a fracture, the leg swells, the skin turns red (begins to turn red due to blood flow) and the temperature rises - this clear signs inflammatory process, which occur after a certain period of time after damage. In cases where it appears heat in case of a leg fracture, it is necessary to inform the traumatologist about this during the examination.

Signs of a closed fracture

Symptoms of a closed leg fracture:

The appearance of significant changes in the shape of the leg.
Crunch during palpation.
The appearance of unnatural mobility.

It is often difficult for a person who has not previously encountered fractures to understand how such an injury differs, but this does not exclude the fact that it is very important to understand and see a fracture, and it is necessary to transport the patient to the trauma department of the hospital as soon as possible.

The skin in the area of damage after a while turns black or darkens, darkening occurs due to the influx and stagnation of blood in the area of the fracture.

How to identify an open fracture

An open fracture is considered to be significantly more dangerous than a closed injury due to the risk of infection in the large surface of the wound.

The skin in the area of damage burns, signs of violation of the integrity of the tissue, such as bleeding and swelling, are noticeable. The main feature is the bones protruding to the surface of the skin. The skin in the area of damage aches, injured muscle fibers can also whine (it must be taken to relieve aching sensations and pain after a fracture).

The reasons

It is customary to divide the causes of injury into categories such as traumatic fractures of limb bones and pathologies that contribute to the development of injuries.

Mechanical reasons include:

injuries as a result of direct impact of a heavy object or impact with the application of force;
falling from height;
accidents and traffic accidents;
blockages in mines, while hiking in the mountains;
during a wound received from a firearm;
violation of safety during the adoption of childbirth (in infants).

Causes of low bone density include:

development of osteomyelitis;
bone tuberculosis;
oncological neoplasms;
fibrous dysplasia;
hereditary diseases;
polyarthritis;
osteoporosis (may break bones in older people).

Most of the diseases that affect the integrity of the bone structure develop with age. However, to ask why and why the leg of a child leading active image life is no less important.

Injuries to the small bones of the foot are accompanied by swelling and blueing (if a hematoma has formed), but in everyday life the baby may not really give it importance so the parents should do it for him.

First aid

— milestone in the treatment of the victim.

What to do with a broken leg:

If a trauma patient shows signs of heavy bleeding(large vessels are damaged), it is necessary to put a tourniquet on the patient's leg (no more than 2 hours, it is necessary to note the time).
Identification of heart or respiratory failure.
The use of drugs - anesthetics (for wound treatment), analgesics (pain pills).
Immobilization of the lower limb.
Transportation of the victim to a medical facility.

A simple bandage will not be able to securely fix the injured limb.

Harness rules

During an injury, both the appearance of hematomas (with internal hemorrhage) and severe bleeding during open form injuries:

before applying the tourniquet, the leg must be slightly elevated for outflow venous blood(raise for 5 seconds);
under the tourniquet you need to put a bandage of gauze or bandage, or put it on top of the clothes;
in case of a leg fracture, a tourniquet is applied in the middle of the thigh;
the first 2 turns when applying a tourniquet are applied with force;
in warm time a tourniquet is applied for a period of not more than one and a half hours;
in the cold season for a period of not more than an hour.

After the specified time has elapsed, the tourniquet must be loosened and the artery pressed with fingers for a period of 15 minutes. If after this time the tourniquet still needs to be applied, the place of its clamping is slightly shifted higher or lower from the previous one.

If the measure of providing PMP (first aid for a fracture) is applied to a child, total time applying a tourniquet should not exceed 1 hour.

If the first aid measure was successful:

The bleeding stops.
The skin below the tourniquet becomes lighter and cooler.
The pulse is not palpable.

There may also be mild signs that the limb is numb (the leg is numb due to impaired blood flow).

Rules for fixation after a leg fracture

To fix the leg after injury, it is necessary to find out in which area the injury occurred; in the case of a closed fracture, this can be determined by swelling and pain in the injured area.

In the event of a hip fracture:

Before starting the manipulation, you need to give the victim an anesthetic and explain the purpose of further actions, reassure.
It is strictly forbidden to remove clothes and shoes from the victim. If a person's trousers are too tight or to examine the injury (signs that the leg is swollen, dark and broken bones), it is recommended to cut the fabric along the side seams.
To fix the leg after a hip fracture, the Dieterichs method is used, however, before the start of manipulations, it is necessary to cover the patient's leg with layers of soft tissue or cotton wool to avoid the formation of bedsores.
If the victim has an open fracture, it is necessary to apply a tourniquet so that a change in its condition does not interfere with the application of the tire, and in case of removal it is not necessary to disassemble the structure.
In order to fix the leg, it is recommended to use a frame made of wood or metal.
If the accident occurred in the cold season outside the premises, it is recommended to wrap the victim's leg with an additional layer of clothing.

Treatment methods and procedures:

closed reposition of the bones (restoration of the position is carried out by a traumatologist);
performing surgery with minimal tissue incisions;
plaster overlay;
therapy for restoring the working capacity of the organ of movement.

A leg bandage in the form of a plaster is applied for any form of a closed or open fracture. The length of time it takes to wear such a framework differs depending on many factors, such as the skeletal structure of the limb and how long the fracture of the leg heals.

The rate of tissue healing is individual for each person, therefore, during and after the main treatment, the patient needs to consult with the attending physician and find out what else is needed for successful recovery.

A technique is also used to stretch the bones by stretching to stretch, which allows the bones to remain in position in the presence of splinters (stretching lasts up to 2.5 months).

While wearing a cast for fractures of the bones of the legs, itching may occur (the skin may itch due to diaper rash). To remove the feeling that the dermis under the plaster itches, specialized preparations are used.

Note!

Edema is the accumulation of fluid, the accumulated fluid can be eliminated with the help of lotions and compresses.

Surgical treatment

After determining the joint injury by radiodiagnostics (used in orthopedics and traumatology), the traumatologist proceeds to further stages of treatment.

The operation is assigned in case of:

Detection of an open fracture.
Identifications comminuted fracture(lots of broken bones).
After unsuccessful traction and closed recovery.

Thanks to this method of treatment, a more stable fixation of bone fragments and reposition of difficult cases (when the fragments are displaced) are performed.

Positive qualities of surgical treatment:

significantly reduces the recovery period;
effective elimination of displacements;
the motor apparatus is preserved in integrity due to the installation of metal elements;
prosthetics of the neck and leg of the thigh;
allows you to restore the bone after a leg fracture with displacement.

A leg injury is not an indication for the removal of a part of the motor apparatus by amputation.

Does your leg hurt after a fracture and treatment? In this case, it is necessary to consult with a traumatologist about prescribing an additional course of painkillers.

How to heal a broken leg faster

Recovery time after a fracture of a limb depends on the state of health, age and immune protection person. So, the question can be answered in 3 months, and for people with serious illnesses or in the elderly population, the recovery time reaches six months or more.

In order to start walking faster, you can:

Cooking corn or wheat porridge to speed up recovery.
Recipe one: mix crushed onion, 20g pine resin, 50g vegetable oil(olive), 15g powder blue vitriol; after mixing, boil for 30 minutes over low heat (do not bring to a boil), the chilled mixture must be applied to the injury site for the fastest accretion bones and reduction pain.
Recipe two: preparation and use of a grated raw potato compress.
Recipe three: peeled and dried eggshells must be thoroughly crushed, pour fresh lemon juice and leave in a cold place (refrigerator) until the shell is completely dissolved; the mixture is applied orally in a diluted form, consumed 1 teaspoon 2 times a day; course duration - 1 month.
Fourth recipe: bread balls must be soaked in 5 drops of fir oil; applied 1 ball 3 times a day inside. It is also recommended to lubricate the injury site. fir oil and use for water procedures.
The fifth recipe: fresh rosehips should be poured with boiling water and kept for a quarter of a day; take orally 1 time per day for 1 glass of infusion.

"How long does a fracture heal?" - the answer to the question of how much an injury can grow together, and whether the bones grow together faster from the application folk methods, tested in practice. The speed at which the healing processes are accelerated depends on the general condition of the patient, however, fracture healing can indeed be accelerated when using folk methods, as mentioned above.

Nevertheless, one should not forget that ethnoscience- this is an auxiliary measure of influence and the methods of its use do not replace the actions necessary in the opinion of the attending traumatologist.

How to relieve swelling after a broken leg

What is used to relieve leg swelling after a fracture?

In order to reduce leg swelling after a fracture, methods are used:

traditional medicine;
traditional (the use of medicinal gels and ointments that help reduce swelling);
alternative.

Most often, recovery therapy includes complex impact ways of treatment.

Methods traditional medicine include:

Medicines containing heparin.
Drugs with a strong anti-inflammatory effect, which allows you to remove tissue swelling.
Medicines containing ketoprofen.
Physiotherapy to reduce leg swelling.

It is worth noting that edema can last long enough to answer the question: “how long does tissue swelling last?” - the answer is purely individual, depending on the methods of treatment used and the general condition of the human body.

application of warming ointments local action(ketoprofenic, ichthyol) 3 times a day;
visiting massage and hydromassage procedures;
visiting procedures for electrical muscle stimulation;
electrophoresis;
ultraviolet irradiation places of injury;
photonophoresis.

Some of these methods belong to the section of rehabilitation - physiotherapy.

How long does the leg hurt after a fracture

The fact that after a fracture the leg hurts for a long time after the removal of the plaster or the operation is a natural phenomenon.

How long after an injury can a person walk?

after the recovery period is 4 weeks or a little over a month;
if the position of the patient's leg is difficult, and after the fracture, a displacement was detected, the rehabilitation time varies up to 3 months;
after a kneecap injury - up to 4 months;
in the case of a fracture of the femur, everything depends on the primary condition of the patient, since recovery occurs from 3 to 8 months;
in case of damage to the foot, depending on the severity of the fracture, recovery lasts from one and a half to five months.

How to start walking after a fracture? - most often after a fracture, patients begin to walk with the help of auxiliary elements (crutches) and for a long time leg bandages are used. Average term rehabilitation - 6 months.

Rehabilitation

Rehabilitation for fractures of the limbs has the main tasks:

Restoration of tone muscular frame and performance of blood vessels.
Restoration of joint mobility.
Reduced severity of edema.
Restoration of activity and natural functions.

How to quickly recover from a fracture, the answer depends on the general condition of the body, assistance in recovery from the doctor and the patient himself, since each person recovers at his own speed.

For a rehabilitation course after a leg fracture, the following are used:

physiotherapy;
breathing exercises;
diet;
massage;
physiotherapy;
water procedures and salt baths (sea salt is used for salt baths).

All exercises prescribed during the rehabilitation period are performed under the supervision of an instructor.

Physiotherapy

Fracture of leg bone serious injury, because of which it becomes difficult for the victim to walk, run (to put it rudely, “use the injured leg”).

Physiotherapy is an integral part of the treatment, which should never be neglected if the patient wants to quickly recover and return to a full life without consequences. Exercises and procedures included in the course of physiotherapy are necessary to relieve swelling and improve blood circulation in the area of damage.

Physiotherapy includes ultraviolet irradiation, electrophoresis, mud applications and warming - these methods of physiotherapy allow physiotherapy after a fracture to be as effective as possible in relation to the injured area.

In addition to procedures for recovery, a system is applied therapeutic gymnastics, which allows you to resume the active abilities of muscle tissue and joints.

At the first stages, exercise therapy is carried out under the supervision of an instructor, then the patient can use the knowledge gained independently.

Massage

The basic principle of therapeutic massage It's his system. The procedure for fractures of the bones of the lower extremities is carried out daily in the morning and evening hours. The effect of massage is aimed at restoring a person’s condition and reducing swelling, therefore, the most important point therapy is the absence of pain during exercise.

Edema under the action of rubbing and massage dissolves, which allows you to quickly return to an active life.

Complications and consequences

Complications of fractures of the lower extremities are divided into 2 categories:

Consequences of bone damage during trauma.
Consequences caused by a violation of the treatment method.

The pronounced consequences of a violation of the technique in the treatment of an open fracture are insufficient treatment of the injury site with antibacterial drugs. Thus, the causes that broke the bone lead to the fact that the tissue begins to rot. Infection significantly complicates and prolongs the treatment period, since the development of infection contributes to the progress of the inflammatory process inside the bone tissue.

Possible complications in violation of therapy:

congestion in the lungs, pneumonia;
thrombophlebitis or thrombosis of the lower extremities;
the formation of bedsores;
severe atrophy of the muscular skeleton;
arthrosis;
epiphyseolosis;
reactive synovitis;
arthritis;
one leg is shorter than the other (the injured leg remains short due to a violation of the growth zone);
suppuration;
embolic disorders;
osteomyelitis;
ischemic contracture.

Complications of a displaced fracture include lameness and bone deformity. Both pathological processes are the result of the fact that one leg becomes longer than the other.

During therapy, the attending physician should observe the patient's condition, whether the joints are bent near the site of injury, how much they can be bent and bent. During any illness, the patient's condition may fluctuate, so timely monitoring is very important for the patient's full recovery.

Prevention

Prevention to prevent the development of complications after treatment has different directions depending on the form of the disease, in order not to cause ODS diseases ( musculoskeletal system) necessary:

Intravenous administration 10% or 20% glucose solution to prevent tissue embolism.
Timely inspection and change in the design of the gypsum to identify and eliminate circulatory disorders (prevents thrombosis).
Therapeutic gymnastics begins immediately after the plaster is placed (from the very simple exercises prescribed by a doctor).
During treatment, the knee joint may remain swollen for a long time, so it is necessary to follow all the recommendations for physiotherapy and develop skeletal mobility.
and taking medications.
Taking an additional course.

Preventive measures can reduce the likelihood of complications and speed up the recovery of a person.

Conclusion

Violation of the integrity of one or more bones - a big problem that anyone can face. During a skeletal injury, the formation of fragments is possible and traction is used to treat the pathology, surgical intervention and plastering. For a full recovery, you must adhere to the rules of rehabilitation and consult with a traumatologist.

Dear readers of the 1MedHelp website, if you have any questions on this topic, we will be happy to answer them. Leave your feedback, comments, share stories of how you survived a similar trauma and successfully coped with the consequences! Your life experience may be useful to other readers.

Article author:| orthopedic doctor Education: diploma in the specialty "Medicine" received in 2001 in medical academy them. I. M. Sechenov. In 2003, she completed postgraduate studies in the specialty "Traumatology and Orthopedics" in the City clinical hospital No. 29 im. N.E. Bauman.

Fracture of the lower limb is a fairly common injury. In this case, the integrity of the bone structures and adjacent tissues is violated, so that the damage is large-scale.

There are many types of this type of injury. Common signs are: swelling, severe pain, impaired mobility and support. The timing and methods of treatment depend on the form of the fracture, the severity and location.

Classification

Depending on the line of damage and the nature of the damage, the following types of fractures of the lower extremities are distinguished:

Transverse. The line of damage is transverse to the length of the bone structure.
Oblique. The line is at an angle.
Longitudinal. The line is located along the length of the bone structure.
Helical. In this case, the fracture line has the shape of a spiral (this happens with a sharp twisting of the limbs).

Depending on the number of fragments, they distinguish:

Polyfocal. There are more than 2 large bone fragments.
splintered. Several fragments are separated.
Fragmented. There are many small debris.

Depending on the nature of the injury, there are:

Compression. The bone is compressed, cracked, flattened, deformed.
Impacted. In this case, one chip is embedded in another.
Tear-off. A fragment is separated from the bone structure.

Depending on the level of the fracture on the lower limb, there are:

Fracture of the bones of the leg. This includes injuries to both the main part of the bone and its edges.
Fracture of the bones of the foot. In this case, the tarsal, metatarsal, and phalanxes of the fingers are also damaged.
This includes the head and neck of the femur.

Damage to the distal and proximal ends of the bone structures are intraarticular and periarticular. In the first case, the ligaments, capsule, cartilage are also damaged. In parallel, there may be a dislocation or subluxation. Periarticular fractures are usually located in the area between the end of the articular joint and the diaphysis.

ICD-10 code

A fracture of the lower limb, according to the ICD-10 classification adopted in 2016, belongs to the general class "Injuries, poisoning and certain other consequences of external causes (S00-T98)". But in the lower limb there are a large number of bones, so several subclasses are distinguished.

Fracture of the femur combined with some injuries hip joint. It is included in the subclass "Injuries of the hip and thigh area". In this block itself, the fracture has the code S72.

The ICD-10 code for an ankle fracture is S82. It is included in the block "Injuries of the knee and lower leg". In addition to such fractures, there are also injuries to the joints.

Foot fractures have the code S92. They belong to the large block "Injuries in the ankle and foot."

All these blocks have many subcategories, which include injuries to various bone structures.

Symptoms

With a fracture of the lower limb, the following general symptoms are distinguished, which appear in most cases:

pain at the site of injury, it has a dull and aching character, does not go away;
pain, if a person tries to step on his foot, there is a sharp and throbbing;
restriction of mobility;
blueing of the skin at the site of injury, swelling, symptoms of hematoma;
crepitus, which occurs due to the fact that the fragments rub against each other;
characteristic sharp sound, similar to a crunch, occurs at the time of injury;
unnatural mobility at the site of injury, but this applies only to tubular bones, that is, the femur, tibia and metatarsal;
the bone is visible if there is an open fracture;
the ability to probe the debris, if there is a displacement;
unnatural position of the legs;
increase in body temperature;

In addition, the length of the affected limb may decrease compared to the healthy one. When the patella is fractured without displacement, swelling occurs. There is also a complete disruption of the functioning of the articular joint. If there is a fracture of the toes or the entire area, then the functions will be impaired only partially, and the leg will swell slightly.

Signs of a fracture can be seen with other injuries. For example, this applies to cracks or dislocations. If the temperature rises, sore spot swelling and redness, this indicates the development inflammatory processes. Be sure to tell the traumatologist about such symptoms.

As for the closed fracture of the bones of the lower extremities, then characteristic symptoms the following:

the shape of the leg changes greatly;
a crunch is heard on palpation;
mobility is unnatural;
blackening of the skin at the site of injury after some time (caused by stagnation of blood).

It is usually difficult for a person who has not received a fracture before to determine such an injury. But you need to get to the emergency room as soon as possible.

An open fracture is considered even more dangerous, as there is a possibility of infection in the wound. The skin in this place is very hot. The integrity of the tissue is broken. The injury is characterized by bleeding and swelling. The main difference is that the bones protrude on the surface of the skin. Because of this, it feels It's a dull pain in injured tissues (including muscles).

The reasons

The following reasons are identified mechanical type damage:

hit with a heavy object;
fall from high altitude;
traffic accident;
accident of any kind;
during sports;
when injured with a firearm;
in case of violation of safety rules during childbirth (trauma in a newborn).

There is another group of factors that reduce the density of bone structures, which increases the likelihood of a fracture:

osteomyelitis;
bone tuberculosis;
cancer diseases;
fibrous type dysplasia;
genetic pathologies;
polyarthritis;
osteoporosis.

Most diseases that can lead to a violation of the integrity of bone tissues usually develop with age.

First aid is an important stage pre-medical treatment. The following steps should be taken if the victim has a leg injury:

If there is severe bleeding (that is, the vessels are damaged), then a tourniquet is required. But you need to keep it no more than 2 hours. You must always keep track of time.
If there is respiratory or heart failure, then use anesthetics to treat the wound and take analgesics to reduce pain.
Immobilize the leg and transport the victim to the hospital.

All these steps must be completed as soon as possible.

Harness rules

With an open fracture, there is a risk of severe bleeding. When applying a tourniquet, the following rules must be observed:

Raise your leg before applying the tourniquet. Just 5 minutes is enough. This is required for the outflow of blood in the veins.
Place a gauze bandage or bandage under the tourniquet itself. You can put it on clothes.
A tourniquet is required on the middle of the thigh.
The first 2 times you need to wrap the tourniquet very strongly.
In warm weather, keep the tourniquet for no more than 1.5 hours, and in cold weather - up to an hour. After this time, you need to loosen it, but pinch the artery with your fingers. Enough 15 minutes. If after this the bleeding has not stopped, then you need to apply a tourniquet higher or lower previous place. For a child, a tourniquet is applied for no more than an hour.

If all actions are performed correctly, then the bleeding stops. Skin below the tourniquet will be lighter and cooler, and the pulse will not be able to be felt. The leg may go numb.

Rules for fixing the leg in case of a fracture

When a leg is broken, it must be fixed. To do this, it is necessary to accurately determine the location of the damage. If the fracture is closed, then you can find out by pain and swelling in the area of injury.

Before all actions, it is required that the victim take painkillers. The person needs to be reassured and explained everything. You can not take off his clothes or shoes. If the trousers are too tight and interfere with the inspection of the affected limb, then the material will have to be cut.

To fix the legs, the Dieterichs technique is used. But before all the actions, it is required to overlay the limb with a soft material, cotton wool. This will prevent bedsores. At open type a tourniquet is applied to the fracture, but in such a way that it does not interfere with the application of the splint, and it would not be necessary to disassemble the entire structure.

To fix the legs, a frame made of metal or wood is used. If the fracture is obtained in the cold season, then the limb must be additionally insulated. In case of a fracture of the lower leg, fixation is performed according to the Cramer method. This secures the back of the leg.

Diagnostics

Diagnostics includes the following:

survey (determine the situation in which the injury was received);
palpation of the affected area;
radiography;

The last 2 research methods help determine the exact location of the debris and the condition of the bones.

Treatment

Treatment depends on the severity of the pathology. Hospitalization should be done as soon as possible. Medical treatment not included in therapy, but the doctor may prescribe painkillers as well vitamin preparations high in calcium.

Treatment methods are as follows:

closed bone reposition;
surgery with minimal tissue incisions;
plaster application.

Gypsum for a fracture of a toe or any other bone structure of the lower limb is applied with any type of open or closed injury. The term of wearing such a design depends on the severity of the damage. You can also use plastic plaster on the leg. But this is determined by the treating doctor. With a fracture of the calcaneus, the orthosis ideally helps to unload the injured limb.

In addition, they use the technique of stretching the bones so that they remain in the right places if there are fragments. This takes up to 2.5 months.

Surgery is prescribed in the following cases:

open fracture;
type;
failed extraction and closed recovery.

Thanks to the operation, bone fragments are better fixed, so recovery will be faster.

hip fracture

A fracture of the femur is a severe injury that is accompanied by bleeding. Complications include bedsores and congestive pneumonia. In addition, fat embolism is possible in the first 3 days.

Fracture of the femoral neck refers to intra-articular. It most often occurs in older people with osteoporosis. The fracture occurs when you fall. The limb will be turned outward. AT lying position on the back, the patient will not be able to lift the heel.

The injured limb looks shorter than the healthy one. Swelling is small. The femoral neck will not heal well due to insufficient blood flow. Usually carried out surgical operation- bone autoplasty, osteosynthesis, or endoprosthetics.

The trochanteric fracture belongs to the group of extra-articular. It usually occurs in people of working age. The symptoms will be the same as in violation of the integrity of the femoral neck, but they are more pronounced.

The swelling is very severe, as is the pain. But such fractures heal well even without surgical intervention. Skeletal traction is required for 2 months, and then gypsum bandage. If you need to recover quickly, then an operation is performed - osteosynthesis.

A diaphyseal fracture of the femur is usually caused by an accident, a fall, or an accident at work. As a rule, with such an injury, there will be displacement due to the fact that the muscles pull and unfold the fragments. Severe pain is felt, swelling, bruising appears. The leg is shortened, and the thigh has a deformed shape.

Strong pain medication is required first to prevent shock. After that, an extract or osteosynthesis is used.

Condylar fractures are intra-articular. They usually appear in older people. The most common cause is a fall or a blow. Feels sharp pain in the knee and lower thigh area. Movement is limited, it is impossible to lean on a limb. The knee area swells, hemarthrosis develops. If there is an offset, then the tibia deviates.

For treatment, traction or plaster is used. If it is not possible to combine the fragments, then osteosynthesis is performed.

Fractures of the lower leg

Fractures of the leg are among the most common. They occur due to an accident, a strong and vigorous impact on the bone, or a fall from a great height. The only exception is an ankle fracture, which usually occurs when the foot is twisted. In this case, there is also a rupture of the ligaments.

Fractures of the condyles of the tibial bone structure are intra-articular. They occur in most cases due to a fall from a height. It can be damaged as one condyle (external or internal), and both at once.

Hemarthrosis develops in the knee, swelling appears. Movement is difficult. For treatment, a puncture and anesthesia are performed. Then plaster is applied, and if there is a displacement, then traction, osteosynthesis or the Ilizarov apparatus are used.

Diaphyseal fractures of the bone structures of the lower leg, if both are damaged at once, are considered a very serious injury. Most often there is a displacement that requires surgical intervention. After reposition, plaster is applied.

Fractures of the bones of the foot

Fractures usually occur when falling from a great height. Be sure to know where the talus is. This is one of the bony structures of the tarsus. It connects to the heel bone.

The fracture can be both intra-articular and extra-articular, with and without displacement of the fragments. In the place where the talus and heel structures are located, swelling and severe pain appear. Can't rely on. The heel is greatly expanded. If there are no displacements, then plaster is applied. Otherwise, a closed reduction is carried out. AT severe cases can mount the Ilizarov apparatus.

The sphenoid bones of the foot are 2 tarsal structures. Their fractures are very a rare event. It can occur with a direct blow, fall, tuck. The tissues in the area of the sphenoid bones of the foot swell, there is pain, problems with movement and support. You will have to wear a cast for up to 1.5 months.

With fractures of the bones of the metatarsus and fingers, which is a fairly common injury, confusion often occurs. The distal region of the foot swells, pain appears. It is very difficult to lean on the leg.

Treatment involves the use of a plaster cast. If there is a shift, then reposition is carried out first. Fixation with knitting needles is carried out in the case when it is impossible to fix the breaks in the desired position.

In any case, you can not do without the help of specialists.

- this is a violation of the integrity of one or more bones of the lower limb as a result of injury. It is an extremely widespread injury. Severity, timing and methods of treatment, as well as long-term effects can vary significantly depending on the level and characteristics of the fracture. Common signs of leg fractures are swelling, pain, and impaired support and movement. Pathological mobility and crepitus are often detected. To clarify the diagnosis, radiography and CT are used, in some cases MRI and arthroscopy are prescribed. Both conservative and surgical treatment is possible.

ICD-10

S72 S82 S92

General information

A broken leg is an extremely common injury. According to statistics, 45% of total number skeletal injuries accounted for fractures of the lower extremities. A leg fracture can be isolated or multiple, or it can be observed as part of a combined injury (polytrauma). Possible combinations with bone fractures upper limbs, pelvic fractures, chest injuries, TBI, kidney injury, spinal fractures, and abdominal blunt trauma. Treatment of leg fractures is carried out by traumatologists. Depending on the severity of the injury, both outpatient monitoring and hospitalization are possible. Both conservative methods and various operational methods treatment.

The reasons

Leg fractures are more often the result of accidents in everyday life (for example, falls on a slippery surface). The second and third most common are leg fractures due to road accidents and falls from a height. In addition, the cause of injury can be criminal incidents, as well as industrial or natural disasters.

Classification

Leg fractures can be complete or incomplete (fractures). Fractures of the legs that communicate with the external environment through a wound on the skin are called open. If there is no wound, the fracture is closed. Depending on the features of the fracture line and the nature of the fragments, the following types of leg fractures are distinguished in traumatology:

transverse- the fracture line is located transversely to the length of the bone.
Oblique- the fracture line is at an angle to the length of the bone.
Longitudinal- the fracture line is located along the length of the bone.
Helical- the fracture line has a spiral shape (such injuries are usually formed as a result of a sharp violent twisting of the limb).
polyfocal- there are two or more large bone fragments.
splintered- there are several fragments.
Shattered- there are many small fragments.
Compression- Accompanied by compression of the bone. In this case, the bone cracks, flattens, squeezes and deforms.
Impacted- accompanied by the introduction of one fragment into another.
Tear-off- a small fragment breaks off from the bone (such damage can be observed, for example, when the ligament is torn off at the place of its attachment).

Taking into account the level of the leg fracture, there are:

Fractures of the femur, including damage to the proximal end of the bone (fractures of the head and neck of the femur, as well as intertrochanteric and pertrochanteric fractures), diaphyseal fractures and damage to the distal end of the bone (fractures of the femoral condyles).
Fractures of the leg bones, including damage to the proximal end of the bone (fractures of the condyles of the tibia), diaphyseal fractures (fractures of both bones of the lower leg, isolated injuries of the tibia and fibula), and injuries to the distal end of the bone (fractures of the ankles).
Fractures of the bones of the foot, including damage to the tarsus, phalanges of the fingers and metatarsal bones.

Injuries to the proximal and distal ends of the bone can be intraarticular (epiphyseal) or periarticular (metaphyseal). With intra-articular leg fractures, concomitant damage to various articular structures is observed, including cartilage, capsule and ligaments. Possible combination with subluxation or dislocation. Periarticular leg fractures are formed in the transition zone between the articular end and the diaphysis and are often impacted. Diaphyseal fractures occur in the middle part of the bone and are usually accompanied by displacement of fragments.

Types of leg fracture

Hip fractures are intra-articular and occur more frequently in older patients with osteoporosis. A fracture of the leg is formed due to a fall at home or on the street, with significant reduction strength of the bone, its integrity can be broken even with an awkward turn in bed. The patient complains of moderate pain in the joint area, the pain increases with movement. The leg is turned outward, in the supine position the patient cannot independently raise the heel above the bed. When the fragments are displaced, shortening of the limb is revealed. Swelling of the injured area is usually minor.

The diagnosis is confirmed by radiography of the hip joint. Due to insufficient blood supply, the femoral neck does not grow together well, a full-fledged callus, as a rule, is not formed, the fragments are “grasped” together by the connective tissue, which causes high percent disability exits. Given this circumstance, the preferred method of treatment for such leg fractures is surgery - osteosynthesis with a three-blade nail, arthroplasty or bone autoplasty.

If a general state does not allow surgical intervention, use skeletal traction. sick old age impose a plaster boot with a transverse bar, excluding the rotation of the limb. This allows for the formation of fibrous callus while maintaining sufficient physical activity of the patient.

Trochanteric fractures are extra-articular and are more often formed in patients of working age. The signs of a leg fracture are the same as in case of damage to the femoral neck, however, the symptoms are more pronounced, there is a more pronounced pain syndrome and significant swelling of the injured area. For diagnosis, radiography of the hip joint is also used. These lesions usually heal well without surgery. The patient is given skeletal traction for 8 weeks and then replaced with a plaster cast. For early activation of patients, various surgical techniques can be used, including osteosynthesis with a plate, a three-bladed nail or screws.

Diaphyseal hip fractures occur with direct or indirect trauma. The immediate cause of a leg fracture can be a blow, a fall from a height, an accident or an industrial injury. People of working age are most often affected. Powerful muscles attached to the femur act on the fragments, "pulling" or turning the fragments, therefore, with such leg fractures, in most cases, a pronounced displacement is observed.

Arises sharp pain and significant swelling, bruising may appear on the skin. The limb is shortened, the hip is deformed, crepitus, pathological mobility is revealed. In some cases, traumatic shock is possible. To confirm the diagnosis, an x-ray of the thigh is prescribed. Treatment is conservative or surgical. At the stage of admission, high-quality anesthesia is carried out to prevent the development of shock. Then skeletal traction is applied or osteosynthesis of the femur is carried out with a plate, pin or rod.

Condylar hip fractures are intraarticular. More common in the elderly, occur when falling or hitting the knee. Accompanied by a sharp pain in the knee and lower thigh. Support and movement are limited. The knee joint is swollen, hemarthrosis is determined. With fractures of the condyles with displacement, deviation of the lower leg inward or outward is observed. To clarify the diagnosis, an x-ray of the knee joint is prescribed. Upon admission, the joint is punctured, then plaster or skeletal traction is applied. If the fragments cannot be compared, an operation is performed - osteosynthesis with screws, a plate or tie bolts.

Fractures of the lower leg

Diaphyseal fractures of the bones of the leg. Formed as a result of direct or indirect high-energy trauma. A fracture of only the tibia or only the fibula, or a fracture of both bones of the lower leg (the most common) is possible. In case of fractures of one bone, displacement of fragments is not observed, or it is less pronounced and easier to correct, since the second bone remains intact and holds the broken one in a relatively correct position. Fractures of both bones are more severe, more often there is a pronounced displacement and more often surgery is required.

Damage is manifested by pain and severe swelling. Observed pathological mobility, crepitus. Support is impossible, movements are very difficult. The diagnosis is confirmed by X-ray. Treatment of fractures of one of the bones of the lower leg is often conservative - if necessary, reposition is carried out, then plaster is applied. Treatment of damage to both bones of the lower leg can be conservative or surgical. In the first case, skeletal traction is applied for 4 weeks, and then immobilization is carried out with a plaster cast. In the second, focal osteosynthesis is performed using lockable rods, screws, less often plates, or extrafocal osteosynthesis with the application of the Ilizarov apparatus.

Ankle fractures- a very common injury. Such fractures of the legs often occur when the foot is twisted, less often they are the result of a direct blow to the joint area. A fracture of one ankle (internal or external), a fracture of both ankles (bimalleolar fracture) and a fracture of both ankles in combination with damage to the posterior or anterior edge of the tibia (trimalleolar fracture) are possible. Trauma may or may not be accompanied by subluxation, displacement of fragments, and rupture of ligaments. In most cases, the more ankles that are broken, the more likely there are aggravating factors (subluxation, displacement, etc.).

There is a sharp pain. The area of the joint is edematous, movements and support are sharply difficult or impossible. With subluxation and displacement of fragments, deformation of the damaged area is revealed. Diagnosis is confirmed by radiography of the ankle joint. Treatment - anesthesia, reposition, gypsum. The immobilization period is determined based on the number of broken ankles (4 weeks for each ankle), that is, 4 weeks for single ankle fractures, 8 for double ankle fractures and 12 for triple ankle fractures. If it is impossible to adequately compare the fragments and eliminate the subluxation, surgical intervention is indicated - osteosynthesis of the ankle with screws, plates or knitting needles.

Fractures of the bones of the foot

Fracture of the calcaneus usually formed when falling from a height. It may be intra- or extra-articular, accompanied or not accompanied by displacement of fragments. The heel region is edematous, dilated, sharply painful, support is impossible. To clarify the diagnosis, an x-ray of the heel is performed. In case of leg fractures without displacement, plaster is applied, with displacement, a closed reposition is carried out, in especially difficult cases, the Ilizarov apparatus is sometimes mounted.

Tarsal fractures- such fractures of the legs are quite rare, they occur as a result of twisting the leg, a fall or a direct blow. Accompanied by pain, swelling of the foot, difficulty in support and movement. The diagnosis is confirmed by foot x-ray. Treatment is conservative - gypsum for 1-1.5 months.

Metatarsal and toe fractures- quite common fractures of the legs. More often they are formed as a result of a blow or a heavy object falling on the foot. Sometimes there is a shift. The distal part of the foot is edematous, painful, support is difficult. X-rays are used to clarify the diagnosis. The treatment is usually conservative - a plaster bandage (if there is a displacement - with a preliminary reposition). If it is impossible to keep the fragments in the correct position, they are fixed with a needle.