An arm fracture is one of the most common injuries and often causes swelling. Hands are of great importance for normal human life, so if they are damaged, it is important to properly treat them and ensure full restoration of functionality.
Edema is formed due to damage to the circulatory system and metabolic disorders in tissues and is an accumulation of fluids in the injured area. Victims are concerned about how long the swelling lasts after a broken arm, as it causes significant discomfort. Most often, the swelling goes away on its own and quite quickly, but in some cases, due to complications, this process may be delayed. To treat swelling of joints and tissues, traditional and traditional medicine is used.
Swelling after a fracture almost always appears, since this is a natural reaction of the body. The causes of swelling are:
As a result, lymphatic fluid accumulates in the injured area, which causes swelling. It leads to rapid fatigue and causes muscle stiffness in movements. Swelling slows down the recovery process and can lead to unpleasant consequences, such as limited mobility, death of bone and tissue.
Depending on how long the swelling does not go away after a fracture of the radius, you can use different methods to eliminate it and speed up the movement of lymphatic fluid in the arm.
When talking about a broken arm, most often we are talking about injuries near the radial joint or forearm. The most common is a fracture of the radius, which is accompanied by severe swelling. Fingers, humerus, and other parts of the arm may also be affected. The fracture can be single or multiple.
Swelling from a broken arm is not the only obvious symptom. Injury is also indicated by severe pain, limited mobility in the joint, sometimes crunching and paralysis.
Swelling of the hand can be exacerbated by accessories and jewelry on the hand. Therefore, doctors recommend immediately removing watches, rings and bracelets. If you can’t do it yourself, it’s best to wait for the help of a doctor.
With an open fracture, bleeding is possible. If an artery is torn, a tourniquet should be used before arriving at the hospital to prevent significant blood loss.
Finger fractures are very common. There are two types of such damage:
Swelling due to a fracture of the fingers is removed after removing the fixing bandage. To do this, they use special preparations of traditional or folk medicine, physiotherapeutic procedures, and perform physical therapy exercises.
A radius fracture is the most common type of hand injury. It can be caused by a fall on your hand, a blow, etc. After a fracture of the radius, swelling in the arm is observed - one of the first signs. If it occurs, you should immediately consult a doctor for help.
Swelling from a fracture of the radius is removed after removal of the plaster cast. To do this, a rehabilitation complex is carried out, which will help to fully restore performance and eliminate unpleasant consequences.
After a fracture, there is a need to remove swelling from the arm as quickly as possible. In a cast, the limb is immobilized for one and a half months. This leads not only to swelling, but also to weakening of muscles and ligaments. In a displaced fracture, the swelling of the radius lasts much longer, since the surrounding tissues were more traumatized. However, it also goes away over time. With proper treatment and rehabilitation, the hand fully restores its functions.
To eliminate swelling, special ointments and gels are used, physiotherapeutic procedures and physical therapy courses are carried out.
If the swelling lasts too long, the doctor may prescribe a number of medications that speed up the process of blood circulation and healing of tissue injury. They are used after removing the plaster cast.
Medicines to relieve swelling can have two types of effects:
To relieve swelling from the hand, most often, cooling ointments are used, for example, heparin ointment, Lyoton or Troxevasin. They must be applied 2-3 times a day to the damaged area of the hand. The ointment helps relieve pain and cool tissues, which promotes speedy recovery.
Therapeutic massage is included in the rehabilitation course after a fracture. It allows you to quickly eliminate the consequences of the injury and return to normal activities. This is one of the most effective methods.
How to remove severe swelling from the arm after a fracture using massage? A professional massage therapist conducts a comprehensive course that helps normalize blood circulation, especially in the atrophied area, stimulates the work of nerve endings, as well as regenerative processes in the tissues of the hand. Then you can continue the massage at home.
When there is damage near the joint of the humerus or radius, as well as in the area of the fingers, a callus is formed, the muscles lose activity, and a number of processes in the tissues are disrupted. To avoid consequences, a number of physiotherapeutic procedures are carried out aimed at normalizing the functioning of the hand:
After the plaster cast is removed from the arm, the person must perform a series of exercises. They have a versatile effect:
The arm must be loaded gradually, slowly increasing the duration of exercise and the range of movement. Exercises must be performed every day, strictly following the instructions of the traumatologist.
If swelling persists on the wrists for a long time and does not subside, you can use traditional medicine. They are often no less effective than medications.
Folk remedies for relieving swelling include:
To prepare the baths, essential oils of spruce, pine, cypress, cedar, as well as iodine or sea salt are used. For this purpose, you can use decoctions of calendula or chamomile. An application of blue clay can be done twice a day for half an hour. For compresses, decoctions of arnica, chamomile, St. John's wort, etc. are used.
Rehabilitation and removal of edema, if not carried out over a long period of time, can lead to complex stagnation processes and disruption of tissue nutrition. Subsequently, this can even lead to amputation of the arm, so it is important to carry out treatment on time and correctly.
Almost any injury can cause swelling in the affected area. It occurs due to damage to capillary networks, which in turn disrupt the exchange between blood and tissue fluid. An ankle fracture is no exception. This is a long-healing injury, and swelling of the foot can be uncomfortable. If the fracture is complex, then not only tissues are damaged, but also ligaments and tendons. In this case, very severe swelling occurs (it is also called elephantiasis). There are cases when improper application of plaster leads to lymph stagnation. It is not surprising that the victim is often interested in the question: how long can swelling last after an ankle fracture.
The duration of foot swelling depends on the extent of the ankle injury. Mild swelling goes away without medical intervention. But if the fracture damaged tissue or tendons, it will take time and effort to relieve the swelling. This may take from several days to several weeks.
Sometimes the leg is in a cast for a long time, which leads to muscle atrophy and disruption of the exchange between blood and lymph, and this in turn increases the duration of swelling.
First aid is to apply a cold compress to the injured area. This has not only an anti-edematous effect, but also an analgesic effect. Cold constricts blood vessels, reduces blood flow and relieves swelling after an ankle fracture.
The next stage of assistance is immobilization. The limb must be elevated (placed on a hill) and bandaged, which will lead to the outflow of blood. In this condition, you should wait for the ambulance to arrive. If it is possible to get to the hospital on your own, then crutches will help the victim; under no circumstances should you stand on your leg.
In the hospital, the doctor will conduct a diagnosis, determine the degree of the fracture, apply a plaster if necessary, and prescribe the recommended treatment. The period of stay in the cast is about 4 weeks, depending on how quickly the callus can form.
A day after the fracture, you can begin applications using ointments that warm up and improve blood circulation. These include: troxevasin, ichthyol and heparin. Gently rub into the skin, massaging it. Carry out the procedure several times a day, while assessing how the leg swells.
As mentioned above, swelling can persist for a long time and to speed up the healing process, the doctor may prescribe physiotherapy: electrophoresis, hydromassage, UV irradiation, ozokerite. Add a few drops of essential oil to the hydromassage bath. UV irradiation promotes bone healing. Usually the procedures last for 10-15 minutes. Together with ointments, they increase tissue metabolism and improve blood circulation. Swelling of the leg with any type of ankle fracture in this case decreases much faster.
Folk remedies in the form of compresses made from tinctures and oils remain very popular. For tinctures, herbal mixtures from wormwood, arnica, calendula and chamomile flowers are used. These herbs have anti-inflammatory properties. A warm compress is applied to the injured ankle for 30 minutes, then the leg is wrapped in a warm cloth.
Fir and cedar oils have regenerative properties for swelling after an ankle fracture. Thanks to them, the skin restores the lipid layer and improves metabolism.
At home, swelling that occurs after wearing a cast for a long time is often treated. Here the leg may swell for physiological reasons.
Methods for treating swelling with folk remedies:
You can start massage in the first days after removing the plaster. It is important that it is not the area of swelling that is massaged, but the muscles near the ankle. Under no circumstances should you touch the bone so as not to deform the callus. Massage the entire leg completely to restore blood circulation as a whole. Start with light loads, light movements with massage cream. Over time, the strength increases. You can do the massage yourself at home several times a day for 15-20 minutes.
While wearing a cast, the muscles weaken, so be sure to add gymnastics: make rotational movements with the foot, bend the toe toward you and away from you, and walk in place. The goals of gymnastics are to restore muscle endurance and walking biomechanics.
Proper nutrition during illness contributes to a speedy recovery. More foods containing vitamins and minerals are introduced into the diet. Vitamin D will help absorb calcium in the body.
According to statistics, bone fractures occupy 1/4 of the structure of injuries in the Russian population, where a third is allocated to lesions of the leg bones. Often they are traumatic in nature as a result of adverse external influences, but there are also fractures of a pathological nature caused by diseases. In both cases, not just nutritional adjustments, but a strict diet will help speed up the regeneration of the patient’s tissues during the rehabilitation period. A person’s food habits can significantly reduce the risk of bone fractures, especially legs, if the diet is rich in proteins and balanced with vitamin and mineral components.
Nutrition for a person with fractures of bones, especially long tubular ones (tibia, fibula and femurs of the legs), is aimed at speedy healing. With extensive fractures, the human body begins to work to eliminate this difficulty, increasing the breakdown of protein and removal from all accessible places, for example, from muscle tissue. The patient is recommended to eat foods rich in protein, mainly of animal origin (60%), including bone vitamins and minerals - calcium, phosphorus, vitamin D. The most nutritious foods are: milk, cottage cheese, cheese, eggs, meat and fish.
In order for protein to be delivered to injured bones without delay, it is additionally necessary to speed up metabolic processes in the body. This is achieved by introducing vitamins into the patient’s diet: A, C, D, K and B vitamins.
As a rule, leg injuries clearly limit a person’s motor activity; the patient’s diet is light in order to eliminate the risk of passive weight gain and increased stress on the legs, but energy-intensive so that the body has the strength to regenerate damaged tissues.
Diet No. 11 corresponds to the intended purpose, rapid healing of bones during fractures and activation of metabolism. For fractures of small areas of the skeletal system, it is recommended to use diet No. 15 with a reasonable increase in the protein content of food and the addition of calcium to the diet.
Diet No. 11 is intended for patients with tuberculosis, but its content is useful for fractures of legs and arms. It has a high energy value (3400 kcal), which is important during the recovery period, as well as an increased protein and vitamin-mineral component of nutrition, accelerating the healing of broken bones. The daily diet includes:
Diet No. 15 represents complete nutrition, excluding fatty and spicy foods that are poorly digested and absorbed by the body. The daily energy value of the diet is 2900 kcal and includes:
The most important vitamins used for bone fractures, especially the lower extremities, are mentioned:
Vitamins A, D and K are fat-soluble and are recommended to be consumed with butter, sour cream, and cream. The remaining vitamins dissolve in water, without requiring companions for successful absorption.
A patient with fractures in the osteoarticular system is prescribed to eat foods that include the following beneficial elements:
The patient’s nutrition includes the composition of products and regimen. Food intake is provided in fractional, small portions 5-6 times a day. During the day you should drink at least two liters of ordinary water; to avoid swelling, most of the liquid should be consumed before six o’clock in the evening.
Products that are considered undesirable in normal life without dietary restrictions are prohibited: all types of sausages, semi-finished products, spicy, excessively salty, smoked and fatty foods. You shouldn't like this kind of food. The zest of taste has an imaginary saturation effect, essentially being poor in vitamins and beneficial microelements. Often, unhealthy food leads to disruption of the water-salt balance of the body and aggravates the general condition of a bedridden patient.
It is necessary to exclude hot drinks that have become traditional, accompanying any meal, and carbonated drinks. Black tea and coffee contain caffeine, which removes calcium from the body, which is important for bone regeneration. Sodas and lemonades also suffer from the removal of calcium and are also high in sugar content. These drinks count towards the amount of liquid consumed per day, which is so necessary for human life and health. It is advisable to replace chocolate oversaturated with caffeine with a healthy source of endorphins - honey.
A balanced diet promotes rapid tissue regeneration and healing of injuries to the legs and arms, but it is much better to enrich the body with the necessary proteins, vitamins and minerals in advance, strengthening the skeletal system. This will avoid many injuries and reduce the risk of complications during the recovery period.
The swelling that appears after a fracture is caused by poor circulation in the injured area of the body. Most often, such swelling occurs after a fracture of the lower extremities. Such swelling may appear immediately after injury, or may develop even after several years, when all traces of the fracture have disappeared.
The edema that appears after a fracture, like any other, is caused by the accumulation of fluids in the intercellular space. Since after a fracture the injured area of the body is in plaster for a long time, the circulation of fluids in it is disrupted. As a result, swelling occurs that needs to be removed.
If the swelling is severe, immediate assistance from a doctor is necessary to relieve the swelling. After all, this may mean that an important artery was compressed by the bone. If you do not pay attention to this, tissue death may begin after a while. The reason for this is the lack of nutrients and oxygen that are carried through the arterial blood.
To prevent swelling, it is first necessary to work correctly with the injured limb. Primary requirements:
To relieve swelling after a fracture, the following traditional medicine methods are used:
And several folk recipes that also help resolve swelling after a fracture:
Swelling after a fracture is common and can be easily treated in most cases, so there is no need to worry about it. It is important to see a doctor promptly if pain and swelling increases and follow all instructions from your doctor. If the swelling is not removed in time, complications are possible.
1. Classification of fractures.
2. Signs and complications of fractures
3..PP for fractures of limb bones.
A fracture is a violation of the integrity of bones.
Fractures can be closed (without damage to the skin) and open (with a violation of the integrity of the skin and sometimes even with exposure of bone fragments).
Modern classifications distinguish types of fractures depending on the following characteristics:
Traumatic - caused by external influence.
Pathological - occurring with minimal external influence as a result of bone destruction by some pathological process (for example, tuberculosis, tumor or others).
Without displacement (for example, under the periosteum).
With displacement of fragments [3] .
Incomplete - cracks and breaks.
Transverse - the fracture line is conditionally perpendicular to the axis of the tubular bone.
Longitudinal - the fracture line is conditionally parallel to the axis of the tubular bone.
Oblique - the fracture line runs at an acute angle to the axis of the tubular bone.
Helical - rotation of bone fragments occurs, bone fragments are “rotated” relative to their normal position.
Comminuted - there is no single fracture line, the bone at the site of injury is crushed into separate fragments.
Wedge-shaped - usually occurs with spinal fractures when one bone is pressed into another, forming a wedge-shaped deformity.
Impacted - bone fragments are displaced proximally along the axis of the tubular bone or are located outside the main plane of the cancellous bone.
Compression - bone fragments are small, there is no clear, single fracture line.
Closed - are not accompanied by tissue injuries penetrating to the fracture site and do not communicate with the external environment. Single - if there is one fracture of one segment of the musculoskeletal system. Multiple - if the fracture is within one segment or different segments of the musculoskeletal system.
Open - (gunshot and non-gunshot), bone fractures accompanied by soft tissue injuries and communicating with the external environment. Combined - if the fracture is combined with injury to internal organs or the skull. Combined - if the lesion is in one anatomical area or in different anatomical areas.
Within the tubular bone there are
Also, the most common types of fractures have generally accepted names - after the name of the author who first described them.
For example, a fracture of the styloid process of the radius is called a Colles fracture. Also fairly well-known types of injuries of the upper limb include the Monteggia fracture, which occurs with a fracture of the ulna in the upper third and dislocation of the head of the radial bone with damage to the branch of the radial nerve, and the Goleazzi fracture, which is a fracture of the radius in the lower third with a rupture of the distal radioulnar joint and dislocation in this joint. [4][5]
In childhood and adolescence, fractures along the non-ossified growth (epiphyseal) line - epiphysiolysis - are observed. In old age, fractures occur with a significantly lower traumatic load and recovery time increases. This is due to a change in the ratio of mineral and organic components of bone.
2. SIGNS AND COMPLICATIONS OF FRACTURES.
All signs of limb fractures are divided into reliable and relative.
Reliable signs include:
- bone fragments visible in the depths or protruding outward in an open fracture;
- shortening of the limb due to significant longitudinal displacement of its bone fragments;
— deformation of the limb due to angular displacement of fragments; the sign is especially characteristic of fractures of the shin bones and forearm;
- pathological mobility of bone fragments at the site of injury; the sign is revealed as follows: the examiner holds the central part of the limb with one hand, and with the other hand slightly lifts and moves its peripheral part to the side; the presence of mobility outside the joint indicates a bone fracture;
- crepitus of bone fragments (bone crunch); the sign is detected by the same technique; at the moment of movement of fragments, sounds are felt, reminiscent of the crunching of snow underfoot or the gurgling of boiling water.
Relative signs of a fracture include:
- swelling of the limb at the site of injury due to intermuscular and subcutaneous hematomas;
- pain at the site of the suspected fracture, increasing with palpation and axial load;
— dysfunction of the injured limb in the form of limitation or impossibility of movements.
The presence of at least one of the reliable signs confirms the diagnosis of a fracture. In the absence of reliable signs (their unclear manifestation), the basis for diagnosis can be the presence of the entire complex of relative signs.
Complications of tubular bone fractures:
Damage to internal organs.
Wound infection, osteomyelitis, sepsis.
PP FOR FRACTURES OF LIMB BONES.
First aid is provided at the scene of injury.
For a closed fracture, the procedure is as follows:
- cold to the site of injury;
- rest and warm the victim;
-if you faint, inhale ammonia
In case of an open fracture and severe bleeding from the wound, the following is carried out:
— finger pressure of the main artery;
-Next, apply a bandage to the wound,
- then transport immobilization is performed and the victim is immediately sent to a medical facility.
In case of an open fracture not accompanied by intense bleeding, the wound is covered with an aseptic bandage. In this case, you should not completely free the damaged part of the limb from clothing; it is enough to cut out the area directly adjacent to the wound.
An examination of a fracture of the upper limb is recommended to be carried out with the victim in a sitting position, and of the lower limb - lying down. All manipulations must be gentle; clothes and shoes do not need to be removed. The examiner should always pay attention to the color of the skin of the peripheral part of the limb and its temperature. Pale skin, a decrease in local temperature and sensitivity indicate a circulatory disorder caused by pressure on the main blood vessel from a displaced bone fragment or a tense interstitial hematoma. In such cases, after transport immobilization, the victim must be immediately evacuated to a medical facility.
In case of fractures, the main task is to immobilize the damaged limb or area. Any movement of a broken bone can lead to painful shock, loss of consciousness and damage to surrounding tissue. . Moreover, if the victim, after a fall or blow, complains of severe pain that intensifies with any movement or touch, there is no need to guess whether there is a fracture, or a dislocation, or a severe bruise - in any case, you need to immobilize the limb and call an ambulance. . It is under no circumstances recommended to attempt to correct the position of a damaged bone or to replace a broken bone on your own. Moreover, you should not set protruding bones into the depths of the wound. Let the professionals do this. To alleviate the condition of the victim, you can apply cold to the sore spot to reduce swelling, and also give him analgin, tempalgin, amidopyrine or another painkiller. You can give the patient a drink of water or warm tea and cover him (if it’s cold). When a hand is broken, the easiest way to immobilize the hand is by hanging it with bandages or a triangular scarf on a sling that is tied around the neck. For a fracture of the forearm bones, two splints are used, which are applied on both sides - palmar and dorsal.
Immobilization of the upper limb using a scarf.
For a fracture of the shoulder, collarbone, scapula - DEZO bandage. For fractures of the shoulder girdle, you need to put a small cushion under the arm, and hang your arm with a bandage or scarf and tie it to your body. The victim is transported in a sitting position. If a finger is broken If a finger is broken, it must be tightly bandaged to the adjacent healthy finger. For the leg: For a broken leg , tie the injured leg to the healthy leg in the area above and below the fracture. Or, if it is not possible to transport the victim in a lying position, apply a splint covering at least two leg joints. A primary splint is placed on the back of the leg to prevent joint flexion. In case of a hip fracture, a splint is applied from the outer surface to the armpit, and from the inner surface of the thigh to the inguinal fold.
Transport immobilization is the immobilization of an injured limb for the period necessary to transport the victim from the site of injury to a medical facility.
Indications for transport immobilization are fractures of skeletal bones, damage to joints, large vessels, extensive wounds and prolonged compression of the limbs, as well as burns and frostbite.
The most important thing is to fix the fracture site in the most physiological (comfortable) position, making sure to also fix the joints closest to the fracture site (dislocation). To avoid additional pain caused by the pressure of the splint on the protruding bones, soft pads are usually used between them.
If there are no emergency medical indications for giving a certain position to the patient, he takes a position that is comfortable for him.
Means for transport immobilization are divided into standard tires and improvised ones. The most convenient means at hand are wooden slats, bars of sufficient length, thick cardboard, etc. If there are no suitable materials at hand, you can perform autoimmobilization - fix the arm to the body with items of clothing (belt, scarf, etc.) or a bandage, and immobilize the injured leg by bandaging it to the healthy one.
During transport immobilization the following rules must be observed:
- the injured limb should be immobilized immediately after the injury;
- before immobilization, the victim must be given an anesthetic;
- if there is an open fracture, apply an aseptic bandage to the wound and only after that a transport splint is bandaged;
- if it is necessary to use a hemostatic tourniquet, the latter is applied to the limb before immobilization, and in such a way that it can be removed without disturbing immobilization;
- the injured limb with a transport splint applied must be insulated before transporting the victim in cold weather in order to prevent frostbite.
Apply cold to the area of injury (ice, snow or cold water in a plastic bag on a bandage), except when a tourniquet is applied to the limb. Careful placement and gentle transportation of the affected person is the most important condition for the prevention of shock.
Immobilization is the creation of immobility (immobility) of a limb or other part of the body during damage, inflammatory or other painful processes, when the damaged (sick) organ or part of the body needs rest. It can be temporary, for example, for the period of transportation to a medical facility, or permanent, for example, to create the conditions necessary for the fusion of bone fragments, wound healing, etc.
Transport immobilization is one of the most important first aid measures for dislocations, fractures, wounds and other severe injuries.
It is unacceptable to carry and transport victims without immobilization, especially those with fractures, even over a short distance, because this can lead to increased displacement of bone fragments, damage to nerves and blood vessels located next to the moving bone fragments. With large wounds of soft tissue, as well as with open fractures, immobilization of the damaged part of the body prevents the rapid spread of infection; in case of severe burns (especially of the extremities), it contributes to a less severe course in the future. Transport immobilization plays an important role in the prevention of such a serious complication as traumatic shock.
Rice. 9. Immobilization using improvised means.
a, b - with a fracture of the spine;
c, d — immobilization of the hip;
d - forearms; e - collarbone; g - shins.
1,2,3—stages of applying a Dieterichs splint.
a- Dieterichs splint
d, f, g-tires from scrap material.
Folding, plastic splints for the forearm and shin.
Cramer tire. Overlay Stages
Training in the skills of gentle application of transport tires
Before applying a transport splint, it is necessary to mold it to the shape and size of the healthy leg.
The splint should be applied by two people. The first participant fixes the injured leg. The second participant forms a splint, and, holding it, places it under the raised limb.
The procedure for applying a folding splint to the lower leg.
At the scene of an accident, you most often have to use improvised means for immobilization (for example, boards, branches, sticks, skis). Using these means, they fix (bandage, strengthen with bandages, belts, etc.) the damaged part of the body. Sometimes, if there are no available means, you can provide sufficient immobilization by pulling the injured arm to the body, hanging it on a scarf, and in case of a leg injury, bandaging one leg to the other. The main method of immobilizing an injured limb while the victim is being transported to a medical facility is splinting. There are many different standard transport splints that are commonly applied by medical professionals such as emergency services. However, in most cases of injury, you have to use so-called improvised splints, which are made from scrap materials. It is very important to carry out transport immobilization as early as possible. The splint is placed over clothing. It is advisable to wrap it with cotton wool or some soft cloth, especially in the area of bony protrusions (ankle, condyle, etc.), where the pressure exerted by the tire can cause abrasion and bedsores.
If there is a wound, for example in cases of an open fracture of a limb, it is better to cut the clothing (possibly at the seams, but in such a way that the entire wound becomes easily accessible). Then a sterile bandage is applied to the wound and only after this immobilization is carried out (the belts or bandages securing the splint should not put much pressure on the wound surface). In case of severe bleeding from the wound, when there is a need to use a hemostatic tourniquet, it is applied before splinting and is not covered with a bandage. You should not tightly tighten the limb with separate rounds of the bandage (or its substitute) for “better” fixation of the splint, because this may cause poor circulation or nerve damage. If, after applying the transport splint, it is noticed that constriction has occurred, it must be cut or replaced by applying the splint again. In winter or in cold weather, especially during long-term transportation, after splinting, the damaged part of the body is wrapped warmly. When applying improvised splints, you must remember that at least two joints located above and below the damaged area of the body must be fixed. If the splint does not fit well or is not sufficiently fixed, it does not fix the damaged area, slips and can cause additional injury.
What are bone fractures and what fractures do you know based on the severity of the injury?
What is the classification of fractures based on the shape and direction of the fracture line?
Describe the types of fractures based on the integrity of the skin.
What are the reliable signs of fractures?
What relative signs of fractures do you know?
List the complications of fractures.
What is the algorithm for the rescuer’s actions when providing PN for closed fractures?
What is the algorithm for a rescuer’s actions when providing PN for open fractures?
What is transport immobilization and what are the indications for its use?
What methods of limb immobilization exist?
What are the basic rules of transport immobilization?
The human foot consists of 26 bones, interconnected by numerous ligaments and articular joints. During any movement, it is subjected to heavy loads, since it bears the entire weight of the body. Therefore, a fracture of any structure of the foot affects its functionality. And such an injury is quite common and accounts for approximately 10% of all fractures. It can be easily obtained not only in case of an accident or fall from a height. A fracture of the bones in this place can occur when the leg is twisted or during an unsuccessful jump.
And damage to even one bone leads to deformation of the foot and the inability to support it due to severe pain. In addition, swelling of the foot occurs very often after a fracture. After all, this place contains many blood and lymphatic vessels, as well as nerve endings that can be damaged during injury. This condition aggravates the patient's situation and slows down bone healing.
Edema is the accumulation of fluid in the soft tissues of the body. In case of a fracture, it can occur due to bones squeezing blood or lymphatic vessels, as a result of which the outflow of blood is disrupted. It accumulates in tissues damaged by injury, causing even more inflammation. The permeability of capillaries is also impaired, which slows down the removal of interstitial fluid in this area. Therefore, swelling of the legs is often observed after a fracture. Indeed, due to the remote location of the lower extremities from the heart, circulatory disorders are more often observed there.
The cause of foot swelling can also be damage to the muscles, ligaments and other soft tissues, causing their inflammation. This leads to severe swelling of the entire foot. If an injury affects a joint, the area swells even more due to the accumulation of joint fluid. Most often, swelling is localized on the sole or in the ankle joint, since this place bears the heaviest load. With serious comminuted fractures, not only the area of injury, but also the entire foot swells.
When swelling is caused by damage to the lymphatic vessels, the condition is called lymphedema. In this case, serious complications can develop. The skin at the site of swelling becomes denser, and thickening may occur. With severe edema, fibrosis, elephantiasis or trophic ulcers may develop.
Swelling of tissues after a fracture may be accompanied by redness of the skin and changes in its sensitivity
Swelling can occur either immediately after an injury or later, after a cast is applied. There are also cases where the foot swells during rehabilitation, when the bone has already fused. This is due to prolonged immobility of the leg, due to which blood circulation and metabolic processes in this place are greatly slowed down. In addition to swelling, symptoms of edema include changes in skin color. They may turn purple or bluish depending on the amount of blood. The skin may lose sensitivity or, conversely, become excessively painful.
When a person breaks a bone in their foot, the pain is usually so severe that it forces them to see a doctor right away. Proper treatment will prevent swelling from occurring. But most often the foot swells immediately after the injury. This may interfere with therapeutic measures. Therefore, ice is applied first, which slightly reduces the swelling. For the same purpose, the leg is raised on a pillow so that the heel is higher than the hips.
Various methods can be used to relieve swelling of the foot following a fracture. First of all, it is necessary to restore blood circulation in the injured limb. To do this, almost immediately after the injury, it is necessary to perform special gymnastics and massage the muscles above the fracture site. These procedures should not cause increased pain, and during massage you should not touch the bone, as this can lead to the formation of a large callus. Immediately after an injury, magnetic therapy is also effective.
If a cast is applied for treatment, this does not eliminate the need to perform gymnastics. Without putting any weight on the leg, you need to force muscles that are not connected to the damaged bone to work. To prevent swelling, the leg should be kept horizontal or even higher than the body, placed on a pillow. It is very important to ensure that your fingers are warm and do not lose sensitivity. After all, swelling can occur due to strong compression of tissue by plaster.
After the fracture heals, swelling may also form. To prevent this, immediately after removing the cast, it is recommended to use orthopedic orthoses on the ankle joint or bandage it with an elastic bandage. It is recommended to use this method for several weeks after the cast is removed. At first, you should try not to put any strain on the injured limb, but you must move to restore blood circulation.
To prevent swelling after removing the cast, you need to fix the foot for some time with an elastic bandage or a special orthosis.
If swelling has already appeared, you need to take action immediately. Otherwise, swelling may persist for a long time and lead to the development of complications. Therefore, if such a problem occurs, you need to consult a doctor to prescribe treatment.
The most commonly used external medications are those that have the ability to improve lymph flow and blood circulation:
After removing the plaster, it is useful to do massage and therapeutic exercises, this will prevent the appearance of swelling
Sometimes oral medications are also required. These may be means to improve blood circulation, for example, Trental, Troxerutin, Pentoxifylline, Vazonit. Vitamin complexes containing B vitamins, calcium, phosphorus and magnesium are also useful.
The rate of tissue repair at the site of injury is highly dependent on the general health of the patient. Therefore, for a speedy recovery and to prevent severe swelling, it is necessary to eat properly. The diet should be rich in proteins and microelements, which accelerate tissue regeneration.
If the injury site is severely swollen, it is recommended to take diuretics to improve the removal of fluid from the tissues. In addition to medications prescribed by a doctor, you can also use home recipes.
The following remedies help relieve swelling:
Traditional methods will help speed up tissue restoration
After consulting a doctor, you can also use traditional recipes. But they should only be used as aids.
In most cases, swelling after a foot fracture is inevitable. But timely treatment and compliance with all doctor’s recommendations helps to cope with the problem.
The description is valid on 24.06.2017
The healing process of fractures is very long and takes place in several stages. The first stage (3-10 days) is the primary “gluing” of bone fragments. the hematoma is reabsorbed , swelling and inflammation decrease. The second stage (10-50 days) is a soft callus, when the fragments are less mobile, but the callus is pliable, and there is practically no pain. The third stage (from 1 to 3 months) is bone fusion, the phase of callus calcification. But the process of consolidation of the fracture has not yet been completed; disturbances in venous circulation and changes in soft tissues are noted. The fourth stage (a year or more) is the completion of consolidation, morphological and functional restoration of the bone.
The timing of bone fusion is strictly individual, but there is a dependence of regeneration on the age of the patient. Over the years, this process becomes less intense, which is why older people experience slow consolidation, especially with displaced fractures. The most important thing for any fracture is complete immobilization (ensuring immobility) for the required period and proper nutrition.
For bone fractures, nutrition should be aimed at accelerating the healing process. With extensive injuries, protein breakdown increases (due to muscle proteins) and basal metabolism increases significantly. The diet for fractures of leg bones (especially large tubular bones) should contain a high protein content - up to 100-120 g per day. Among the amino acids lysine , glutamine , arginine , glycine , proline , cystine , which are part of the proteins that form bone tissue, are especially important
In the formation of bone tissue, the main role is played by calcium, phosphorus, magnesium and zinc, so proper nutrition should include these elements.
The skeleton accounts for 99% of all calcium contained in the human body. Calcium in food is in the form of insoluble salts, so they are not absorbed in the stomach. Here, the main absorption occurs in the duodenum, and bile acids have a great influence on this process. For more effective absorption of calcium, vitamin D (fatty sea fish, fish oil). Nutrition for a broken leg must include foods that are sources of calcium: milk, fermented milk products, dairy products (cheeses and cottage cheese), milk powder, hazelnuts, lettuce, spinach, sesame seeds.
The main “depot” of phosphorus (its organic compounds) is bone and muscle tissue. With its deficiency in the body, growth in children is impaired, bone deformities and osteomalacia . Its sources are milk, meat, fish, sturgeon caviar, beans, yolk, walnuts, beef liver, oatmeal and buckwheat and all dairy products.
The main “depot” of magnesium is also located in bones and muscles. It is a necessary component of enzymes that are associated with the metabolism of phosphorus and carbohydrates. Magnesium, together with calcium, is necessary for the processes of new bone formation. It enters the body with salt, food and water. Particularly rich in this element are unprocessed grains, wholemeal flour, dark green vegetables, and legumes. The leading cereals in terms of magnesium content are buckwheat, oat and wheat cereals, watermelon, hazelnuts, coffee beans, milk powder, almonds, and bananas. Excess magnesium has a mainly laxative effect.
Zinc is deposited in the liver, muscles and skeletal system. Deficiency causes growth retardation in children and poor wound healing. This element enhances the effect of vitamin D and, accordingly, promotes the absorption of calcium. The richest foods in zinc are bran (wheat, rye and rice), yeast, cereal grains, legumes, seafood, cocoa, beef, dairy products, animal entrails, sesame seeds, pumpkin seeds, baking yeast, peanuts, sunflower seeds, onions, potatoes. Mushrooms contain the largest amount of it.
Rational and long-term nutrition is especially important for leg fractures, since the lower limbs bear a large load of weight, and the person’s future activity will depend on how well the bone tissue is restored. Ankle fractures are no exception. Immobilization is carried out for 45-60 days and consolidation of fragments is noted during the same period. However, for a long time you should spare your leg and not put any strain on it. Rehabilitation after an ankle fracture can take 3-6 months for some patients until pain and swelling .
Fat-soluble vitamins A and D can be synthesized from their precursors in the body. Carotenes that come from plant products (orange carrots, sea buckthorn, rose hips, wild garlic, rowan berries, red sweet peppers, tomatoes) are broken down to form retinol ( vitamin A ). Ergosterol (found in plant foods and yeast) is converted into D vitamins when exposed to ultraviolet light. As already noted, vitamin D plays a major role in providing the body with calcium. The body receives ready-made vitamin D from chicken yolk, fish oil, fatty sea fish and its high content in sprats.
vitamin C content are rose hips and sea buckthorn, and B vitamins are offal (pork and beef liver, kidneys), walnuts, hazelnuts, cereals, milk, milk powder, garlic, yeast, sweet peppers. Vitamin C, together with other vitamins, is a catalyst for reactions that occur during the healing of fractures. Vitamin B9 (folic acid) and vitamin B6 are necessary for the formation of the collagen framework. We get folic acid by eating bananas, legumes, leafy vegetables, Brussels sprouts, wheat germ, beets, brewer's yeast, liver, and citrus fruits. Vitamin B6 is found in potatoes, shrimp, bananas, salmon, ham, wheat germ, chicken, beef, sunflower seeds, and beef liver.
Antioxidants , of which vitamin C is the most powerful, restore damage to bone tissue and reduce inflammation. Sources of antioxidants are nuts, fruits, vegetables, legumes. Moreover, brightly colored vegetables and berries contain the most antioxidants.
If you adhere to therapeutic diets, then the most suitable for a fracture of the lower extremities is Diet No. 11 . It is this that provides enhanced nutrition, increased body defenses, and enhanced recovery processes. This is a diet with increased calorie content due to an increase in protein content (100-120 g), minerals, vitamins, as well as a moderate increase in fats and carbohydrates. It provides all the nutritional points mentioned above. Diet up to 5 times a day. Conventional cooking is used.
The diet for broken arm bones may not be as high in protein content. For this localization of fractures, the introduction of protein in the amount of 80 g will be sufficient. Therefore, nutrition for a broken arm is usually organized on the principles of Table No. 15 with the additional introduction of dairy and other products containing calcium. A fracture of the arm (radius) heals in 28-35 days, and an ulnar fracture takes a little longer - in 60 days. All this time you need to eat right.
In case of jaw fractures or maxillofacial injuries, chewing and swallowing are impaired, so liquid or semi-liquid food is first recommended. As the pain and swelling decrease, pureed and mushy food is added. A suitable option is Diets No. 1A , 1B or No. 1 for moderate chewing disorders. The basic principles of nutrition regarding protein and macronutrient composition are the same, but the food is passed through a meat grinder, then diluted (with broth, vegetable broth, milk, water) to the consistency of liquid sour cream. Patients have problems chewing bread, so it is given in the form of crushed crackers added to main dishes. With maxillofacial injuries, there is a perversion of taste and lack of appetite, so it may be necessary to add foods (at the request of the patient) to improve taste.
If with fractures of the ribs (one or two are not subject to immobilization) or bones of the upper extremities, a person leads a more or less active lifestyle (at least you can walk and do simple housework), then with a fracture of the femoral neck the patient is bedridden for many months. The average fusion time ranges from 90-120 days. In 70% of cases, fractures of this location in elderly people do not heal. Nutrition is no different from the above, but given the patient’s immobility, constipation . To this end, include more fiber in the diet in the form of vegetables and fruits (beets, prunes, dried apricots, pumpkin), which have a laxative effect. If these measures turn out to be ineffective, then they switch to taking laxatives ( Lactulose , Normaze , Duphalac ).
There are “small” injuries of the spine (articular, spinous or transverse processes) and large (compression). The timing of fusion and the duration of adherence to the diet depend on this. Fusion of the vertebral bodies occurs in 2-4 months. The time for consolidation of a compression fracture is 14 weeks. First, it is recommended to adhere to bed rest and wear a corset (plaster or metal-plastic), which is selected by a traumatologist. Even after an uncomplicated compression fracture, it is recommended to sit less and move actively (running, jumping), and avoid physical activity. In such a situation, bending and turning the body and lifting heavy objects are prohibited.