A fracture is a break in continuity of a bone. It may vary from a crack to a complete break.
Causes of fractures
Fractures occur due to application of force to the skeleton. The force may be direct or indirect.
Direct force
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The bone breaks at the spot where force is applied. Indirect force
The bone breaks at some distance from the spot where force is applied, e.g. fracture of collar bone due to fall on the outstretched hand.
Types of fractures: Fractures are classified as follows:
1. Closed fracture: Here, the bone is broken but the overlying skin is intact.
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2. Open fracture: The bone is broken and also there is a break in the skin or mucous membrane overlying the fracture.
3. Complicated fracture: There is an associated injury to some internal structure like blood vessel, nerve, lung, heart or liver.
4. Comminuted fracture: The bone is broken into several fragments.
5. Impacted fracture: The broken ends are driven into one another.
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6. Depressed fracture: This occurs in the skull bone where the broken part of the bone is driven inwards.
SUPRACONDYLAR FRACTURE OF HUMERUS
Cause
It is an important fracture which occurs near the elbow. It occurs commonly in children. It frequently occurs following a fall from a swing.
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Signs and symptoms
Pain, swelling, deformity and inability to use the elbow.
Treatment
It is a serious fracture. It may lead to injury to blood vessels in the elbow. It is treated by padding the arm and supporting in a triangular sling.
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FRACTURE NECK OF RADIUS
Cause:
It is a common fracture. It occurs due to a fall on outstretched arm.
Signs and symptoms
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Pain and inability to rotate the arm. Also interference with full flexion and extension.
Treatment
A triangular sling.
FRACTURE OF RADIUS AND ULNA Cause
These two bones may be fractured together in the forearm by a direct or indirect blow.
Signs and symptoms
Pain, swelling, deformity and inability to use the arm. The patient may support the injured arm.
Treatment
Well padded splint with a triangle sling to support the limb.
FRACTURE SHAFT OF ULNA
It occurs due to direct blow, it is treated exactly as above i.e. fracture of radius and ulna.
COLLE’S FRACTURE
Cause
It is a very common fracture occurring at the wrist. It occurs due to a fall on the outstretched hand.
Signs and symptoms
It produces a typical ‘dinner fork’ deformity at the lower wrist. There is pain, swelling and tenderness over the fracture. Also there is inability to use the hand.
Treatment
A triangular sling and padded splint.
Pelvis is a strong bone. It is designed to resist the weight of the body and the force of lower limb. So it is caused by great force such a fall from a hight.
in transverse fracture, there will be separation of fragments. The patient will not be able to straighten the leg. A painful, tense swelling of the knee joint will occur.
Treatment
The leg is straightened gently. It is fastened to the other leg with broad bandages above and below the joint. The ankle is tied with figure eight bandage. The patient is carefully transported to the hospital in a stretcher.
12. FRACTURE OF SHAFT OF TIBIA Cause
Tibia is easily felt under the skin. So fracture of tibia may be associated with damage to the skin. So this fracture must be carefully dealt with to avoid making it an open fracture. Tibia fracture occurs due to a direct or indirect injury.
Signs and symptoms
Bruising pain, swelling and tenderness of the leg. Deformity with angulation and rotation may be present. There may an open wound with protruding bone.
Treatment
The limb is gently straightened and rotated. The ankles are bound together by figure eight bandage. Broad bandages are applied above and below the fracture . The knees should be bound together. The patient is then safely transported to the hospital.
FRACTURE OF THE ANKLE
Cause
Fracture of the ankle may occur due to direct or indirect injury.
Signs and symptoms
Pain, inability to walk, swelling, bruising may present. With severe, injury, there may be displacement of the foot.
Treatment
Figure eight binding of the two ankles and feet.
USE OF SPLINTS IN FRACTURES
Splint
A splint is defined as an appliance which restricts the movements of an injured part. Splints are used in first aid, to prevent the complication of a fracture during transport. Also they give rest to the part and so relieve pain and quicken healing. They are helpful when the limb cannot be supported against the body.
Types of splints
1. Wooden splints: They are straight pieces of wood of varying length and width.
2. Metal splints: They are made of tin and aluminum. They are molded to fit the natural curves of the body.
3. Wire splints: Cramer’s wire splint is commonly used. It can be cut to the desired length. Also, it can be bent to support a limb in any desired position.
4. Inflatable splint: They are inflated by mouth. They are easy to use. Also, they are comfortable to the patient. In addition to the above, vacuum splint and box splint are available.
THOMAS SPLINT
It is a special type of metallic splint. It is useful in the fractures of femur and other injuries of lower extremity. It contains
an outer longer rod.
an inner shorter rod
an oval ring bent at 120° to the inner rod.
The ring is padded with felt and covered with leather. Thomas splint can be used either for the right of left leg.
USE OF SLINGS IN FRACTURES
1 Collar and cuff sling: It is used for the hand and wrist. In this there is a cuff attached to the west. The cuff is fixed to the collar through a sling. By this, the hand is elevated and it prevents edema.
2. Triangular sling: It is used for the forearm. A triangular bandage is placed in such a manner the apex lies under the affected arm beyond the elbow. One end of the base of the triangle passes over the opposite shoulder to the back of the neck. The affected forearm is now placed across the chest over the bandage, so that wrist is at a higher level than the elbow. The lower end of the base is brought up and tied with the other end of the base by the side of the neck. The apex is now brought forwards and pinned in front.