The structure of the adult's skeleton includes more than two hundred bones( in babies there are more of them, but then some bones coalesce).And each of the bones can be broken. Can you imagine how many types of fractures and methods of first aid need to be learned by students of medical schools? Of course, the volume of one article does not allow to consider absolutely all types of bone lesions. Here you will get information about the main types of fractures, their signs and first aid to the victim before the arrival of a doctor.
Signs of open and closed fractures of
Fracture of is a complete or partial violation of bone integrity as a result of mechanical damage.
Fractures are open and closed, the differences between them are as follows:
- with closed injuries there is no damage to the skin, bone fragments are located in the thickness of soft tissues;
- with open lesions, bone fragments break through the surrounding soft tissues and skin.
With closed fractures, a sharp swelling and a hemorrhage quickly appear at the site of the injury. The intensity of pain can range from insignificant to unbearable, it intensifies not only from the movement of the injured limb, but also from a change in the position of the body. The limb itself either lengthens, or shortens, begins to bend in completely unsuitable places for this. When probing the site of the fracture, crunching of bone fragments is determined. The injured limb completely loses its function.
With open fractures, trauma is accompanied by external bleeding, strong - with damage to large vessels, insignificant - when ruptured small;In the open wound, bone fragments are visible.
After identifying the symptoms of a fracture, first aid should be given immediately.
Collar fractures: Species, Symptoms and First Aid
A clavicle can break in the middle or at the ends.
There are two types of fracture of the collarbone, these are:
- straight lines - arise when falling on an elongated arm;
- indirect - arise when the shoulder joints are compressed laterally.
With a central fracture, the fragment is displaced upward and posteriorly, and in the peripheral case, it is displaced upwards and forwards. The bone is deformed, moving in different directions. The site of the injury swells, when it feels, crunching of bone fragments is determined. The hand along with the shoulder joint is turned inward, down and forward. Another symptom of a clavicle fracture is the smoothing of the supraclavicular fossa.
Before helping to break the clavicle, the patient is given an anesthetic, for example 2 ml ketorol. The effect of the drug can be strengthened if you simultaneously inject suprastin, diphenhydramine or any other antihistamine. A good analgesic effect gives a fracture site fracture 1-2% solution of novocaine( not more than 10-15 ml).Then, when first aid is given in case of fracture of the clavicle, the affected limb is immobilized by suspending the hand on the kerchief or by bandaging it on the trunk.
Transported to the injured point of the victim in the sitting position.
Types and signs of shoulder fractures, first aid
There are three types of fracture of the shoulder: of the upper third, middle third and lower third of the bone.
In case of fracture of the upper third of the bone( near the shoulder joint), the victim complains of severe pain in the shoulder region, which is amplified by the slightest movement and touch. The joint itself is edematous. To reduce pain, a person flexes his arm in the elbow joint and presses it against the body, supporting with a healthy arm. An additional sign of a fracture may be crunching of the fragments, which is sometimes felt when the area of the joint is felt.
If the victim comes late for help( more than a day after the injury), a bruise appears in the elbow joint area or even on the forearm.
In fractures in the middle third, the nerve that passes over the shoulder can be damaged. In this case, the victim, in addition to the classic signs of fracture( such as shortening and deformity of the shoulder, pathological bone mobility, well-felt crunching of the fragments), there are signs of nerve damage: the brush passively hangs, it can only be opened passively, active movements are impossible. Another indication of a shoulder fracture in the middle third is the impossibility of removing the thumb.
In case of a fracture in the lower third of the bone, the protruding elbow process is clearly contoured, above which the region of occlusion is determined. The elbow joint swells, it becomes sharply painful. At the site of the injury crunching of the fragments is determined.
Before giving first aid for fracture of the shoulder in the upper third, 2 ml of a 50% solution of analgin is administered for anesthesia( the effect of the drug can be increased if suprastin, dimedrol or any other antihistamine is administered concomitantly).The hand is suspended on a kerchief, with strong pains - it is fixed to the body with a bandage.
With a fracture of the middle part of the shoulder, the injured person's hand is fixed with a transport bus( instead of it, racks, straight sticks and tree branches, armature, etc.) can be used.
The splint is applied from the healthy shoulder blade to the base of the fingers. The arm is bent at right angles to the elbow joint. For anesthesia, inject 2 ml of a 50% solution of analgin or 5 ml of a solution of baralgin.
First aid for a fractured shoulder in the lower third is to fix the hand after anesthesia with a transport tire, bending at the elbow joint at an angle of 90-100 °.
Varieties of forearm fractures, symptoms and first aid
There are a great many varieties of forearm fracture. With a fracture of the elbow process, there is swelling, a flattening of the posterior surface of the joint, the trying one holds a straightened hand, pressing it with a healthy hand to the trunk;active flexion in the elbow joint is possible, and extension is not.
With a fracture of the coronoid process, swelling appears, maximum flexion is limited, the rest of the movements are not disturbed. The symptom of this fracture of the forearm is the smoothness of the contours of the ulnar fossa.
Fracture of the upper parts of the radial bone occurs as a result of a fall on an elongated arm. The victim can not completely unbend his hand, a sharp pain appears when trying to turn the forearm outward.
In case of fracture of the ulna, active flexion and extension in the elbow joint are possible, the remaining movements are carried out in a limited volume.
With fracture of the radius, active movements are almost impossible due to severe pain.
A fracture of both bones is also possible. Usually it comes as a result of a direct blow to the forearm, tightening the forearm and brush in the moving parts of the machines, during a car accident. In this case, the forearm is noticeably deformed( while with a fracture of one bone the deformity is not so pronounced), the bones are abnormally mobile, when the injured limb feels, the crunching of the fragments is felt distinctly.
After insertion of an anesthetic( 2 ml of a 50% solution of analgin, 2 ml ketorol, 5 ml baralgina), a transport splint is placed on the injured limb from the lower third of the arm to the base of the wrist, bending the arm at the elbow joint at an angle of 90-100 °.To reduce edema, providing first aid for fracture of the forearm, apply cold.
Fractures of the hand: types, signs and first aid
The main types of hand three fractures are:
- fracture of wrist bones;
- fracture of metacarpal bones( I metacarpal and II-V metacarpal bones);
- fracture of phalanges( basic, middle and nail).
The main signs of hand fractures are acute pain, deformity( with fractures with displacement) of the wrist( or wrist), swelling, crunches. In fractures of the nail phalanx under the nails appear hemorrhages.
First aid for a fracture of the hand is to anesthetize and immobilize the damaged area. The victim is given a small ball( a bottle, a platen made from improvised materials) into the sick arm, and the fingers in a half-bent state are bandaged to him. Then hang the hand on the kerchief.
Types and symptoms of hip fractures, assisting
Fractures of the hip can occur in several places. Fractures passing through the place of attachment of the thigh to the pelvis occur when it falls on its side. This type of hip fracture is characterized by very severe pain in the hip joint region, the limb is turned outward so that the outer edge of the foot becomes parallel to the surface of the bed. At the site of the injury, swelling develops rapidly, a hemorrhage appears. At the slightest attempt to raise a leg, there is a very strong pain. Shortening of the foot for this type of fracture is uncharacteristic. An additional sign of a fracture is a sharp soreness in the hip joint area when heels on the heel.
With a fracture of the femoral neck, the soreness is much less than in the previous case, but the injured person can not lift the leg on his own, while the doctor lifts it without causing painfulness. This symptom of hip fracture is called "stitched heel".Beating on the heel causes a slight soreness.
Fracture of the hip closer to the knee joint is possible with a direct impact, with a fall on the bent knee, when falling on the straight legs. Trauma is characterized by sharp soreness in the knee joint area. The joint itself is enlarged and deformed due to hemorrhage and displacement of fragments of bones. Any attempt of active or passive movements is accompanied by intensification of soreness and often causes crunching of fragments.
After injection of 2 ml of a 50% solution of analgin for pain relief, the injured person is placed on the damaged limb of the tire. To help with fracture of the thigh, the ankles are wrapped with a soft material( cotton wool), two tires are placed on the foot - one on the inside, the other on the outside, capturing not only the leg but also the trunk;the tires are bandaged, on top - straight to the chest.
Shin bones fractures: types, signs, first aid
There are two types of shin fractures: , there is often a fracture of both bones of the shin, rarely - only one( tibial or peroneal).The mechanism of injury as a direct( strong impact on the shin, the fall of heavy objects on the leg), and indirect( sharp rotation of the shin with a fixed foot).
Fractures accompanied by the displacement of bone fragments are easy enough to diagnose. With them, deformation and a decrease in bone length are clearly visible. The site of the injury is sharply painful, swollen, a hemorrhage appears quickly. When you feel the fracture, the crunching of the fragments is revealed. Attempts by the victim to raise their own legs fail.
Much more difficult to diagnose fractures of one bone. In this case, the shape of the shin practically does not change, and the victim freely raises his leg. In this case, the probing of the area of injury helps. In the place of fracture, there is a sign of a shin fracture, like local soreness, which is strengthened with passive and active foot movements, effleurage on the heel. In some cases, there is a hemorrhage.
For analgesia, inject 2 ml of a 50% solution of analgin. Then, providing first aid for a shin fracture, the injured person is placed a splint from the upper third of the thigh to the end of the toes.
Damage to the ankle and foot, emergency care
Sprain of the ankle joint is characterized by a rapid increase in edema in this area due to hemorrhage, pronounced soreness when trying to move in the joint. Sometimes a trauma is complicated by a fracture of one of the bones of the rear of the foot. In this case, when palpation of its base, acute pain occurs.
In the case of a fracture of the external ankle, soreness and swelling also occur, but the area of greatest pain is directly in the ankle area.
Fracture of both ankles with a subluxation of the foot - this is a very serious injury. The joint is very swollen and the foot is shifted to the side. Any movement, both passive and active, causes acute pain, and in some cases patients feel crunching of fragments at the same time.
The fracture of the calcaneus is characterized by an increase in the heel in the volume and its displacement to the outside. Often there is a flattening of the arch of the foot. Soreness occurs when trying to rest on a sore leg, when feeling the heel, and also when moving in the ankle joint.
Emergency care for ankle and foot injuries is to apply a tire from the knee joint to the fingertips. Anesthesia is performed with 2 ml of 50% solution of analgin intramuscularly.
Symptoms of a fracture of the pelvic bones and how to provide first aid
Similar injuries occur when the pelvis is compressed, when falling from a height and strong bumps into this area( when the car hits).A single, isolated fracture of one of the bones, uncomplicated, often passes without any serious consequences for the body, which can not be said about multiple fractures of the pelvic bones. Such trauma often leads to severe internal bleeding, often the urinary tract is damaged( bladder, urethra).In most cases, this is the cause of severe traumatic shock.
An indication of a fracture of the pelvic bones is severe pain at the site of the injury, which is further intensified by feeling the area of the pubis and the crests of the iliac bones. In the course of time, a hemorrhage may appear in the region of the external genitalia. A characteristic sign of a fracture is a symptom of a "stitched heel" appearing on the side of the injury. In this case, the victim is unable to tear off the heel from the bed.
Before helping to break a pelvic bones, the victim is placed on a stiff stretcher on his back. Knees bred in the sides and put under them a roller( the position of the "frog").Bus overlap is not required. If the stretcher is soft, then the victim is transported on the stomach. It is mandatory to use painkillers( analgin, baralgin).
Types of broken ribs, symptoms and first aid
There are two types of hip fractures: isolated and multiple fractures of the ribs. The causes of injury are usually a strong blow to the chest, fall, etc. The older the person, the greater the likelihood of a fracture in a chest injury, because with age, it becomes less and less elastic.
At the site of the fracture, a sharp soreness appears immediately, which is amplified by respiratory movements. Another symptom of fracture of the ribs is a decrease in the mobility of the thorax from the side of the lesion. When you feel your chest, you can determine the place of greatest soreness, feel the crunching of fragments. The victim often breathes superficially, tries to move as little as possible.
With multiple fractures of the ribs, when one or more bones are damaged in two places, during an inspiration the site limited by fractures sinks, and during exhalation, on the contrary, swells, paradoxically as it may sound. Such a state very quickly leads to a disruption in the function of respiration, and subsequently blood circulation.
First aid for fracture of the ribs begins with mandatory analgesia with a solution of analgin( 2 ml of 50% solution).Then the victim is tightly bandaged chest( a wide bandage, towel, sheet, etc.) and delivered to a trauma center.
Fracture of the spine: types, symptoms and how to provide first aid
There are two main types of vertebral fractures: damage to the cervical vertebrae and trauma to the thoracic and lumbar spine.
Damage to the cervical vertebrae occurs with a sharp bend or over-extension of the neck. Observed when falling on the head, in divers, in car injuries, especially when the seats in the car are not equipped with head restraints. Part of the victims are complicated by damage to the spinal cord of varying severity.
Trauma is manifested primarily by severe pain in the neck. To reduce it a little, a person supports his head with his hands and avoids turning and bending. If the integrity of the spinal cord is broken, then there is complete paralysis of the hands and feet. The main symptom of this type of vertebral fracture is the impossibility of active movements, loss of all kinds of sensitivity. In addition, acute urinary retention develops.
Injuries of the thoracic and lumbar spine often occur when falling on the back, less often - with impact, falling from a height, excessive bending. A sign of a fracture is pain in the corresponding area, which increases when the trauma site is felt. Often, the protruding process of the damaged vertebra is clearly visible.
In the provision of first aid, if there is at least the slightest suspicion of a fracture of the spine, in no case should one be turned over or carried in the usual way, as this can cause displacement of the vertebrae and damage to the spinal cord. Before providing first aid for a fracture of the spine, in order to avoid such a complication, the injured person should be shifted so that the head and neck remain in the same plane with the trunk. First, he is turned over on his back. This requires at least three people: one holds the head and neck of the patient, the second - the trunk, the third - the legs. Rotate produce synchronously. After this, it is necessary to fix the hands and feet of the victim. Hands are stacked on the chest and tied behind the wrists, legs are stretched, knees and ankles are tied.
For transporting a person with a spinal fracture, a solid stretcher or wooden shield is required( from the tools available, boards, cupboard doors, plywood sheets, sheet metal, plastic, flat slate, etc.) can be used. At the location of the waist, providing first aid for a fracture of the spine, pre-roll a roller( made of clothes, towels, etc.).Raise the victim also three, synchronously. At this moment the fourth person pushes the stretcher under the patient, after which it is also simultaneously lowered. It is strictly prohibited to plant a patient! Before transporting it is also necessary to fix the head with a roller or a rubber wheel.