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Comminuted Fracture
Why are elderly people prone to fragility fractures?
In clinical settings, elderly individuals commonly experience comminuted fractures, primarily due to their reduced levels of physical activity, which can lead to the loss of proteins, calcium, minerals, and moisture in the bones. This reduces bone strength and density, and if they have osteoporosis, bones can easily break into pieces when subjected to external force. Therefore, it is crucial to apply proper treatment methods promptly after a comminuted fracture occurs. This can involve manual reduction, external fixation, or surgical treatment such as open reduction and internal fixation. Postoperatively, treatments like electrotherapy and physical therapy, along with oral calcium supplements and bone-healing medications, can facilitate recovery. Nutritionally, it is beneficial to consume foods rich in proteins and calcium to aid in the healing of fractures.
How long does it take for a comminuted tibial fracture to heal?
The healing time for comminuted fractures of the tibia generally takes about three months, but it still depends on the method of treatment. Generally, there are two methods for treating a comminuted fracture of the tibia: The first method is conservative treatment, which involves using casts or braces to immobilize the affected limb. Generally, the healing time for this method is about three months. The second method is used when there is significant displacement at the fracture site, such as obvious shortening, rotation, or deformity, which then requires surgical treatment. After surgery, the healing time may take about three to four months. Additionally, severe comminuted fractures can disrupt the blood circulation at the fracture site, leading to poor local circulation and a condition called delayed union, where healing might take about six months. Another scenario involves extremely severe disruption of the blood circulation at the fracture site, leading to nonunion where the fracture ends do not heal together at all. Generally, this requires about a year of observation. If after one year the fracture ends still haven't healed, a second surgery might be necessary. However, for most comminuted fractures of the tibia, the general healing time is about three to four months.
How long does it take to recover after surgery for a comminuted fracture of the humerus?
Generally speaking, the recovery time after surgery for a comminuted fracture of the humerus is about three months, but this can vary from person to person. If the patient is young, the healing of the fracture ends might be quicker, potentially achieving bony union within two to three months. However, if the patient is elderly, their healing might be slower, possibly requiring three to four months to achieve bony union. Therefore, it is necessary for patients with fractures to regularly take X-rays to observe whether the fracture ends have achieved bony union. Typically, they should visit the hospital to get an X-ray about every two weeks to check on the growth of the fracture ends.
Is a comminuted fracture of the hip bone serious?
The answer is definitely yes. A comminuted fracture of the hip bone can affect the stability of the pelvic ring, thus absolute bed rest is necessary, and surgical treatment may be needed when required. Especially in middle-aged and elderly people, early ambulation after surgery can help avoid various complications that can arise from prolonged bed rest, such as three to six months, or even more than half a year, which could exacerbate complications in the elderly and even be life-threatening. Therefore, comminuted fractures of the hip are relatively severe and require active surgical treatment. Post-surgery, appropriate bed rest is also needed, and it is advisable to use a pulsating air mattress to prevent potential complications like pressure sores, and appropriate body massages should be performed to prevent the occurrence of lower limb venous thrombosis. Additionally, turning and patting on the back should be performed to prevent dependent lung pneumonia.
Will a comminuted fracture of the tibia cause limping?
If a comminuted tibial fracture is treated correctly, with proper alignment and the shortening kept within one centimeter, limping will absolutely not occur. The reason for limping after surgery for a comminuted fracture is due to unequal leg lengths. There are many reasons for differences in leg length, but no matter the cause, if the difference is less than 1 centimeter, a person will absolutely not limp. However, if it is less than two centimeters, or more, it then becomes apparent that one leg is longer and the other shorter, resulting in a limp. Therefore, for comminuted fractures, whether it is of the tibia, femur, or another bone, as long as the alignment is properly maintained and the shortening is controlled to within 1 centimeter, postoperative recovery will be very good, without any limping.
Why can't it rotate five months after a comminuted fracture of the humerus?
Five months after a comminuted fracture of the humerus, the inability to rotate is due to the lack of early functional exercise post-fracture, leading to severe adhesions in the joint and upper arm muscles, which significantly restrict rotation. This condition can be gradually recovered through later functional exercises, slowly tearing apart the adhered muscles, and increasing the range of motion of the humerus. It is recommended that patients seek rehabilitation treatment in the physical therapy department of a hospital. Additionally, various physiotherapy methods can be used to improve local blood circulation, promote muscle healing, relieve joint and muscle stiffness, and methods such as electrotherapy and magnetotherapy can also be applied to assist in improving the rotational capacity.
Is a comminuted patellar fracture serious?
Patellar comminuted fractures are usually quite severe because once the patella is shattered, it can no longer guarantee a smooth cartilage surface. Moreover, the more severe the fragmentation, the harder it is to restore smoothness. If the smooth surface is not well restored, certain conditions can arise. The first is post-traumatic arthritis, the second is patellar chondromalacia, and the third is patellofemoral arthritis. Therefore, patellar comminuted fractures usually require open reduction and internal fixation surgery. In this surgery, it is crucial to align the cartilage surface of the patella as accurately as possible, making the joint surface as smooth as possible, and then fasten it securely with wire loops or tension bands. If the patellar fragmentation is particularly severe, and it's impossible to restore the integrity of the cartilage surface, it may be considered to remove the patella. If feasible, a prosthetic patella can be installed. If not, the ligaments and joint should be repaired, and then functional exercises should begin three to four weeks post-surgery, although this method of surgery typically results in weakness in extending the knee on the affected side.
Post-traumatic sequelae of femoral head comminuted fracture
A comminuted fracture generally refers to a fracture with more than three fragments. When a comminuted fracture occurs in the femoral head, it is also a type of intra-articular comminuted fracture. Generally speaking, after the fracture is reduced and stabilized, there can be some damage to the joint surface as well, leading to unevenness of the joint surface and a higher chance of developing postoperative traumatic arthritis. There is also a possibility that the comminution of the femoral head fracture could affect the blood supply to the femoral head, leading to ischemic necrosis of the femoral head. After treatment for the fracture injury, there will inevitably be some impact on postoperative function. Therefore, after a comminuted fracture of the femoral head, the first sequelae to appear is usually traumatic arthritis, followed by ischemic necrosis of the femoral head, and thirdly, symptoms of restricted movement in the hip joint may occur.
How long will it take for a comminuted ankle fracture to heal?
Hello! You're asking how long it takes for a comminuted ankle fracture to heal. Generally, the healing time for a comminuted fracture in the ankle is about three months. Depending on your specific condition, you may need to have an X-ray to confirm if your ankle fracture has achieved bony union. If bony union has been achieved, you can then appropriately begin weight-bearing activities to promote blood circulation in the lower limbs and restore joint mobility. However, if the X-ray shows that bony union has not been achieved, it is absolutely crucial not to bear weight. Premature weight-bearing can cause the fracture ends to break again and shift, potentially necessitating a second surgery. So, generally speaking, the healing time for non-comminuted ankle fractures is also about three months, but it is essential to check the final X-ray to see if the fracture has healed.
How long after a patellar comminuted fracture can one start walking?
Patellar comminuted fractures generally require surgical treatment. If the surgery goes well, patients can start moving around with the aid of crutches one week after the surgery. Initially, changing positions is not allowed. Generally, patients can start by placing the toes on the ground two weeks post-surgery, followed by the middle part of the foot, and finally the heel. This progression occurs from two to six weeks after the surgery.