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Comminuted Fracture
How long will it take to walk after a comminuted fracture of the tibia?
The decision on when to walk depends on the recovery status of the fracture. Generally, a tibial fracture requires about 4-6 weeks of rest. Around 4-6 weeks, you can revisit the hospital for an X-ray checkup. If the callus is growing well, and the fracture line is blurred or disappeared, you can start using crutches to walk and perform functional exercises. However, recovery from a comminuted fracture takes longer, so an X-ray examination is essential before starting to walk. If the examination results show good recovery, then you can start walking. If you walk too early, it may interfere with the fracture healing, and in severe cases, it might even cause the fracture to break again. Therefore, the time it takes for someone with a comminuted tibial fracture to walk depends on the specific circumstances, and an X-ray examination must be performed before walking.
Is a comminuted fracture of the tibia serious?
A comminuted fracture of the tibia is defined as a fracture where there are three or more fracture fragments, termed a comminuted fracture. The severity of a comminuted fracture of the tibia depends on the location of the fracture. If the fracture is located at the epiphyseal end, where there is abundant blood supply, healing may occur more quickly. However, if the fracture is accompanied by surrounding soft tissue injuries, the healing process can be very slow. If the fracture occurs in the middle to distal third of the bone, where the blood supply is more limited, healing can be slower compared to simple transverse fractures, and the prognosis may vary depending on the choice of treatment method.
Is a pelvic comminuted fracture serious?
For comminuted pelvic fractures, the condition is very serious, demonstrating that the external force involved was quite significant. It causes a disruption in the continuity and integrity of the bone. The patient will exhibit localized pain and swelling, and restricted movement in the affected area. Pressing on the area will produce a distinct bone crepitus or feel, and there might be extensive subcutaneous bruising. For comminuted pelvic fractures, the primary treatment is usually surgical. It is essential to conduct thorough preoperative examinations to exclude any surgical contraindications, and then proceed with the open reduction and internal fixation surgery under general anesthesia.
Can a lumbar crush fracture cause paralysis?
Whether a lumbar burst fracture will cause paralysis mainly depends on the severity of the comminution and whether the fracture fragments protrude into the vertebral foramen, compressing the nerves. If it is simply a comminuted fracture and the fragments do not protrude posteriorly and do not compress the nerve roots, then it will not cause paralysis of the lower limbs. However, if the fracture fragments protrude backwards and compress the spinal nerves, or even damage the spinal nerves, the patient may experience complete loss of muscle strength and sensation in both lower limbs. In this case, emergency surgery is required to relieve this compression and reduce the pressure on the nerves, thereby alleviating the symptoms. If lower limb paralysis occurs, long-term oral medication to nourish the nerves is needed to help the nerves gradually recover. Therefore, whether a fracture can cause paralysis mainly depends on whether the nerve is compressed by the fracture fragments. If there is compression, it will result in complete loss of muscle strength and sensation in the patient's lower limbs. (Please take medication under the guidance of a professional physician.)
Is a comminuted fracture of the iliac bone serious?
Iliac fractures are assessed based on the severity of the fracture. Generally, there are two types of iliac fractures. The first type is a linear fracture. If this linear fracture does not involve the joint surface and is a simple, non-severe linear fracture, a plaster cast can be sufficient for complete recovery, usually within about two months. The second type is a comminuted fracture, where the fracture ends affect the joint surface; in such cases, surgical treatment may be required to restore the smoothness of the joint and stabilize the fracture pieces, with a recovery time generally ranging from two to three months. Therefore, a comminuted patellar fracture is generally very serious and typically requires surgery. This is because comminuted patellar fractures are likely to lead to the most common form of post-traumatic arthritis, resulting in pain during activity later on.
How to treat a lumbar compression fracture
A comminuted fracture has occurred in the lumbar vertebrae, and the treatment method should be chosen based on the degree of displacement of the fracture, that is, the occupancy within the spinal canal and the extent of compression of the lumbar fracture. Generally speaking, if there is significant compression inside the spinal canal, and the height of the vertebral body of the lumbar spine is also greatly compromised, surgical intervention is necessary to restore the height of the vertebral body. If necessary, decompression inside the spinal canal should be performed to relieve pressure on the spinal cord, alleviate symptoms, and facilitate early functional recovery of the patient.
Post-syndrome of comminuted femoral fracture
The main sequelae of comminuted femoral fractures are as follows: The first is a delay in healing and nonunion of the fracture ends. Due to the comminuted nature of the fracture, local blood circulation has been damaged, and even with surgery, it is difficult to restore circulation. This can lead to delayed healing and nonunion of the fracture ends, generally requiring observation for around one year. If fracture lines are still clearly visible after a year, this confirms a nonunion, necessitating further surgery and bone grafting to restore the healing of the fracture. The second, in cases of nonunion, is the possibility of plate fracture. Many patients, unable to endure extended bed rest, need to start weight-bearing walking. If the fracture ends have not healed and weight-bearing occurs, the body's full weight concentrates on the plate, leading to stress fractures of the plate and screws. Should such stress fractures occur, immediate surgical intervention is needed to replace the internal fixation.
Will a comminuted patella fracture cause limping?
Patellar comminuted fractures, as long as treated promptly and correctly, and if the surgery poses no issues, generally heal in about six months, thereby not causing any significant impact. Thus, there's no need to worry about limping. Limping usually means that when walking, one leg appears longer than the other. Under what circumstances can limping occur? If the difference in leg length is within one centimeter, it's imperceptible and won't have any effect. If the difference exceeds two centimeters, then there is a noticeable tilt in the lower limbs, and only then can limping be observed during walking; however, even if limping occurs, it is not severe. It just means that while walking, there is a tilt towards the shorter side. After treatment, patellar comminuted fractures have a complete chance of healing and once healed properly, it's almost like before the injury. Even in severe cases where the fracture is critically fragmented and requires removal, even without patellar replacement, by reinforcing the patellar tendon, it typically does not result in limping. It only impacts the strength in knee extension, possibly creating a mild impediment compared to the other side, and might make walking appear slightly abnormal, but it definitely does not lead to limping. Hence, patellar comminuted fractures do not result in limping.
Can a pelvic comminuted fracture cause paralysis?
A pelvic fracture generally includes avulsion fractures, in which the pelvis remains stable, while other types of fractures tend to be comminuted fractures. Whether paralysis occurs following such a fracture depends on whether there is nerve damage. If there is no significant nerve damage, paralysis is generally unlikely; however, if the fracture is accompanied by nerve damage, such as damage to the sacral nerves causing numbness and limited mobility, it may significantly impact function, especially of the lower limbs. Therefore, it is advised to seek treatment in the orthopedic department of a reputable hospital if a pelvic fracture occurs.
How long does it take for a comminuted patellar fracture to heal?
If the patella is fractured into fragments, conservative treatment is usually not chosen, and surgical treatment is necessary. There are several surgical methods, but as long as the fixation is sturdy and the joint surface recovers well, normal life and work can generally resume in about six weeks. Typically, a follow-up at the hospital is needed in the fourth week or the twelfth week after surgery. If there are no issues at these check-ups, normal work and life can continue. However, the internal fixatives such as steel pins, wires, or memory alloy bone clamps should be removed within six months to a year post-surgery. It is generally recommended that the internal fixation devices be removed around thirteen months after surgery when the patella has healed well, and the knee joint function has been restored, allowing for a return to a normal life. So, for a comminuted patellar fracture, recovery to normal life typically takes about six weeks, and the internal fixation devices can be removed in about a year.