Fracture


Fractures are categorized into several types.
In short, fractures can be classified into the following types: First, based on the integrity of the skin and mucous membrane at the fracture site, it can be classified into closed fractures and open fractures. Second, based on the shape and degree of the fracture. It can be categorized into oblique fractures, transverse fractures, spiral fractures, comminuted fractures, greenstick fractures, impacted fractures, compression fractures, and bone injuries. Third, based on the stability of the fracture ends, it can be classified into stable fractures and unstable fractures. Among unstable fractures, these include oblique fractures, spiral fractures, and comminuted fractures. Thus, fracture classification fundamentally falls into these major categories.


Principles of Fracture Treatment
Usually, the treatment principles for patients after a fracture are mainly reflected in the following aspects: First, it is necessary to actively reposition displaced fractures, as continuously misplaced fractures can easily lead to nonunion or malunion later on. It is crucial to actively perform manual repositioning or consider open reduction and internal fixation surgery. Second, strict rest and immobilization must be adhered to, as these provide the best conditions for fracture healing. During the treatment period, patients can take non-steroidal anti-inflammatory analgesics and medications that promote fracture healing. Third, once callus formation begins in the later stages, diligent functional exercises are necessary. (Please use medications under the guidance of a doctor)


Rib fracture complications
Rib fractures often result from trauma and can involve a single fracture or multiple fractures in one rib. In severe cases, there might be multiple fractures across several ribs, causing a flail chest condition. Rib fractures initially lead to localized bleeding and swelling, making breathing difficult. This situation might also result in increased pleural effusion or hemothorax. In severe cases, it leads to significant breathing difficulties. Therefore, if a rib fracture occurs, it is advisable to visit the thoracic department of a formal hospital for medical consultation.


Symptoms of secondary lumbar vertebral fracture
It usually manifests as the patient experiencing significant lower back pain symptoms, and limited mobility in the lower back area, inhibiting walking. When the fracture is severe, it can cause damage to the patient's spinal nerves or cauda equina nerves, resulting in numbness, weakness, and pain in one or both lower limbs, and even weakness in extending the big toe or the ankle. The patient may feel a sensation of heat in the perineal region, and abnormalities in urination and defecation may occur, which in severe cases can lead to complete paralysis. These are common clinical symptoms of secondary lumbar spine fractures. Usually, a diagnosis can be confirmed with a regular X-ray, a local CT scan, and magnetic resonance imaging.


Symptoms of toe fracture
The symptoms of a toe fracture primarily include pain, swelling, and limited mobility. If there is a noticeable displacement of the fracture ends, a typical deformity can also occur. For the treatment of toe fractures, conservative treatment such as casting or using a brace may be sufficient if it is a simple linear fracture without significant misalignment of the fracture ends. However, if there is substantial shortening, rotation, separation, or if the fracture is comminuted, surgical treatment is required. During surgery, the fracture ends are repositioned through an incision. After repositioning, a Kirschner wire is used to internally fixate the fracture ends, allowing the bone to heal in the proper alignment without leaving any deformity. This describes the surgical treatment method.


How to exercise for fracture recovery
After the fracture heals, rehabilitation exercises can reduce pain and shorten the healing time of the fracture. The main rehabilitation training methods include physiotherapy such as hot compresses, massage of the fracture site, acupuncture, electrotherapy, and exercises like muscle training of the fracture site, isometric contraction, isotonic contraction, etc. Once the fracture reaches relative stability, further activities like getting out of bed and non-weight bearing exercises at the fracture site can also help accelerate the healing time.


Is the fracture serious?
A fracture is when the integrity and continuity of the bone is compromised, resulting in symptoms such as pain, swelling, limited mobility, and deformity. The severity of a fracture depends on the extent of bone displacement, the location of the fracture, and whether there is associated damage to vital organs, blood vessels, or nerves. If the fracture is a simple one with minor displacement, it generally is not very serious. Appropriate repositioning can be selected, followed by brace support or plaster cast external fixation to facilitate bone healing. If the fracture is accompanied by significant damage to important blood vessels, nerves, or organs, and there are multiple fractures, this type of fracture is considered more serious. It could lead to shock from bleeding caused by the fracture, which can be life-threatening.


What are the symptoms of a fracture?
After a fracture, three characteristic manifestations occur. The first one is abnormal movement. This abnormal movement is due to the formation of an unusual activity of the fracture ends in the affected limb, known as abnormal movement. The second one is called deformity, which is also due to a significant deformity in the affected limb after the fracture ends. The third one is called bone crepitus, also known as bone rubbing sound, which is the sound produced when the fracture ends rub against each other. These three are specific signs of a fracture. In addition to these three, there will also be severe pain in the affected limb, and this pain is very intense, rendering the limb immobile. Secondly, there will be obvious swelling, which is caused by bleeding in the medullary cavity of the fracture ends. The third is functional impairment, as the affected limb will definitely be immobile after the fracture.


Symptoms of fractures
Patients with fractures typically exhibit marked pain symptoms locally, accompanied by local swelling and limited movement. Some patients may also present with fever as a clinical symptom. There might be clear signs of bone crepitus and a sensation of bone rubbing on palpation. In severe cases, deformities or abnormal movement may occur, which are common clinical symptoms of fractures. For the diagnosis of fractures, it is necessary to actively take a regular X-ray. For some occult fractures, it is essential to conduct a CT scan and three-dimensional reconstructive CT to confirm the diagnosis.


How long to stay in bed with a rib fracture?
Rib fractures are very common clinically. After a rib fracture, it is necessary to rest in bed, immobilize, and reduce activity, otherwise excessive pulling of the ribs will cause pain. Generally, the bed rest period is about 10-14 days. Generally, after two weeks of treatment, the ribs will form fibrous connections and no longer cause severe pain. After two weeks, appropriate activity out of bed can be resumed. At the same time, oral antibiotics can be taken to prevent infection, as well as medications that promote blood circulation and remove blood stasis to enhance the absorption of the hematoma.