Is a pelvic comminuted fracture serious?

Written by Cheng Bin
Orthopedics
Updated on September 19, 2024
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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.

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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.

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Written by Wang Cheng Lin
Orthopedics
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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.

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Written by Wang Cheng Lin
Orthopedics
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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.

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Written by Li Jin
Orthopedics
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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.

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Sequelae of comminuted fracture of the humerus

Regarding the sequelae of comminuted fractures of the humerus, in clinical practice, if treatment for humerus comminuted fractures is proactive and patients diligently engage in functional exercises without any nerve damage, most patients will not experience any sequelae. However, if treatment is improper, a series of sequelae can often occur, mainly reflected in the following aspects: First, if there is accompanying nerve damage that is very severe, it can cause patients to experience sensory disturbances or motor function impairments. Second, poor repositioning of comminuted fractures can lead to nonunion or malunion of the fracture, affecting normal functions of the patient. Third, long-term immobilization in the later stages can cause joint stiffness. When patients eventually start exercising, fear of pain may lead to insufficient exercise, resulting in very poor joint mobility, thereby affecting normal functions.