yogabook / pathologie / fracture

fracture

Definition of

Complete or incomplete interruption of the continuity of a bone. Distinguish between open (contact of the bone with the outside world) and covered fractures, further according to course: transverse, longitudinal, oblique, spiral, according to the shape of the gap: Y or T, by number of fragments (single-fragment fractures, i.e. only one split, fragment fractures, up to 3 additional fragments, comminuted fractures, more than three), by position of the fracture ends, by dislocated or not, by localization (shaft fractures, fractures close to the joint, joint fractures), further by complete or incomplete. Fractures are very painful although only the periosteum contains nociceptors. Further pain is caused by bleeding and soft tissue edema(pressure pain)

1. open fractures:
2. Closed fractures:
3. By shape:

ICD various

Cause

1. Direct exposure to force
2. Indirect non-local exposure to violence
3. Repeated exposure to microtrauma(fatigue fracture)
4. Inadequate trauma with pre-damaged bone (spontaneous fracture)

Predisposing

1. for spontaneous fracture: osteoporosis, bone tumor, bone metastasis

Diagnosis

1. safe signs
2. uncertain characters

The absence of certain signs is not proof of the absence of a fracture!

Symptoms

1. Immediately on breakage: noise
2. Pain at rest
3. marked pain on movement
4. closed: see diagnosis
5. Open: Wound with possibly visible bone fragment

Complications

1. Fat embolism
2. for open fractures: sepsis, osteomyelitis
3. Compartment syndrome
4. Sudeck’s disease with prolonged casting
5. Risk of thrombosiswith plaster cast
6. CRPS
7. Necrosis
8. Infections (especially open fractures)
9. Blood loss up to volume deficiency shock
10. Injury to neighboring structures
11. Pseudoarthrosis (formation of a false joint due to the bone ends not growing together)
12. Bridging callus (additional bone mass that does not conform to the shape, if the fragments do not fit exactly or do not lie against each other, reversible within months or years)
13. ischemic contracture

Therapy

1. Reposition
2. Retention (fixation)
3. Plaster, splinting if necessary
4. Exclusion of the lesion of neighboring nerves