bone damage
Introduction
Introduction to bone injury Bone injuries often occur when a fracture block penetrates a limb during trauma or occurs when an open fracture is debrided. Bone damage mainly includes two major parts: bone defect and defect repair. Bone injury is a common clinical disease, and it is also one of the problems that is good at orthopedic treatment. Patients often suffer from shock due to extensive soft tissue damage, massive bleeding, severe pain, or complicated visceral injuries. There is a large amount of internal bleeding in bone injury. When the hematoma is absorbed, the body temperature is slightly increased, and the possibility of infection should be considered. The bone injury is properly fixed and bone graft repaired at the right time. basic knowledge Proportion of disease: found in trauma patients, accounting for 10% of traumatic diseases Susceptible people: no specific population Mode of infection: non-infectious Complications: shock, fat embolism syndrome, paraplegia
Cause
Cause of bone injury
Fall from a height (30%):
More caused by falling from heights or improper safety measures. When falling from a height, most of the ground is first hit by the ankle, and the reaction force of the ground is transmitted upwards, causing a typical clavicular conduction chain injury of the ankle.
Pressure damage (25%):
Many injuries caused by accidental or accidental landslides in labor. The wounded are mostly young and middle-aged workers. The wounded parts are more common in the lower extremities, such as the ankle, tibia and femur. Its clinical features are high incidence of paraplegia, the most common combined injury is chest and spinal cord injury.
Machine damage (15%):
The main cause of injury is that the limbs are involved in the rollers, gears and conveyor belts of the running machine, mostly young workers or farmers, which are most likely to cause multiple bone and joint injuries.
Life injury (20%):
Most occur in the elderly, due to accidental injury and injury. Often caused by a typical distal radius fracture and ipsilateral femoral trochanteric fracture or femoral neck fracture, generally no combined injury.
Prevention
Bone injury prevention
The first principle of first aid in severe trauma is to save lives. In addition to timely and appropriate hemostasis, open wounds should be immediately wrapped with sterile gauze or clean cloth to prevent the wound from continuing to be contaminated.
Complication
Bone injury complications Complications, shock, fat embolism syndrome, paraplegia
(1) Shock: severe injury, caused by major bleeding or major organ damage.
(2) Fat embolism syndrome: occurs in adults, due to excessive tension in the hemorrhage of the sacral cavity in the fracture, fat drops into the ruptured sinus, can cause lung and brain fat embolism.
(3) Important internal organ damage: 1 liver and spleen rupture. 2 chest and lung injury. 2 bladder and urethral injury. Intestinal damage.
(4) Important surrounding tissue damage:
1 important vascular injury; common such as straight rib exploration fracture, proximal fracture end is easy to cause aortic injury, pre-cavity or posterior luminal artery injury, upper femoral fracture, distal fracture end can cause Take arterial injury.
2 peripheral nerve injury: especially in the area where the nerve is closely adjacent to the bone, such as the fracture at the middle and lower 1/3 of the rib, it is easy to damage the nerve that is close to the skin, and the fracture of the rib is easy to cause total nerve damage.
3 spinal cord injury; a serious complication of spinal fracture and dislocation, more common in the cervical spine and thoracolumbar segment, paraplegia can occur.
Symptom
Symptoms of bone injury common symptoms shock persistent fever comminuted fracture simple fracture open injury
Whole body performance:
(1) Shock. Patients often suffer from shock due to extensive soft tissue damage, massive bleeding, severe pain, or complicated visceral injuries.
(2) Fever: There is a large amount of internal bleeding in bone injury. When the hematoma is absorbed, the body temperature is slightly increased, and the possibility of infection should be considered.
Signs:
(1) Malformation: The displacement of the fracture segment can change the shape of the affected limb, mainly showing shortening.
(2) Abnormal activity: In normal conditions, the part of the limb cannot move, and abnormal activity occurs after the bone injury.
Examine
Bone injury examination
Laboratory examination: no special performance.
Other auxiliary examinations: the positive side of the line and other areas that are good at different orientations can show the location and extent of the skull defect. The combination of scanning and X-ray film can not only further clarify the location and extent of the skull defect, but also understand the surrounding skull and brain and brain bulging tissue, which is conducive to surgery.
Diagnosis
Diagnostic identification of bone injury
Diagnosis: Local clinical manifestations of typical defects, many combined with X-ray plain film, CT scan, can be diagnosed. No need to identify.
