The femur is the largest tubular bone in the human body. With a hip fracture, there is a high probability of damage to large vessels and nerve fibers, grazing which threatens the life of the patient, so it is very important to know how to provide first aid to a person who has received such an injury.
In the article we will tell you how to understand that the bone is broken, what is the first medical aid for the victim, how to properly immobilize with a hip fracture so that the patient can be safely taken to the hospital.
Need event
A hip fracture can be without displacement, with displacement, with fragments, open or closed. If such a large bone has shifted from its place, then sharp edges can severely damage muscle tissue, pierce large arteries or veins, damage nerve fibers or endings. Bleeding from the thigh can be fatal, and nerve damage can lead to disability and immobilization of a person.
Immobilization for hip fracture is to ensure complete rest not only of the hip itself, but also of joints on both sides. Even if there is no displacement, then the damaged bone can move when transported to the hospital. Immobilization of the leg will also reduce pain.
Types of immobilization
Immobilization of a limb with a hip fracture is of two types:
- Transport, when the main requirement is to safely deliver the patient to the hospital without further harm on the road. This is necessary, since during the movement there may be rough roads or sharp braking, during which the bone may shift or the fragment may move, damage the tissue.
- Therapeutic, when immobilization is performed by a doctor after an X-ray or, if necessary, setting the bone in the desired position using a plaster cast.
In the article, we will consider how transport immobilization is performed in case of a hip fracture, which tires are used, how to properly help a patient at home.
How to understand that a hip is broken
After falling or hitting the victim, complaints of severe pain in the hip appear. Immediately after the fracture, the leg begins to swell, and deformation of the limb is visually visible, especially when compared with a healthy second leg. If there is a bias, then there is a hematoma from which the activity of nerve fibers is disrupted and the toes begin to be poorly obeyed, the fingers go numb or a tactile sensation disorder occurs.
Unnatural mobility in the damaged place is externally visible. A person cannot move his leg and, especially, step on it. These are all symptoms of a closed hip fracture. Even if such a problem is suspected, first aid should be provided and immobilization should be carried out for a hip fracture.
First steps
So that the victim does not receive pain shock, you must first give an anesthetic. If the fracture is open, it is necessary to stop bleeding and rinse the wound with an anesthetic, applying a sterile dressing. If you are in the city, then you need to call an ambulance by calling 103.
Further actions are aimed at immobilization. For hip fracture, use tires. Let's consider what types of tires are, how to install and fix them.
Diterichs Tires
Such a fixation system was invented by the Soviet professor M. M. Diterichs during the Great Patriotic War. It is popular to this day, as it perfectly captures not only the hip, but also the hip joint.
Such a tire consists of two wooden crutches that keep the foot level, a foot support, on which the foot becomes, and a twist. Each bar is divided in half, and each half can be extended to the desired length depending on the height of the person. At the upper ends of the crutches, fabric is stretched so as not to rub the armpit from the outside and the crotch from the inside.
The cross bar with straps threaded into the holes, allows you to hold the entire structure motionless. The foot sole is attached directly to the foot. The hip fracture is immobilized with tires that are conveniently fixed with bandages or strips of tissue.
Cramer Wire Tires
This is a set of long and thin wire gratings that can be shaped into any shape. You need to fix the structure around the leg and strengthen it with straps or bandages. In order not to injure the limb, the lattices are covered with cotton. Since the Kramer retainer is flexible, it is wrapped along the entire leg from the outside and inside, bending at a right angle around the sole of the foot.
In the area of armpits and perineum, the edges of the tires are wrapped with fabric or cotton rolls so as not to rub the skin. Measure the tire size by a healthy limb, so as not to disturb the sore leg once again.
Modern method
The easiest and most convenient means of fixing the limb is a set of pneumatic tires. This is an inflatable bag consisting of two walls. In a deflated state, they slip it under the foot and blow air into the walls. Absolutely anyone can use such a device; donning does not require any preparation.
The immobilizer is made of modern high-quality materials. The convenience of such tires also lies in the fact that during an X-ray examination it does not have to be removed, it does not get wet, it is not necessary to purchase additional materials - cotton wool and bandages.
How to put on tires
The rules for putting a tire on a sore leg for a hip fracture are as follows:
- It is necessary to fix the bone on both sides.
- On the inside, the tire should rest against the groin, while the ankle and knee joints are fixed.
- On the opposite side, fixation is carried out immediately of three joints - hip, knee and ankle.
- Immobilization for hip fracture is carried out only in a supine state.
- Under the armpit and in the groin area, a roller is put on the tire, which should be at least 10 cm (from cotton wool and fabric or bandages).
- The patient is placed lying on his back and at first the length of a healthy leg is measured, only then the tire set out by standards is transferred to the sore limb.
- If the tire touches the naked body, then you need to put cloth or a towel in this place so as not to cause unnecessary discomfort to the victim.
- If the patient is wearing pants, then they do not need to be removed.
- In the case of an open fracture, you can only incise clothing and treat the wound with an anesthetic, for example, hydrogen peroxide, and then treat the wound edges with iodine.
Absolutely forbidden
The length of transport immobilization during a hip fracture can last a long time, depending on the place of the accident, so the tires should not be tied tight to the leg so as not to block blood circulation in the limb.
You can’t try to independently insert a deformed bone or to move fragments.
No need to remove clothes and shoes on a sore limb, you need to wear a tire directly on the shoes.
Hip fracture immobilization
The length depends on the complexity of the fracture and the age of the patient. After delivery to the medical institution, anesthesia is performed, and with large blood loss - a blood transfusion. Then an exhaust system is installed with a suspended load, the weight of which is not less than 5 kg, it is held on metal knitting needles through a bone. This stage can last up to 40 days. At this time, pressure sores may occur, the patient is recommended to put a special mattress or linings, monitor the cleanliness of the body. In the presence of debris, the installation is removed after 1.5-2 months. Then an operation is performed, during which all the bone fragments are put in the right places and strengthened with plates and screws. A plaster cast is applied. From this period, walking with crutches is allowed. The system is removed only after 3-4 months, however, the full restoration of the motor function of the limb is possible only after 9 months or a year.
The length of immobilization when installing the Ilizarov apparatus is much less. Spokes are screwed into the bone, strengthened with bolts. At the same time, motor activity is not limited, all metal structures are removed after complete bone growth.
For complete rehabilitation, you need to undergo a course of physiotherapy, do limb massage, engage in therapeutic gymnastics with a trainer. To restore faster, you need nutrition with an increased content of calcium. These are dairy products and fish, jelly and currant or raspberry jelly. It is useful to eat nuts, dried apricots and raisins, persimmons and herbs. You also need to take vitamin D, which contributes to better absorption of calcium. It is necessary to follow all the instructions of the attending physician, then the injured limb will recover faster.