An extraordinary fracture of the femoral bone tissue is characterized by damage to the femoral neck up to the trochanter. Such injuries of the lower extremities are called lateral and are accompanied by severe bleeding and a violation of the integrity of neighboring tissues.
Description of this ailment
Most often, an overtight fracture in the elderly occurs, but in middle and young age this injury is much less common. Such a fracture of the hip bone is more characteristic of the fair sex. It is the elderly women who get to the traumatologist with such damage more often than men.
Despite the seriousness of the injury, such damage threatens with lesser consequences than a fracture of the femoral neck. This is due to the fact that with a hip bone injury with a displacement, parts of the fragments can grow together correctly independently. When a fracture of the femoral neck occurs , the supply of bone structures with blood stops and self-adhesion is not possible. An extraordinary hip fracture in the elderly is a great danger, since the risk of complications is quite high. In particularly difficult situations, such an injury can be fatal.
The main causes of pathology
Closed femoral fracture can occur when falling to the side, with a directed blow to the trochanteric region or with twisting of the limb. In addition, a number of factors are highlighted that can provoke an extraverticular fracture of the leg:
1. Calcium deficiency in the body.
2. Unbalanced diet and abuse of harmful foods.
3. The period of gestation.
4. Bone tuberculosis.
5. Malignant neoplasms.
6. Osteomyelitis or osteoporosis.
7. Changes in the body of an elderly patient of a degenerative nature.
In the area of the femoral bone structures, pathological fractures more often than traumatic.
Types of damage
Extraterrestrial and intertrochanteric fractures of the femur manifest identically and require the same treatment prescriptions, therefore they are not divided into several groups. There are several main types of damage in this area of the human skeleton:
1. Intertrochanteric with punching without displacement.
2. Intertrochanteric without punching with displacement.
3. Thrilling with driving without bias.
4. Extraordinary fracture of the femur with displacement without sticking.
5. Helical transverse.
6. Excessive diaphysis fracture with displacement.
The resulting injury can demonstrate stability, while eliminating significant damage to the cortical layer. More often than not, a transverse femoral fracture with a displacement is characterized by a lack of stability. The restoration of bone structures after receiving such an injury can last quite a long time. In addition, this type of injury has a poor prognosis, especially for elderly patients.
Fracture symptoms
With a transverse fracture (ICD 10) of the bone structures of the thigh in a person, a pronounced pain syndrome of a high degree of intensity occurs. A damaged leg swells, it is not possible to stand on a limb. In addition, there is the so-called sticky heel syndrome, when a person in an upright position cannot tear his leg off the bed even after an anesthetic injection. With a forced turn of the limb there is a sharp pain in the leg.
With an alternate hip fracture with and without displacement, the blood vessels of the circulatory system are always damaged, which is accompanied by the appearance of a bruise, gradually diverging over the entire surface of the damaged thigh. In addition to the above symptoms, dizziness and weakness, pallor of the skin, due to internal bleeding, are observed. In some cases, a person with a fracture may lose up to a liter of blood. If, during a fracture, one fragment is pounded into another, the symptoms are not so pronounced and the patient is able to lean slightly on the injured leg.
First aid for this disease
It is very important to provide first aid to a person who has broken a hip. The success of rehabilitation therapy in the future will depend on timely measures taken. It is forbidden to move or transport a person with an alternate fracture (ICD S72) without first fixing the damaged limb. If you do not immobilize the leg and do not fix it in one position, the fragments can disperse and thereby complicate the treatment of the fracture.
In order to avoid consequences and complications, the tire for transportation is superimposed on the zone from the waist to the heel on the outside and from the heel to the inguinal region on the inside. Boards, umbrellas or sticks may be suitable as tires. Particularly careful fixation is required on the knees and waist.
To prevent traumatic shock during an alternating fracture, the patient is given an anesthetic. It will be optimal to do an intramuscular injection into the injured hip, but without medical skills, it is better not to risk it. Before you begin providing first aid to the victim, you should call an ambulance, describing what happened in detail. You can’t panic and try to do everything quickly, you must be careful and careful when applying tires.
How does fracture diagnosis go?
In order to clarify the diagnosis, the traumatologist conducts a visual examination and palpation of the damaged hip. The conclusion is made on the basis of the identified shortening of the broken limb, as well as an increase in the intensity of the pain syndrome when the heel is tapped. Next, the patient undergoes an x-ray examination, which allows you to determine the type and location of damage. If fragments are detected, computed tomography is performed, which makes it possible to assess the degree of damage by bone fragments of adjacent tissues, including muscles, blood vessels, ligaments and nerve endings. In addition, a blood and urine test is prescribed.
Treatment of this pathology
A life-threatening hip fracture does not present a life threat. In most cases, patients after the rehabilitation period return to normal life and do not lose their ability to work. Fragments of the bone are fused relatively quickly, due to the fact that the nutrition of the vessels of the periosteum is not interrupted. The treatment is quite simple, but there is a high risk of complications due to a prolonged stay in a supine position. A patient with a hip fracture may experience congestive signs, pneumonia, and the formation of pressure sores. Due to the high likelihood of severe complications, surgery is often indicated for patients with an extratemporal fracture of the femur.
Conservative methods for treating a hip fracture involve wearing a plaster cast and stretching the skeleton with a load. The dressing is applied for a period of up to two months. Traction takes the same amount of time. Specialists are trying to reduce this period for elderly patients, since they have a much higher risk of complications.
Operation
In some cases, surgery may be required. Thanks to surgical procedures, it is possible to shorten the recovery period. The most important point in bone fusion is the careful attitude to the injured leg for several months.
The task of surgical intervention is to compare bone fragments and their fixation by means of special pins, plates or staples. Any fixing elements are made individually based on the obtained x-ray. Successful recovery depends on a number of factors:
1. The model of the locking device.
2. Correct mapping of fragments.
3. Type of fracture.
4. Complications.
5. The quality of bone structures.
If the patient has osteoporosis or other pathologies of the musculoskeletal structures, it is likely that another operation will be needed. Contraindications for surgical manipulation are the following diseases:
1. Kidney or heart failure.
2. Heart disease.
3. Changes in the atherosclerotic type, a tendency to blood clots.
4. Disorders in the endocrine system.
5. The increased content of purines in the body.
Most often, angular plates and dynamic screws are used to fix fragments. The advantage of the latter is that when moving the load is distributed over the bone and maintains the position of the screw in normal. In other cases, the clamps do not distribute the load, which renders them unusable over time. In such a situation, another operation will be required, the purpose of which will be to replace the mounts.
Quite often, in the treatment of fractures in elderly patients, pins are used. This design is installed through small incisions. After the operation, the patient is shown wearing a special dressing that does not allow the leg to curl. Two weeks after the operation, the patient may begin to stand on his leg and perform some exercises.
Rehabilitation
The recovery period after conservative treatment is completed reaches two and a half months. Moving during the rehabilitation period is recommended only with the use of crutches. Throughout the treatment, the specialist needs to control the process of fusion of bone fragments, as well as the general condition of the patient. In old age, the restoration of damaged tissues is much harder, and complications can be unpredictable.
Additional treatments
To accelerate the restoration of damaged bone structures, the patient is assigned several procedures. Their implementation improves blood circulation and the restoration of muscle tissue and bone. The most common fracture prescriptions are:
1. Massage.
2. Laser stimulation.
3. Hydrotherapy.
4. Warming up.
5. Electrophoresis.
6. Paraffin therapy.
7. Therapeutic gymnastics.
Full restoration of the functions of damaged bone tissue can occur in six months. In especially difficult cases, rehabilitation reaches a period of 12 months.
The prognosis for this ailment
The forecast is quite favorable. Skewers are better supplied with blood than the neck of the thigh, so the bones grow together faster. Such fractures often do not require surgical intervention.
The prognosis for transverse hip fracture in the elderly is also favorable, but if help and treatment are timely.
Find out what people say about this ailment?
Reviews about this pathology
Most of the reviews for the treatment of a transverse femoral fracture are left by relatives of patients who have broken a hip in old age. Most often, bone tissue fuses, provided that all the recommendations of a specialist are followed.
Traumatologists note that the most important thing in the recovery period is to start developing the damaged joint in time, as this will ensure its normal operation in the future. In general, doctors are of the opinion that an overt hip fracture in older people grows together and does not require the use of surgical treatment methods. However, when the risk of serious complications is high, the surgeon may decide to have surgery.
Patients note that supportive therapy plays an important role in the recovery period, including taking calcium supplements, vitamin complexes and preventing pressure sores. Avoid traumatic situations, try to maintain joint mobility and flexibility for as long as possible, strengthen bone structures and take care of the state of health in general.