Any person at least once in his life meets with people of the medical profession: doctors, nurses. This does not happen of our own free will. When we are born, these people give us first aid, care. In the process of life, during a professional examination, we can visit doctors of different specialties, for example, therapists, endocrinologists, oculists and so on. But sometimes by chance we have to meet with traumatologists. These doctors help correct the effects of various injuries. Doctors in this area are associated with plaster on the arm or leg. But they not only treat fractures. Every day, traumatologists are confronted with a host of other pathologies, for example, joint sprains, bruises or dislocations, compile trauma histories and prescribe treatment. And each injury requires special knowledge and specialist approach.
What does traumatology do?
Traumatology is a medical specialty and a section dealing with traumatizing the body and methods of treating pathological conditions that developed as a result of exposure to a traumatic factor. Accordingly, a doctor trained to solve these problems is called a traumatologist.
Depending on the traumatic factor, several types of injuries are distinguished:
- Blows by any material bodies and masses. Depending on the strength of the impact and the nature of the matter, any damage can be observed: from bruises to open injuries and fractures. Now traumatology, fractures and bruises are inseparable concepts. Since they are the basis of the specialty.
- Exposure to any aggressive liquids and gases. They lead to the development of local and / or general lesion. The most striking examples are chlorine and mustard. Locally, these gases cause irritation and damage to the mucous membranes and skin. Their systemic effect is associated with poisoning.
- Exposure to high and low temperatures. This leads to burns and frostbite.
- Exposure to rays. These are photons of light, radioactive rays. In the first case, a burn can develop (with local exposure) and various forms of hyperthermia, up to sunstroke. In the second, radiation sickness develops.
But at the present stage, the specialty of traumatology has become narrower, and now it deals only with mechanical injuries, such as bruises, sprains, fractures. All other types of injuries are the destiny of other specialties: cambustiology, surgery, cardiology, toxicology, hematology.
What are traumatology case histories?
The medical history is a reflection of all the main points of pathogenesis and treatment. And trauma histories are no exception. But they have a number of specific features.
- The initial examination must necessarily contain a section on the mechanism of injury, time, place and circumstances of its receipt.
- Local status is the basis of a trauma examination. Therefore, he is given enough attention. He is present at any examination by a traumatologist.
In addition, the medical history of traumatology should include a description of all the manipulations. If necessary, a protocol of surgical interventions and other surgical procedures is done.
Causes of Fractures
Fracture - complete or incomplete violation of the integrity of the bone. Occurs as a result of mechanical injury. It can be applied both externally and from the body itself.
Traumatic fractures are associated with external mechanical influences. They make up the vast majority. Associated with direct or indirect external effects on the bone. Moreover, the force of impact should exceed the limits of bone strength.
Pathological fractures are the result of internal causes. For example, bone destruction by tuberculosis or due to osteoporosis. Then fractures can occur even from normal loads.
Classification of fractures, their types
The classification of fractures is based on several criteria. All of them are of great importance for their treatment. Depending on the damage to the skin, all fractures are divided into open and closed. For the former, it is mandatory to damage the skin with the release of part of the bone fragments. In the case of a closed fracture, the skin is not damaged.
Complete fractures are common. Fragments of the bone are completely separated due to damage to its integrity. These fractures, in turn, are divided into fractures with and without displacement. At the first there is a displacement of fragments relative to each other. In the second case, the fragments are not displaced. For example, childhood injury occurs as a closed fracture without displacement due to the high strength of the periosteum. Traumatologists call it a “green twig type fracture”.
Depending on the form of violation of the integrity of the bone, several types of fractures are distinguished:
- Transverse. The fracture line runs perpendicular to the axis of the bone.
- Longitudinal fractures are called if the damage line is approximately parallel to the bone line.
- Slanting. The line is to the axis at an angle not equal to 90 °. In most cases, a wrist fracture is oblique.
- Helical fractures are formed when the fragments turn relative to the normal axis in one direction or another.
- Comminuted. At the fracture site, more than two fragments are formed, the location of which is chaotic relative to the bone axis.
- Wedge-shaped. Part of the bone enters the body of another bone. This is characteristic of spongy bones, such as vertebrae. In tubular this species is called hammered. Since fragments of one bone are wedged. The most striking example is a fracture of a leg bone in a vertical jump down.
- Compression fractures - damage to two contacting surfaces of the bones without a clear line. Also found in trauma to trabecular bones. This is the spine, pelvic bones.
Special options are the so-called incomplete fractures. Here the damage ends with incomplete destruction of the integrity of the bone: cracks, damage to the periosteum.
Finally, all fractures are divided into complicated and uncomplicated. The first group includes any significant pathological disorders resulting from trauma.
- Shock. Painful and hemorrhagic.
- Organ damage. It is characteristic of bones located in close proximity to the internal environment of the body. Such as ribs, pelvic bones, and spine.
- Embolism or blockage of blood vessels. And not necessarily it can be nearby arteries and veins. Sometimes vessels that are far from the site of damage can undergo embolization. With fractures, fat embolism is most common. Since fragments damage the tissue during injury. Including fat cells. The lipid droplets released during this can easily penetrate through the damaged vessels into the general bloodstream and cause blockage of any part of the body.
- Wound infection. It takes place only with damage to the skin. It is associated with the free penetration of microorganisms through damaged areas of the skin.
- Sepsis. The result of wound infection. Infectious agents penetrate the bloodstream and spread throughout the body, forming peripheral purulent foci.
- Osteomyelitis. Purulent inflammation of the bone.
Uncomplicated fractures are not characterized by the above pathological conditions. This, for example, is a closed fracture without displacement of fragments.
Troubleshooting
Any fracture treatment aims to restore bone integrity. For this, any possible methods are used.
Conservative methods. They include all actions that do not imply the use of surgery. These include plaster and tight bandaging. So, for example, they treat a fracture of the wrist. With some degree of probability, skeletal traction can be attributed to this. Since to fix the spokes, it is necessary to drill holes in the bones, with which weights will be fastened.
Surgical methods consist of using various plates, pins, brackets and other equipment to restore bone integrity. All these devices are directly attached to the bone to restore its integrity. After fusion of bone fragments, all structures are removed. Naturally, traumatology case histories are required to reflect this fact.
Along with the mechanical impact on the fracture site, systemic therapy is prescribed. Its goal is to improve bone cell nutrition. This will increase the rate of recovery processes. Even childhood trauma often requires systemic therapy. She, of course, is less pronounced than in adults.
Bruises: how to identify a bruise?
Bruising means traumatic tissue damage without significant changes in their structure. Naturally, this type of injury is found on soft tissues much more often than on hard ones.
Identifying a bruise is easy. It is enough to have the fact of exposure to a specific area and subsequent soreness. Moreover, the presence of bruising, redness and local edema is not necessary. So, for example, a bruised foot often occurs without any external signs.
The basis of any injury is damage to the small vessels of the tissues. As a result, plasma (or even blood) comes out of them. It compresses tissues, causing constant mechanical irritation of pain receptors. The greater the swelling, the more pronounced the pain. But this rule applies to soft tissues. In the case of mixed densities, things can look different. The same bruised foot can be sharply painful in the absence of external signs.
Treatment
Therapy of bruises is often called symptomatic. For this, various analgesics are used. With their help, pain is relieved, the body is given the opportunity to independently repair damage.
More radical therapy is necessary in case of severity of external signs and the presence of complications. So, a severe bruise may require not only adequate pain relief, but also the use of local anesthetics or even surgical intervention.
In any case, a severe injury should alert, as this may be the beginning of a more serious injury, even if there are no signs of it during the first call for medical help.
Dislocation: symptoms and treatment
Dislocation - a form of injury, consisting in the violation of the normal structure of the joint while maintaining the integrity of all its tissues. It occurs both as a result of external mechanical action, and due to pathological processes. These are arthrosis, arthritis.
The first (and most true) sign is a decrease in the amplitude of movements in the joint. In second place is the next important sign - a change in the shape of the joint. Traumatologists call this change "deformation."
What to do with a dislocation? Of course, correct. But it is better to provide this procedure to a specially trained doctor. Otherwise, more serious injury could result. The joints, especially in children, are very fragile, therefore, if problems arise, they require the intervention of specialists.
But what to do with a dislocation if it happened far from the place of possible medical care? It is necessary to immobilize the joint. Why apply a fixing bandage. But in any case, it is important to contact a specialist as soon as possible.
Tensile characteristics
Stretching is an increase in the longitudinal length of the ligaments due to the separation of one of the sides. When examining stretching at the cellular level, it should be noted that there is always a rupture of small fibers.
External signs of stretching are:
The question of how to treat sprain does not depend on any medications or special treatment methods. In the case of such a pathology, rest, care and anesthesia are necessary.
What is the danger of childhood injuries?
In childhood, rapid bone growth is noted. Therefore, the development of the periosteum is maximum, and the connective tissue has high elasticity. This, it would seem, contributes to a more favorable course of recovery processes after injuries. Therefore, in the question "How to treat sprain in children?" many experts do not see any problems.
But there are pitfalls here. After all, childhood injuries leave an inevitable mark on growth processes. Instead of spending its resources on the active growth and formation of new cells, the body is forced to use precious time to recover.
Finally, the main danger of childhood injuries lies in the revaluation by adults and, above all, by the children themselves of their abilities. What can cause irreparable injuries for life. Sometimes adults want to grow flexible and active people out of their children, not having enough experience and knowledge for this. As a result of intensified attempts to realize their dreams, parents instead of physical development provoke childhood injuries.