Crack or fracture of the bone: distinguishing features

Violation of the integrity of the bone occurs when the load exceeds the limit of their strength. In professional terminology, there is no concept of "crack", but there is a complete or incomplete fracture, the latter corresponds to the term "crack" accepted in wide circles, that is, partial damage to the bone.

Which is worse, a fracture or a crack? A crack, of course, heals faster and is easier to heal, but not everything is so simple, since a fracture of the little finger, for example, is less painful than a leg fracture. It all depends on the location of the damage.

Epidemiology

Researchers from a number of Ukrainian medical institutes specializing in traumatism, orthopedics developed a questionnaire that included 17 blocks of questions providing extensive information about the mechanism of injury, its localization, severity, the treatment method used, its effectiveness, etc. In total, about 3 thousand fractures. This analytical work gave the following data: of all the injured, there were 51% of women and 49% of men, domestic injuries prevailed (51%), street injuries were in second place (30%); The largest age group of victims was in the range of 40-59 years (40%), followed by a range of 20-39 years (37%).

Causes of the fracture or fracture of the bone

One of the criteria for classifying fracture types is the cause of their occurrence. There are two:

• traumatic (occur under external influence);
• pathological (tuberculosis, bone tumors, osteoporosis and other pathologies), for which insignificant loads are sufficient.

Risk factors

The strength of bones largely depends on its density, which in turn is directly proportional to the content of minerals (phosphorus, boron, calcium, etc.) in the bone tissue. Their lack is one of the serious risk factors leading to fractures. You can not discount the genetic factors, nutrition, environmental conditions, lack of physical activity.

An important role is played by a person’s age (in older people there is a gradual loss of bone mass), gender (osteoporosis in women is much more common than in men), ethnicity (Europeans and Southeast Asian peoples are more susceptible), weight (thin bones are more fragile), bad habits (smoking, alcoholism), certain medications (hormonal drugs, anabolic steroids).

Pathogenesis

Bone tissue consists of 60% minerals and its strength depends on it, 30% of collagen responsible for elasticity and 10% of water. Vessels are concentrated in its mineral part. Fracture of bone tissue leads to their rupture, respectively, to bleeding, hematomas, and edema.

Symptoms of the fracture or fracture of the bone

The first signs of a fracture or crack make themselves felt with severe pain, aggravated by touch, palpation. Injury to the limbs: the arms or legs respond with pain when moving, at rest the pain is dull, muffled. Symptoms of a fracture or crack of the rib, chest are expressed by pain during a deep breath, coughing, talking. Multiple fractures of the ribs can cause increased heart rate, pallor, and sometimes cyanosis of the skin.

The next evidence of a violation of the integrity of the bone is the appearance of edema at the site of injury, often a hematoma (the latter is more characteristic of fractures).

Complications and consequences

The most possible consequences are in case of fractures with displacement, since improper fusion is possible, which leads to loss of organ functionality. Other complications include blood loss, hyperemia, and the development of inflammatory processes.

But the most dangerous fractures of the femur, because they entail the development of a fat embolism from the yellow bone marrow - blockage of the vessel with subsequent circulatory disorders, even fraught with death.

Diagnostics of the fracture or fracture of the bone

A fracture is indicated by characteristic symptoms. The orthopedic doctor studies the anamnesis, conducts a physical examination, palpates the damaged area. The absolute signs of a fracture are the unnatural position of the limb, pathological mobility, a kind of crunch that occurs when pressed, the presence of bone fragments in an open wound.

The most accurate confirmed diagnosis is instrumental, carried out by means of radiography. The picture is taken in two projections, direct and lateral. It is the X-ray examination that allows you to find a fracture. There are many varieties of images of fractures in the picture, but the classic one is a linear section of enlightenment, displacement of fragments, if any.

Cracks are sometimes not visualized, so computed tomography comes to the rescue.

Differential diagnosis

In the absence of obvious evidence of bone fractures, they are differentiated with bruises, dislocations, sprains, and cracks. Treatment tactics depend on the accuracy of the diagnosis.

Treatment of the fracture or fracture of the bone

Fractures require an immediate response, because the complications that accompany them are more dangerous than the injury itself. First, you need to provide first aid to the injured: determine the location and severity of the injury, stop it if there is bleeding, in case of an isolated injury, apply a splint, give painkillers, sedatives, call an ambulance or take the patient to the emergency room.

Medical care depends on the severity of the condition and can be both conservative and operative.

The conservative one consists in anesthesia and anesthesia, if necessary, the imposition of a fixing plaster bandage, the use of traction methods - traction to neutralize the action of muscles attached to bone fragments, and to improve bone tissue regeneration. Also, according to the indications, the immobility of the affected areas is ensured.

Surgery

Where it is impossible to carry out conservative treatment (fractures of spongy (short) bones, the vault of the skull, jaws), or after improper bone fusion, they turn to surgery. This can be fixation of bone fragments with knitting needles, plates, pins, staples. The method is determined by the surgeon based on the location of the injury, its severity, the general condition of the patient, etc.

Prevention

It is impossible to foresee all possible situations leading to injury, but it is necessary to try to avoid traumatic moments. Other preventive measures include minimizing the individual-specific risk factors listed above.

Forecast

Timely treatment of fractures in combination with rehabilitation measures, which include massage, therapeutic exercises, physiotherapy, gives a favorable prognosis. Usually, the recovery time ranges from several weeks to several months.