Wednesday, June 1, 2011

Break

The fracture is the interruption or discontinuity of a bone as a result of trauma. While most fractures are the result of impact forces or stress, they can occur as a result of medical conditions that weaken bones as osteoporosis, some cancers or when osteogenezis imperfecta is called pathological fractures.
Fractures are produced due to the action of external force. To produce a fracture is important in size, duration and direction of the forces acting on bone and how bone is required. Age when most fractures occur between 20-40 years, because when people are exposed to trauma. The second period as the age incidence is the third due to osteoporosis reduce bone strength. Although children are often exposed to trauma are rarely broken bones due to their high elasticity.
The choice of fracture treatment, orthopedic surgery, as well as the type of surgery must take into account how the fracture, displacement and cominutie important, skin condition, patient's age. Functional recovery irrespective of the method orthopedic or surgical treatment must be started immediately after immobilization. Mobilization of the patient in how it is beneficial.Progressively increase the recovery treatment as consolidation of the fracture, gradually increasing the load member. Add physiotherapy, swimming, hydrotherapy, occupational therapy.
Good moves towards consolidation fractures treated by the union heads broken by a callus. Clinical pain and swelling disappear progressively reduced functional deficit and may feel a heavy feeling union between the two fracture fragments. Depending on the function of bone fracture can be resumed in 4-12 weeks.
Pathogenesis of bone fractureIn orthopedic medicine, fractures are classified into different types:
Simple fracture closed - those where the skin is intact, while open fractures involve wounds that communicate with the fracture or a bruise or bone fracture exposes the bacterial contamination. Open lesions carries a high risk of infection requiring urgent surgical treatment and antibiotic treatment, debridement (removal of devitalized tissue, foreign bodies and decontamination).
Multifragmentation or contaminated fractures involves bone breaking into several pieces. A simple closed fracture is easier to treat and has a better prognosis.
Fracture displacement or angulation often requires reducing the bone and surgical care. These lesions require a longer healing.Another type is the compression fracture. Usually occurs in the vertebrae by osteoporosis.Other types of fractures include:- Full fracture in the bone fragments are separated total- Incomplete fracture in the bone fragments partially maintain contact between them- Linear fracture that is parallel to the long axis of the bone- Transverse fracture is perpendicular to the long axis of the bone- Oblique fracture that is diagonal to the axis of long bone- Spiral fracture of a bone fragment is twisted- Compacted fracture the bone ends are one in the other handlers- Thick periosteum in children is due only the convex cortical fracture of the bone, two broken pieces remain in continuity, "green wood fracture."Bone healing:Natural fracture healing process begins when the injured bone and surrounding tissues singereaza form a hematoma. The blood coagulates to form a clot situated between the fracture fragments.In a few days blood vessels grow in the hematoma, bringing phagocytes in this area, which will progressively remove non-viable material. Affect blood vessels and fibroblasts in the vessel walls that will multiply and produce collagen fibers. This blood clot is replaced by a collagen matrix. Rough consistency allows collagen fragments do not move.
At this stage some fibroblasts begin to form calcium hydroxyapatite bone matrix to form insoluble crystals.Mineralization of collagen matrix hardens and turns into bone.Actually, bone is a mineralized matrix. Healing callus mineralized enough to be seen on X-ray of the sixth week. This has no primary bone mechanical properties of mature bone. The remodeling is replaced by mature lamellar bone. The entire process takes 18 months to adult in three months but 80% of the bone is healed.
Several factors may help or hinder bone healing. For example, any form of nicotine prevents bone healing and nutrition, especially adequate calcium intake will help. Reduce stress for bone also help. There are accusations against NSAIDs would slow healing.
Pathological anatomy and soft tissue injuries include fractures.Skin may break open continuity solutions. The muscles around the fracture may be suffering various injuries caused by the agent is vulnerable to the movement of bone fragments. Vasculo-nerve injuries may also be present in the fractures.
Causes and risk factors for fractureDepending on the fractured bone fracture can be:Fracture produced healthy printrun violent trauma on bone with a normal structure.Pathological fracture. Any pathological process that reduces bone density or bone substitutes (infectious, malignant, benign) weakens the strength of bone. At least one such trauma can fracture the bone.
Mechanism of action of fractures may be directly or indirectly:Fractures occur through direct mechanism of the agent directly from the shock of impact contodent over the place. The agent most often cause damage to soft tissue vulnerable and ultimately resulting in a fracture of the bone open. These include fractures of the accident and the firearm.Fractures are the most common indirect mechanism. Force applied to a limb cause a distortion of bone that fractures away from the site of application.After the mode of action they may be:-By bending fracture occurs when the maximum curvatureBy torsion--Compression, compression fracture or cominutivaPull-through violent muscle contraction that pulls the bone fragment with the insertion of that muscle-Mixed-combine the direct and indirect.

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