A fracture is a broken bone. A bone may be completely fractured or partially fractured in any number of ways (crosswise, lengthwise, in multiple pieces).Co-management of existing conditions like diabetes becomes critical.
Types of leg fracture:
Some broken legs are more serious than others it depends on the location of the fracture, how the bone has broken and whether there is any damage to the surrounding tissue. The most common types of fracture are described below.
- Stress fractures : tiny cracks in the bone caused by overuse of the leg; common in athletes.
- Undisplaced or hairline fracture :a fracture through the bone with little damage to the surrounding tissue.
- Displaced fracture : the two parts of the broken bone have moved apart (misaligned).
- Comminuted fracture :the bone has broken (shattered) into several pieces.
- Open or compound fracture :a complicated break where the bone has broken through the skin, or the initial injury has exposed the broken bone.
- The most common causes of fractures are:
- Trauma. A fall, a motor vehicle accident, or a tackle during a football game can all result in fractures.
- Osteoporosis. This disorder weakens bones and makes them more likely to break.
- Overuse. Repetitive motion can tire muscles and place more force on bone. This can result in stress fractures. Stress fractures are more common in athletes.
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Many fractures are very painful and may prevent you from moving the injured area. The symptoms of a fracture depend on the particular bone and the severity of the injury, but may include:
Pain
Swelling
Bruising
Deformity
Inability to use the limb.
Fractures are different from other injuries to the skeleton such as dislocations, although in some cases it can be hard to tell them apart. Sometimes, a person may have more than one type of injury. If in doubt, treat the injury as if it is a fracture. ...more
Self-care instructions:
- Good first-aid care of fractures is always important. Moving the broken bones can increase pain and bleeding and can damage tissues around the injury. This can lead to complications in the repair and healing of the injury later on.
- First aid for fractures is all about immobilizing (limiting movement of) the injured area. Splints can be used for this. Control any external bleeding.
Follow your doctor's advice, but general suggestions include:
- Until the cast has set properly, avoid direct heat such as hot water bottles.
Rest the limb as much as possible.
- Use the techniques shown to you by nurses to walk or manage day-to-day activities. For example, you risk further injury if you use crutches incorrectly.
- Avoid any lifting or driving until the fracture has healed.
- If the skin under the cast is itchy, don't poke anything between the cast and your limb (such as a coat hanger or pencil). Instead, use a hairdryer to blow cool air into the cast.
- Don' t get your cast wet, as wet plaster becomes soft and does not provide the necessary support. Wet plaster can also irritate your skin. When showering, wrap the cast in a plastic bag and tape it directly to your skin, to keep the area watertight.
- See your doctor immediately if you have swelling, blueness or loss of movement of the fingers or toes, pins and needles, numbness or increased pain.
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Possible complications of a bone fracture may include:
- Poor alignment of the limb
- Infection
- Wrongly fitted plaster cast (for example, too tight or too loose).
Other problems caused by bone fracture can include:
- Blood loss bones have a rich blood supply. A bad break can make you lose a large amount of blood
- Injuries to organs, tissues or surrounding structures
- Stunted growth of the bone- if a child's long bone breaks close to the joint where the growth plates are found.
- Damaged muscle, nerves or blood vessels around the fracture ,this can occur during the initial injury (often caused by a sharp piece of broken bone) or during surgery. This may lead to loss of movement or feeling, or may affect the blood supply to the limb.
Acute compartment syndrome -this is a painful and potentially serious condition caused by bleeding or swelling within an enclosed bundle of muscles (a muscle "compartment"). This can occur soon after a fracture, after the plaster cast has been applied or after surgery. Emergency treatment is needed using a surgical procedure called an emergency fasciotomy.
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The most common way to evaluate a fracture is with x-rays, which provide clear images of bone. X-rays can show whether a bone is intact or broken. They can also show the type of fracture and exactly where it is located within the bone.
Consultation with rehabilitation specialists can be useful in helping inpatients to ambulate with the aid of crutches or a walker and, ultimately, to decrease postoperative morbidity and expedite patients' discharge planning. Rehabilitation services can be invaluable for many individuals in regaining their ROM and strength once the fracture has healed.
Schedule for consultations/Diagnostic tests:
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Fractures take several weeks to several months to heal, depending on the extent of the injury and how well you follow your doctor's advice. Pain usually stops long before the fracture is solid enough to handle the stresses of normal activity.
Even after your cast or brace is removed, you may need to continue limiting your movement until the bone is solid enough for normal activity.
During your recovery you will likely lose muscle strength in the injured area. Specific exercises will help you restore normal muscle strength, joint motion, and flexibility.
You will be given advice by your doctor on how much you should move your leg, and when you can put weight on it.
It takes around six to eight weeks for a minor fracture to heal, and you will probably need to use crutches or a wheelchair during this time, until it is possible to put weight on the leg again. The hospital will show you how to safely use any mobility equipment they provide.
More severe fractures can take between three and six months to fully heal. Some fractures can take even longer, especially open or com-minuted fractures.
The hospital may book regular physiotherapy appointments to help you maintain or regain muscle strength, movement and flexibility. This will include specific exercises to do before and after the cast is removed. It is important to follow the physiotherapist's advice to avoid delaying your recovery.
The pain of the injury usually stops before the bone is fully healed so aim to gradually introduce regular activities, especially sports or manual labor.
You should not drive while in a cast. Seek advice from your doctor about when you can drive again.
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Proper diet and exercise may help in preventing some fractures. A diet rich in calcium and Vitamin D will promote bone strength. Weight-bearing exercise also helps keep bones strong.
Things to remember- A fracture is a break or a crack in a bone.
- A fracture occurs when force exerted against a bone is stronger than the bone can structurally withstand.
- The most common sites for bone fractures are the wrist, ankle and hip.
- Treatment includes immobilizing the bone with a plaster cast, or surgically inserting metal rods or plates to hold the bone pieces together.
- Some complicated fractures may need surgery and surgical traction.
In most cases, your cast will be removed after a few weeks, but you must treat your limb with care for at least the next month or so.
Unlike skin, broken bones heal without forming scar tissue. But immobilized muscles tend to weaken and wither. You may need rehabilitation, including strengthening exercises, for a short time.
Taking good care of your cast will help ensure a better recovery.
Plaster cast care advice
- Keep your arm or leg raised on a soft surface, such as a pillow, for as long as possible in the first few days. This will help any swelling to go down and will help the cast dry correctly.
- Don't get your plaster cast wet. This will weaken it and your bone will no longer be properly supported.
- Even if the plaster cast makes your skin feel very itchy, don't be tempted to poke anything underneath it. This could cause a nasty sore. The itchiness should settle down after a few days.
More plaster cast tips
exercise any joints that aren't covered by the cast such as your elbow, knee, fingers or toes to help improve your circulation- avoid getting small objects, powders and sprays inside your cast, as they could irritate your skin
- don't try to alter the length or position of your cast
- don't lift anything heavy or drive until the cast has been removed
- use crutches or a sling, as advised by your health professional
- use painkillers if you experience any pain
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Eat a diet appropriate for your age, gender and body BMI.
Old patients to take care of existing conditions like diabetes and blood pressure and manage diet better so as to aid faster healing.
It is important to eat the right kind of food for a healthy mind and body. Try to incorporate 6-7 small meals/snacks during the day.
Generally, all food items can be classified into six major groups (3) as shown in the Healthy Food Pyramid.
Immediate Diet Plan
Do's
- Include lots of fresh, seasonal, local and if possible organic Fruits and Vegetables.
- Add plenty of Whole Grains (whole wheat flour, brown rice, whole beans).
- Choose foods high in Good Fat such as olive oil, peanut oil, fatty fish, walnuts, flaxseeds. If you do not eat fish, talk to your doctor about taking fish supplements.
Don'ts
1.Say NO to all Sugary beverages and foods. Do not add any extra sugar to beverages like tea coffee etc. Especially important when you are diabetic.
2.Refined ingredients like white rice, white flour, maida should be completely omitted from diets. Especially important when diabetic.
3 .Avoid combination of sugary and refined foods like cakes, pies, ice creams as they do the most harm. Especially important when diabetic.
4.Avoid Unhealthy Fats such as Cholesterol, Saturated and Trans Fat. Stay away from egg yolks, cream, butter, ghee, coconut, deep fried items, whole milk, dalda, vanaspati.
5.Slash down any intake of carbonated, caffeinated or alcoholic beverages.
6. Curb your Salt intake, as sodium in the salt has to tendency to retain water in the body which can increase blood pressure and add other complications. Do not add salt while cooking and restrict consumption of packaged food.
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