How to know if there is a fracture. How to distinguish a bruise from a fracture? Axial load symptom

Broken knuckles, or broken fingers, are one of the most common injuries treated by emergency room physicians. But before you go to the hospital, it is worth determining whether the finger is really broken. A sprain or rupture of the ligaments will also be very painful, but such injuries do not necessarily require an appeal to the department. emergency care. On the other hand, a broken bone can lead to internal bleeding or other damage that requires immediate medical attention.

Steps

Part 1

Recognizing signs of a broken finger

Pay attention to pain and increased sensitivity. The first sign of a broken finger is pain. The intensity of the pain depends on the severity of the fracture. Be careful with your finger after injury and pay attention to the degree of pain first.

It can be difficult at first to tell if a finger is broken because acute pain and hypersensitivity are also accompanied by displacements and stretching.
Watch for other symptoms or seek medical advice medical care if you are not sure about the severity of your injury.

Note swelling and bruising. A fracture of the finger is accompanied by acute pain, after which there is swelling or bruising. This is the body's natural response to injury. After a fracture, the body turns on inflammatory process, which leads to edema as a result of the release of fluid into the surrounding tissues.

Look closely at the deformity of the finger and the inability to move it. At the same time, the phalanx of the finger cracks or breaks in one or more places. The deformity of the bone may show up as unusual bulges on the finger or a twist in the finger.
- If the finger is unusually twisted, it is a sign of a fracture.
- Usually, a broken finger cannot be moved due to the fact that the connection between the phalanges is broken.
- A fracture may be accompanied by so much swelling and bruising that it will be difficult for you to move your finger.
Know when to seek medical attention. If you suspect you have a broken finger, go to the nearest emergency room or emergency room. A bone fracture is a serious injury, the severity of which can not always be assessed only by external symptoms. Some fractures require special measures for the bone to heal properly. If there is a suspicion that you have a fracture, it is better to play it safe and consult a doctor.

Displaced fracture. A displaced fracture, or unstable fracture, is any fracture in which the bone fragments no longer touch each other and are shifted from their normal position.

Open fracture. An open fracture is a fracture in which fragments of the bone are displaced and part of the bone shows through the skin. Because of the severe damage to the bone and surrounding soft tissue, these fractures require immediate medical attention.

From injury and physical damage, no one is immune. To break something or get a bruise, it is not necessary to get into an accident or be raided by hooligans. You can also get injured at home.

If at the time of physical impact there was sharp pain, then immediately understand that a bruise is a fracture is impossible.

To provide adequate assistance, you need to know exactly how a bruise differs from a fracture. But that doesn't mean you shouldn't see a doctor. With many injuries and severe swelling, even an experienced doctor cannot understand what the degree of injury is. For these cases, there is an x-ray.

General signs

The main signs of injury are pronounced edema, hematoma, which can “spread” far enough from the damaged area, and severe pain.

With a bruise, damage is limited to soft tissues and periosteum. The smaller the subcutaneous fat or muscle layer, the more painful the injury.

Mobility may be limited for a while, but this condition is caused not by internal damage, but by swelling of the surrounding tissues.

If the integrity of the bone tissue is violated, movement becomes almost impossible - an attempt to change the position causes severe pain. Moreover, this soreness can be given throughout the body due to nervous innervation.

Pain is present even at rest soft tissues in addition to edematous surfaces, displaced bone fragments exert pressure from the inside. The muscles reflexively contract, trying to return to a given position, but this is impossible to do - the pain increases.

If the fracture is without displacement, then at rest the pain can be expressed moderately.

A pronounced hematoma is considered a characteristic sign of a fracture - if the integrity of the bones is violated, small and large vessels are damaged, and internal hemorrhage occurs. But - for example - with a hip fracture, a hematoma can appear only after a day or even two, since the bone is surrounded by a dense muscle layer.

Features of fractures

How to accurately determine a broken finger or toe?

Symptoms of this type of injury resemble a severe bruise - severe pain is felt in the damaged joint, mobility is limited, swelling and hematoma occur.

If the integrity of the bone of the finger on the hand is violated, it is often impossible to clench a fist, or, on the contrary, the finger seems to hang on a string and deviate in an uncharacteristic direction, of course, this will cause severe pain.

A lot depends on which phalanx the fracture is closer to.

With an injury to the toes, it is painful to step on the foot, regardless of which toe is injured. How to determine the injury - a broken toe or a bruise?

This can only be said after an x-ray.

How to independently determine a broken nose?

A fracture of the nose resembles a bruise - severe bleeding and swelling are almost always present.

However, there are signs that will help differentiate one injury from another.

Violation of the integrity of bone tissue is often accompanied by loss of consciousness or pain shock.
When palpated, the pain intensifies and audible - to the patient himself - the crunch of debris.
Under the eyes appear pronounced hemorrhages in the form of glasses.

It is impossible to refuse medical assistance in case of damage of this type. Individual fragments can damage surrounding tissues, which subsequently increases the likelihood of visual impairment. Injury to the nose often occurs against the background of a concussion or damage to the spine in the cervical region.

How to determine if a rib fracture or just a bruise of soft tissues in the chest area has occurred?

The symptoms of a broken rib are as follows:

general pain, it is innervated throughout the affected area, but it is possible to determine the most painful point;
at rest, the pain subsides;
it becomes painful to breathe, the chest falls unevenly - sometimes when you inhale you can see where the damage occurred;
at a palpation morbidity amplifies.

If the ribs are broken in front, then the pain is more acute, if the damage is from the back, then the victim may experience only slight discomfort. Sometimes, with a bruise, the pain syndrome is even more intense than with a break.

How to determine what happened, a broken foot or a bruise?

Types of damage can be classified depending on the location of the damage - whether the integrity of the metatarsal bones, metatarsal bones, phalanges of fingers. Edema and hematoma occur in all cases.

In violation of the integrity of the metatarsal bones:

pain when resting on the foot and during its palpation;
foot deformity;
bilateral swelling.

Violation of the integrity of the tarsal bones:

swelling extends to the ankle joint;
pain occurs when the foot is turned, and not only when supported;
noticeable deformation.

Fractured fingers have already been discussed in this article.

Hip fractures occur in 6% of all bone fractures. In the elderly, they are diagnosed in 40% of all injuries of this kind.

If the integrity of the femoral neck is violated, pain occurs in the area hip joint and in the groin, palpation increases pain in depth, but does not cause sharp attacks.

With trochanteric fractures - the end femur- attacks of pain are pronounced, they increase when you try to change position, the leg is turned outward. If there has been a shift in bone fragments, the injured limb appears shorter. It is impossible to tear off the leg from the surface - it does not rise.

With impacted fractures, severe pain often appears only with an injury, and then patients lean on the injured limb, and the injury is mistaken for a bruise.

With these injuries, doctors try to play it safe and, together with an x-ray examination, prescribe an MRI of the hip joint.

Signs of a spinal fracture:

sharp pain radiating to the upper or lower limbs, sometimes immediately to the arms and legs;
weakness, dizziness, nausea;
periodic weakening of pain in the initial period is replaced by acute attacks.

With a compression fracture, mobility is practically unlimited.

Features of rendering assistance in violation of the integrity of the bones

The main help after injuries that resemble fractures in symptoms - an accurate diagnosis can only be made after an x-ray - is to ensure peace for the victim.

This is especially important to do if the spine is damaged - in this case, inept assistance can lead to complete paralysis of the victim.

Independently in case of damage to the spine, you can only provide a comfortable position - if you suspect an injury cervical you need to fix the neck with a collar.

If a violation of the integrity of the bone is suspected, the victim must be kept calm and apply cold to the damaged area.

Nose injury. You need to sit straight, bend forward a little, pinch the wings of the nose with your fingers, pressing your nostrils, you need to try to stop the bleeding. A cold compress of ice or a handkerchief moistened with cold water. If the bones are broken, then the bleeding will last for a long time.

A broken leg is a very common injury among women and men. In this case, the integrity of the bone is violated, which can be caused by several reasons. So why does a closed leg fracture occur? This is worth talking about in more detail later in this post.

Causes of the fracture

A broken leg is a serious injury that causes a lot of pain and a lot of discomfort. The causes of a broken leg can be the following points:

Careless movement on the street or at home causes a leg fracture.
The second reason is a fall or an accident.
Incidents at work or criminal situations also lead to a turning point.

A broken leg can happen due to diseases that a person has. In particular, it can be osteoporosis. In this situation, the leg bone can break even with a small load.

A broken leg can happen to:
Athletes because of their professional activities.
Children who lead an active lifestyle.
Pensioners. The bones of these people as a result age-related changes change their structure. Because fractures at this age are common.

How does a broken leg manifest?

If you have a broken leg, then the following symptoms should be observed. They depend, as a rule, on the severity of the fracture and the nature of the injury. But the most common symptoms worth listing below.

Pain sensations. A broken leg when immobile has a dull and aching pain. If the patient wants to move his leg or lean on it, then the pain becomes sharp and throbbing.
Limited limb mobility.
After a fracture occurs, after a while, a hematoma and edema appear next to it.
Crepitus occurs due to the friction of bone fragments with each other.
At the time of injury, a crunch may indicate a fracture.
The leg may be movable in the place where there are no joints during a fracture. This symptom often occurs when the tubular bones are fractured.
With an open fracture, a prominent bone will appear on the surface of the leg, which has torn all the ligaments and muscles.
With a displaced fracture, bone fragments are palpable.
An abnormal position of the leg indicates a fracture.
A fracture may cause shortening of the bone. This happens due to the fact that the muscles are pulled up to the fracture site.
With a fracture of the patella, edema appears instantly. At the same time, the leg cannot be bent and unbent. And if the fragments do not disperse, then you can still rely on the injured leg.
If the foot is injured, then it will not work to stand up. Puffiness does not appear immediately.

Why do swelling appear near a broken leg

If you are worried about the condition when the leg swells after a fracture, then you should immediately say that this phenomenon is considered normal. In this case, it is worth knowing that fractures do not exist without swelling. Edema occurs immediately after injury or appears after. Swelling is formed due to a violation of normal blood flow in the injured area.

Here everything is considered individual. Swelling in some cases may not go away for a long time and be painful. Prolonged swelling is the phenomenon when ligaments, tendons and muscle tissue were injured as a result of a fracture.

Even after removing the cast, swelling may occur. This happens as a result of stagnation of the lymph. This phenomenon is called lymphostasis. This phenomenon is considered serious complication, which leads to the appearance of cysts, tissue fibrosis and the formation of ulcers. Therefore, if the patient has a prolonged edema, then it is necessary to consult a doctor for a consultation.

The doctor will prescribe the appropriate treatment with the use of modern drugs will also be appointed various procedures. Here it can be used: UV irradiation, electrophoresis and phonophoresis, hydromassage and electrical muscle stimulation.

Types of fractures

You can see the broken leg in the photo. The type of fracture depends on certain indicators. Therefore, as a result, the severity of the following damage can be distinguished:

Complete and incomplete fractures. Complete can be characterized by displacement of fragments or be without them.

Open leg injury. These injuries can be characterized by damage to the skin, and the bone comes out at the same time.

Closed injuries of the lower limb. They are localized inside the soft tissues.

Fractures can be complicated. Fat embolism, infection, traumatic shock and injuries to other organs.

Uncomplicated fractures that proceed easily.

From the location of the injury can be distinguished:

Injuries to the femur. These include proximal end injuries, diaphyseal fractures, and fractures of the femoral condyles. In this case, the last fracture is also called a fracture of the distal end of the bone.

Leg injuries. These include injuries to the condyles of the bone and tibia. It also includes injuries of a distal nature with fractures of the bones of both legs and injuries of the ankles.

Fractures of the feet, when the tarsus and metatarsal bones are affected, as well as the phalanges of the fingers.

The following injuries stand out from the features of the fracture line:

If the line is located transversely to the bone, then transverse fractures are observed.

If the line is located at the angle of the bone, then oblique fractures are observed.

If the line runs along the bone, then this means the presence of a longitudinal fracture.

If the line runs in a spiral, then wavy fractures appear.

If fractures are observed with fragments, then there are also their own qualifications.

If a fragment of a small size departs from the bone, then this indicates a tear-off injury.

If more than two large fragments have come off the bone, then this indicates a polyfocal injury.

When one fragment enters another, an impacted injury is observed.

In the presence of fragments, a comminuted injury is observed.

If there are many fragments and they are small, then this is a crushed injury.

As a result of compression of the limb, a compression injury occurs.

Let's talk about a closed leg fracture

A leg fracture without displacement may be closed. Also, such an injury may be without displacement. In the event that a displacement of the fracture occurs, the shape of the leg will be non-standard. It will be deformed. Sometimes a closed fracture can be confused with a bruise. And this is all because both injuries have the same symptoms. But some signs will reveal that you have a fracture. So, you can define it if:

The leg became deformed.
A crunch is observed on palpation.
The bone has mobility in the place where there are no joints.

In any case, only a doctor can diagnose a broken leg. As a rule, the diagnosis will be made after an x-ray. However, it is worth every person to know how to help a person with a fracture. The victim with such an injury should receive an anesthetic tablet or injection. Also, the injured leg should be fixed. Even without specialized tires at hand, dannuduru can be done correctly, using certain knowledge. In this case, you can use: a stick, an umbrella, or something else suitable in strength and length. Next, you need to tie it to the leg. Doing this is very safe. The fixation should not be tight, but strong. After that, the patient can be sent to the hospital.

Open leg fracture

Now you understand what to do after a broken leg. It is also worth reporting details about an open fracture. Of course, an open fracture is considered a more dangerous phenomenon. Here already there are damages not only to the bone, but also to all the tissues surrounding it. An open fracture is easy to detect. In this case, in addition to all other signs, with an open fracture, the bone protrudes outward.

This injury should be treated immediately. Otherwise, this injury leads to death. Therefore, first aid must be provided competently. First, it is worth relieving the patient of severe pain. Therefore, he should use any painkiller. The leg must be motionless. Therefore, any special device is used here. It is good to use a sterile bandage to fasten the leg, but if there is none, then ordinary clean material will do. The wound around is treated with an antiseptic.

On a note! A bone with an open fracture cannot be straightened on its own! This is a matter for specialists.

At open injury bleeding is observed. With arterial bleeding, the blood has a bright color. She comes out intensely. Therefore, a tourniquet is applied over the damaged artery. With venous bleeding, an ordinary dressing with a pull is applied. It should be applied below the area that is damaged. The venous blood has dark color, while the jet will not pulsate. After the person is given first aid, he should be taken to the hospital.

How to develop a leg after a fracture

With the help of the information provided in this article, you can learn how to determine a broken leg. Of course, this injury causes serious damage to the body and it is incredibly difficult to recover from it. Even after removing the cast and undergoing treatment, the leg cannot function normally. Therefore, it is important to pay attention to those activities that will help develop the leg. Rehabilitation therapy can:

Eliminate muscle atrophy and start recovery processes in the vessels.
Make the joints work better.
Minimize or eliminate puffiness altogether.
Resume movement and restore tone and elasticity in the muscles.

For each case, the rehabilitation program is compiled individually. But in any case, exercises should be included in this program. Also in this it is necessary: adhere to a diet, visit a massage parlor. And at home, it is recommended to arrange useful baths for the legs.

Useful exercises

To restore the limbs, you can choose the following simple exercises:

So, sit down on a chair and start doing circular motions. In this case, you need to move both the knee and ankle joints. These movements are recommended to be performed a week after the plaster is removed from the leg.
Ordinary walking also has a positive effect on the condition of the sore leg. Hiking allows the body to be saturated with oxygen.
You can swing with a sore leg. Repeat the exercise up to 10 times a day.
Rise on your toes and then roll onto your heels.
In the prone position, it is useful to make cross swings. At the same time, you do not need to raise your limbs very high.

If the patient performs these exercises for a month, then after this period, improvements will already be noticed. The leg will be obedient. In addition, she will be able to take more serious loads. After that, you can work out in the gym. It is recommended to pedal at the same time for the first time about 10 minutes. As the muscles strengthen, the duration of the exercises increases.

How is a broken leg treated?

The treatment of a leg fracture is characterized by several successive stages. Therapy is started after the doctor examines the patient and makes an accurate diagnosis. The doctor decides to apply a plaster cast immediately or perform an operation.

Doctors do not carry out drug therapy. The patient will be prescribed pain medication. As a rule, they are introduced at the time of the main manipulations. To speed up the fusion of bones, the doctor prescribes drugs containing calcium.

Treatment options for a fracture include:

Closed bone reposition.
Osteosynthesis with small incisions.
Plaster overlay.

On a note! The following activities will be aimed at restoring leg function and bone fusion.

How long should you wear a cast

Of course, in all cases, a plaster is necessarily applied to the fracture.

In case of an ankle fracture without displacement, a cast is worn for 4 to 7 weeks. This period will be extended if the inside of the ankle is injured. And when displaced, gypsum can be worn for 3 months. If the tibia was involved in the fracture (which was also damaged), the plaster is applied for almost 120 days.

A bruise is a common injury in people of all ages, occurs in everyday life, during sports, accidents. Sometimes a bone fracture can be mistaken for a bruise, and, accordingly, the treatment is carried out incorrectly. You need to know the main symptoms and be able to distinguish between these two injuries, as well as provide first aid for them.

Signs of a fracture

A fracture is a violation of the integrity of the bone tissue or periosteum, which can be open when the skin is damaged, closed, with and without displacement of bone fragments, marginal, transversely serrated, helical, depending on the fracture line, incomplete, like a “maple branch” ", pathological in origin. Most often, a fracture can be taken as a bruise without displacement of the bones or marginal.

Symptoms:

Severe pain at the time of the fracture. When bruised, it can also be quite pronounced. But, in the event of a fracture, most often pain do not subside even after a few hours, can become stronger.
Increasing swelling, severe bruising (hematoma). Puffiness can develop very quickly, or increase gradually. Bruising in the case of a fracture of the shoulder or hip usually appears after 2-3 days due to the pronounced muscle density in this area. This symptom is also characteristic of bruises. And with some fractures, for example, impacted, soft tissues are not involved at all, and edema and hematoma may not be observed.
Increased pain when trying to move the injured with a limb, with a broken leg - the inability to fully lean on it, with a broken arm - it is almost impossible for her to take any object, to clench her fist. If the ribs are broken, it is very painful to take a breath, turn the torso. In some cases, dysfunction is practically not expressed, for example, with a fracture of the fibula or one of the metatarsal bones, with impacted fractures of the shoulder, hip.
If there has been a displacement of bone fragments, then it is much easier to recognize a fracture. The limb can be deformed at the fracture site, shortened, or vice versa elongated compared to a healthy one. A change in the axis of the limb is characteristic, for example, with a hip fracture, the leg is somewhat littered outwards, which can be determined by the foot. If broken lower limb, there is also a symptom of a stuck heel: a person in a prone position cannot tear his foot off the surface. You can feel the crunch of fragments at the time of injury, as well as during palpation (the so-called crepitus). It is observed when there is no infringement of the muscles between the fragments. In the case of a fracture with a displacement, pathological mobility is also characteristic, i.e. movement of a bone outside a joint. It is impossible to intentionally check crepitus and pathological mobility in the victim, since in this case it is possible to displace the fragments even more or damage the nerves and blood vessels.
This type of fracture is open, when skin in the area of injury are violated, it is easy to recognize, it is within the power of any person. Bones can be seen in the wound, it bleeds, swelling increases.
Axial load symptom. Checking this test consists in causing pressure on the length of the bone, for this, either a small support is made on the limb, or the doctor knocks on the heel or presses on the wrist or finger in the longitudinal direction, depending on the location of the injury. At this point, there is a sharp pain in the area of the fracture. If the casualty has a bruise, the axial load symptom is negative. The fact is that the periosteum has many pain receptors, and the effect on the bone in the longitudinal direction irritates this layer.

Signs of a bruise

A bruise is an injury to soft tissues (skin, subcutaneous tissue, muscles) without a visible violation of their integrity.

Injury signs:

The pain, expressed at the time of injury, then becomes somewhat weaker;
Edema, gradually increasing during the day. Moreover, if you give the limb an elevated position, it usually decreases.
Impaired mobility of nearby joints due to swelling and pain.

All these symptoms may be present in fractures, especially without displacement of bone fragments, incomplete, subperiosteal in children, impacted.

Only a doctor can accurately determine the nature of the damage, including by applying additional methods diagnostics (radiography, computed tomography). Therefore, if there is even a slight suspicion of a fracture, you need to give rest to the injured area. To this end, in case of injury to the limb, a splint should be applied, fixing the leg or arm in a stationary position. It is also necessary to apply cold to the site of injury in order to cause contraction of blood vessels, to give an anesthetic drug. If the fracture is open, if possible, superimposed sterile dressing. With obvious bruising, the victim will require temporary use of cold and rest for the first few hours, after which the symptoms decrease or disappear.

Which doctor to contact

If you do not know for sure whether a fracture or bruise of a limb has occurred, the right decision would be to go to the emergency room at the place of residence or to the emergency room of the hospital, where there is a surgical or, even better, traumatology department. An orthopedic traumatologist treats fractures of the limbs, but a surgeon can also help. If this is not possible, see a physician or pediatrician who is also familiar with trauma first aid. In the treatment of fractures, it will be useful to consult a nutritionist (in order to avoid osteoporosis or weight gain), a chiropractor, a masseur, a physiotherapist. If the fracture was related to a fall, consult a cardiologist and neurologist to identify the disease that led to the fall, especially in the elderly. A gynecologist and a rheumatologist will help you choose therapy for osteoporosis, which has become the cause of increased bone fragility.

A broken bone can have a variety of consequences, ranging from affecting the blood production process to the possible rupture of attached muscles, tendons, ligaments, blood vessels, and even nerves. “Open” fractures also have open wounds that can lead to bone infection, while “closed” fractures do not show visible skin trauma. "Complex" fractures involve damage to surrounding blood vessels or vital organs. To recognize any type of fracture, see step 1 below.

Steps

Part 1

Recognize the symptoms

Listen for the crunch. If you hear an unexpected crunch or crack in a limb during a fall or impact, you most likely have broken a bone. This sound is characteristic of a bone that has been unexpectedly exposed to much more than it is ready to take on itself, and has broken under this impact. The location of the fracture will depend on the force and angle of impact.

On the medical language this is called "crepitus." This is a characteristic crackling sound similar in sound to "loud, gaseous, bubbling crunch,” which occurs due to the friction of two broken parts of the bone against each other.

You will immediately feel intense pain, followed by numbness and tingling. You may also experience burning pain (except for skull injuries) with varying intensity immediately after the injury. Typically, the person will lose their sense of pain within an hour and begin to feel as if they were under the influence of drugs. This sensation will continue for some time while the injury is still fresh; when this feeling passes, you will feel the pain again with renewed vigor.
- The area of the fracture will be much colder to the touch than any other part of your body; From a pathological point of view, tissue injury activates peripheral pain receptors, known in medical parlance as "nociceptors", which cause the sensation of cold.
Pay attention to tenderness, tingling, swelling, bruising, and possible bleeding. Swelling of all nearby tissues occurs as a result of damage to blood vessels and leakage of blood throughout the damaged area. Since this actually means fluid buildup under the surface of the skin, the damaged area swells and starts to hurt when it is touched.
- The accumulation of blood in the tissues can be seen externally as bruises. As a general rule, bleeding is only to be expected if you have an open fracture, meaning that a piece of the broken bone has broken through the skin and is protruding.
- Bone tenderness can result from certain diseases, such as some types of blood or bone cancer, and/or from physical damage, such as after an accident or injury - especially if the bone has been broken into several small pieces.
Note the limb deformity. Bone injury may be associated with deformity, depending on the force of impact that caused the fracture. In closed fractures, the bone structure may change within the limb; in open fractures, the bone will protrude from the body at the fracture site.

Be aware of the signs state of shock. Many people go into shock some time after an injury. The state of shock is characterized by pallor, a feeling of coldness, dizziness, a fast but weak pulse, and nausea.
- All of these signs of shock can occur as a result of your body's reaction to your injury, as the injury will affect your nervous system and can lead to hypotension (low blood pressure).
- However, in some people these symptoms are so mild that they do not associate them with a broken bone. If you have experienced a severe fall or impact and then experience any of the above symptoms, seek immediate medical attention. You may have a broken bone.
Note limited or abnormal range of motion. If the fracture is near a joint, you will most likely have difficulty moving that limb normally. This is a very clear sign of a fracture. Movements may not even be painful at all, but they will be clearly limited.
- As a rule, a broken bone requires a certain period of stabilization in order to fully recover. There are special surgical procedures to stabilize fractures; you may also need physical therapy in order to fully restore the functionality of the limb.
- Pelvic and spinal fractures require bed rest and an extremely long stabilization period (3-6 months), after which patients may need long-term physical therapy.
Part 2
Get a Diagnosis
1. Seek immediate medical attention. During the examination, he may ask you about the situation in which the injury occurred and what kind of impact led to it (this will help him identify weaknesses in the area of injury). It will also record some details from your medical history, including a history of previous fractures in the same location or in other areas of the body.
  - During the examination, your doctor will Special attention three things. First, he will make sure nothing is blocking your airway. He will then check that you are breathing normally by observing your belly and chest, and at the end, he assess the state of your blood circulation.
  - He will also check things like pulse, skin color, body temperature, bleeding, swelling, and wounds. All these details will help him quickly assess the situation and determine if you are in a state of shock.
2. Get an x-ray. This is a very necessary and important method for diagnosing bone fractures. X-ray can reveal different kinds fractures, as well as any foreign bodies that may be in the tissues around the fracture, and determine if surgery is required. However, x-rays cannot reveal the condition of the affected tissues around the fracture, including muscles and ligaments.
  - If you are pregnant, this method is not suitable for you due to exposure to radiation. Your doctor may only recommend x-rays in the most special cases.
  - Before the X-ray, you will be asked to remove any jewelry and metal items. You can stand, sit or lie down during the x-ray. You will be asked not to move or even to hold your breath.
3. Your doctor will most likely work according to the rule of duality. Here's how it goes:
  - He will need to examine both limbs. He will spend some time with the healthy limb to determine how it works outside of the fracture state.
  - He will examine the injury from two sides - for a correct diagnosis, he will need to examine the area of damage both from the front and back, and from the side at an angle of 90 degrees.
  - He will examine the two limbs above and below the area of injury to determine the angle and reversal of the injury.
  - He can x-ray twice. This is required in some cases, for example, with a fracture of the navicular bone of the wrist. A second x-ray will be needed about 10 days after the injury, as the fracture will be more visible after the bone has returned to its place during this time.
4. Do computed tomography(CT). Your doctor may advise you to have a CT scan if you have complex fractures. A CT scan will show a detailed picture of the fracture, much like a modern x-ray that rotates the image of the scanned area to produce a three-dimensional image of the skeletal and soft tissues.
5. Do a magnetic resonance imaging (MRI). This is usually necessary for soft tissue injuries and osteochondritis (death of bone tissue due to poor blood flow, which can lead to bone fractures). MRI use electromagnetic waves and special computer devices.
  - After a fracture is confirmed, patients are checked for ischemia, increased pressure at the fracture site, and nerve damage.
  - If there is no obvious fracture line, bone density, trabecular pattern, and compact bone are examined.
6. Know the types of fractures. There are a dozen ways to break a bone. Knowing what types of fractures exist will help you understand how your fracture will heal. Here are the types of fractures:
  - stable fracture. When the edges of the fracture line remain in place opposite each other and do not move.
  - transverse fracture. The fracture line is conventionally perpendicular to the axis tubular bone as a result of a strong, direct blow. In some cases this happens from running for long periods of time and is called a stress fracture.
  - Oblique fracture. The fracture line extends slightly at an angle (obliquely). Typically, an oblique fracture occurs when an indirect force is applied to the bone at an oblique angle.
  - Screw fracture. Deformities or spiral fracture due to twisting of the bone (for example, when you are standing on one leg and a sudden twist causes a fracture).
  - Comminuted fracture. The bone breaks into several small pieces, which crumble in the area of damage to the bone. Such fractures usually occur due to severe impact on the bones, such as in car accidents.
  - Green line fracture. This is an incomplete oblique fracture, which occurs most often in children, since incompletely formed bones do not break completely into two or more pieces. Since children's bones are more mobile than adults, when a force is applied to the bone, they bend and break a little on one side only.
  - Comminuted fracture in the form of butterfly wings. This fracture forms one central and two lateral fissures, which form a triangle or butterfly wing rupture. Such a fracture is commonly seen in long bones after car accidents.
  - Longitudinal fracture. the fracture line is conditionally parallel to the axis of the tubular bone.
  - segmental fracture. The bone breaks into several large pieces as a result of a fracture at two points in the bone. Treatment usually requires internal fixation.
  - Thin fracture. This fracture (fracture) is very difficult to diagnose because it is very small. After healing, there will be no trace of injury on the damaged areas.
  - Avulsion fracture. With this fracture, the bone fragment is dislocated from the main bone in the area of attachment of the ligaments to the joints. This can happen when, after a car accident, a person is pulled by the arms or legs, causing an avulsion fracture in the shoulders or knees.
Part 3
Fracture treatment
1. Fix the bone. The main goal of the treatment of bone fractures is to fix the damaged bone in the correct position for the entire healing process. The fixation method your doctor chooses will depend on the type and severity of the fracture. Here are the options:
  - Closed reduction is performed on closed fractures by repositioning the bone (under anesthesia if needed). Then the bone is placed in a bandage treated with plaster or fiberglass until it heals completely.
  - However: If you have an open fracture in which the nerves and tissue surrounding the bone have been damaged, you will need an open reduction, which is performed surgically under anesthesia.
2. Know what you should expect during the operation. At surgical intervention traction techniques are used to return broken bones to their normal position, i.e. the bones are physically moved to their original position. Operational stabilization is usually required to ensure that all bone fragments are moved to their correct locations. Immobilization of adjacent joints may be required for best treatment outcome, depending on the condition of the fracture.
  - Damaged bones are usually held in place with screws and plates.
  - “Osteosynthesis” is used for internal fixation of bones with screws and plates.
  - “External fixation” occurs by placing screws on the inner layers of the skin and attaching the bone fragments to the outer metal frame.
  - “Internal fixation” is a procedure in which bone fragments are reduced to their normal shape, and then special screws and a metal plate are attached to the outside of the bone, or a long metal rod is placed inside the bone.