General measures Cool and elevate. Nicotine restriction (refrain from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in … Bone Fracture: Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection of the injured body region Dolor (pain (periosteal pain)) Tumor (swelling) Rubor (redness) Calor (warmth) Functio laesa (restricted mobility/loss of function); Caution! Elbow extension test after trauma does not rule … Bone Fracture: Examination
Indications for conservative therapy: Existing contraindications to surgical treatment. Fractures on the infantile growing skeleton Fractures whose conservative treatment is not superior to surgical therapy. Stable fractures Basically, bone fracture therapy is carried out according to the principle: reduction – retention – rehabilitation (aftercare): If there is a fracture with dislocation of the fracture ends, … Bone Fracture: Conservative Therapy
Because severe fractures are often emergencies, the patient’s current condition must be assessed, so basic parameters that map the entire system must be determined. Depending on the underlying diseases present, appropriate laboratory parameters should also be determined to prevent possible complications. Laboratory parameters of the 1st order – obligatory laboratory examination. Small blood count Differential … Bone Fracture: Test and Diagnosis
Therapeutic Targets Pain relief Avoidance of complications Fracture healing Therapy recommendations Wg. fracture pain: analgesia (pain relief) according to WHO staging scheme. Non-opioid analgesic (paracetamol, first-line agent; ibuprofen, is equivalent in effect to morphine (opioids) in children). Low-potency opioid analgesic (eg, tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. Antibiosis (antibiotic … Bone Fracture: Drug Therapy
Obligatory medical device diagnostics. X-ray diagnostics of the musculoskeletal system – X-rays of the injured region are the initial medical device diagnostics leading the way for further investigations. Computed tomography (CT) – sectional imaging procedure (X-ray images from different directions with computer-based evaluation), particularly well suited for imaging bony injuries: If necessary, in special cases … Bone Fracture: Diagnostic Tests
Indications for surgical therapy: Vascular and nerve injuries Joint fractures with step formation Irreducible fractures and dislocations (dislocations). Manifest compartment syndrome Open injury/fracture; for tibia/fibula (tibia/fibula) fractures, the risk of infection is significantly higher than for other locations Basically, bone fracture therapy follows the principle: reduction – retention – follow-up. If there is a fracture … Bone Fracture: Surgical Therapy
To prevent fractures (broken bones), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Alimentary osteopathy (nutritional bone disease/ starvation osteopathy due to malnutrition (calcium, calciferol and protein deficiency). Micronutrient deficiency (vital substances) – see prevention with micronutrients. Consumption of stimulants Alcohol Tobacco (smoking) – Smoking leads to accelerated osteoporosis and … Bone Fracture: Prevention
The following symptoms and complaints may indicate a fracture (broken bone): Sure fracture signs: Dislocation (axial misalignment). Visible bone fragments (open fracture). Abnormal mobility Crepitation – crunching at the fracture site. Step formations in the bone contour Diastases (bone gaps) Fracture gap in the X-ray Uncertain fracture signs: Dolor – pain (periosteal pain; pain originating … Bone Fracture: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Healthy bone withstands the compressive, shear and bending forces acting on it without any problems. Only when the elastic properties are overtaxed in appropriate trauma does a traumatic fracture occur. A fracture can be caused by direct force, e.g. by a blow or impact, or by indirect force, e.g. by lever … Bone Fracture: Causes
A common classification of bone fracture is the AO classification (also Müller classification; AO – Arbeitsgemeinschaft für Osteosynthesefragen). The system is used to describe the location as well as the nature of fractures. For this purpose, a code is created based on the classification: Fracture localization – body region numbering. Humerus [humerus] Radius (radius) and … Bone Fracture: Classification
The anamnesis (medical history) represents an important component of the diagnosis of a fracture (bone fracture). Often, especially in older patients, disease-related causes are found for the fall or accident that led to the fracture. These include, for example, cardiovascular-induced dizzy spells or syncope (brief loss of consciousness). A genetic disposition for bone diseases as … Bone Fracture: Medical History
