Fractures that expose the bones

Introduction An open fracture of the bone, that is, the skin or mucous membrane of the fracture site is broken, and the fracture is connected to the outside world. The greatest risk of an open fracture is due to the contamination of the wound, the intrusion of a large number of bacteria, and rapid local reproduction, resulting in bone infection. Open fractures can be divided into three degrees according to the degree of soft tissue injury: 1 The skin is pierced from the inside to the outside by the fracture end, and the soft tissue is lightly damaged. 2 The skin is broken or crushed, and the subcutaneous tissue and muscle have moderate damage. 3 extensive skin, subcutaneous tissue and muscle damage, often associated with vascular nerve injury.

Cause

History of trauma, its own disease state. Trauma or disease directly causes bone damage and brittle fracture. When the stimulation of the trauma reaches a certain level, it will cause the bone to break, thus piercing the muscles and blood vessels and revealing the outside of the skin. At this time, it is necessary to actively send the hospital to the hospital. When the hospital is needed, it is necessary. Pay attention to the local protective measures to avoid repeated fractures.

an examination

Related inspection

Bone and joint soft tissue CT examination bone exploration

diagnosis:

1, ask about the injury

Including the cause of the injury, the time, the location, the body posture at the time of injury and the first place, if there is a wound or bleeding, you should also ask about the wound treatment, whether the tourniquet has been used and the time of the tourniquet.

2, comprehensive physical examination

Pay attention to the presence or absence of shock, soft tissue injury, bleeding, check the size, shape, depth and pollution of the wound. There are no bone ends exposed, with or without nerves, blood vessels, craniocerebral, visceral injuries and other parts of the fracture. Serious injuries must be made quickly.

3, X-ray inspection

In addition to the positive and lateral X-ray, the special body phase should be photographed according to the injury, such as the opening position (upper cervical vertebra injury), the dynamic lateral position (cervical vertebra), the axial position (scaphoid, calcaneus, etc.) and Tangential position (tibia) and so on. Complicated pelvic fractures or suspected intraspinal fractures should be performed on a slice or CT examination as appropriate.

Differential diagnosis

Differential diagnosis of bone fractures:

Closed fracture: The skin or mucosa of the fracture is intact and does not communicate with the outside world. Such fractures are not contaminated. The soft tissue injury of the closed fracture is lighter and the fracture healing is faster. A closed fracture is the interruption of bone integrity and continuity. Closed fractures can be caused by trauma and bone diseases. The latter, such as osteomyelitis, bone destruction caused by bone tumors, fractures caused by slight external force, become pathological fractures. Closed fractures can be caused by trauma and bone diseases. The latter, such as osteomyelitis, bone destruction caused by bone tumors, fractures caused by slight external force, become pathological fractures, with traumatic fractures accounting for the majority.

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