Often in road traffic accidentsthere are injuries of the tibia, as well as small. Often injured shin. These damages occur with the same statistics. Fracture of the tibia is considered a rather serious trauma, which is accompanied by a number of complications.
Description of injury
It should be noted that the tibiaIt takes a huge load when moving. That is why its fracture is a frequent phenomenon. Most of the patients with this trauma occur in the winter, as well as in elderly people who have a broken bone structure. Fracture may be small or large, but sometimes they are simultaneously traumatized.
Where the tibia is located, everyone understandshuman. However, its anatomical structure for many remains a mystery. A large bone is located inside (towards the middle of the body). It consists of a long, tubular bone. The tibia is laterally (laterally). Its shape is the same as that of the big one, but it is smaller in size.
Causes
In order for a fracture of the tibia occurs,A force of influence is needed, which will be much greater than the strength of the bone. Causes include a fall in an accident, a jump from a height or a fall, skiing, skating, skateboarding, a strong blow to the kneecap, car accidents, a footstep, and an ankle blow.
The provoking factor should be called diseases, which affect the strength of bone tissue.
Types of fractures
When fractured tibia predictany outcome will be quite difficult, especially if it is a question of simultaneous trauma of a small and a large part. In this case, complications will most likely arise. Long-term treatment is also required, and in the future, long-term rehabilitation.
Закрытый перелом берцовой кости характеризуется imperceptible at first glance injury, open - the exit of tissues and debris out. The first injuries are divided into full or incomplete (the occurrence of cracks). There are also fractures with and without bias.
Fracture of small bone
As a rule, fracture of a small part of the bone occursdue to impact or fall. This is due to the fact that the structure has lost its integrity and has been deformed. Injury can be obtained with an inaccurate fall or falling into an accident. Also, one should not neglect safety at work, since a fracture of the tibia can be obtained absolutely randomly. It can still be traumatized due to bad weather.
This type of fracture is divided into several species, independing on the nuances of injury. There is a fracture of the spiral form, as well as fragmentary. Allocate transverse trauma, with oblique damage. There is also a fracture of the tibia with and without bias.
If we talk about the symptomatology of the problem, thenhighlight special nuances. A limb may not dent, one will become longer than the other, there will be swelling and pain. In addition, the leg will slightly deviate from the axis.
How to treat this type of fracture will depend on the degree of injury and its nature.
Fracture of large bone
Fracture of the tibia can occur inIf the load exceeds its strength. In this case, the fabric will begin to break down. The cause of injury is a direct blow, which is the result of a collision with a vehicle or a fall.
It should be noted the types of this injury. There are open and closed fractures. There is also a fracture of the tibia without bias, fracture and comminuted injury.
There are also special manifestations.The leg will be slightly deformed, there will be swelling and bruising. Dull and aching pain necessarily occurs. When trying to lean on a damaged leg, the patient will feel severe pain, which can also cause a spasm.
It should be understood that it is important to provide pre-medical care if this bone is broken. The patient should not try to move independently.
First aid
That after fracture of the tibia, rehabilitationwas the most successful, you need to properly provide first aid. Many people are wondering about how and what to do, but when you get into a situation where someone is injured, you should take action only if there is a certain skill or experience. Until the ambulance arrives or the patient is taken to the hospital, a number of manipulations must be made.
With the help of analgesics you need to remove the painEffect. If it is a question of small children, then this paragraph should be omitted. With a closed wound, you must attach something cold. This will help relieve pain, and prevent the development of a hematoma with edema.
Next, the leg needs to be fixed in one position,so that internal fragments do not damage surrounding tissues. This is especially important when a person has a screw injury. It is the most dangerous, since the bone, in fact, is broken into pieces. For fixing, you can take boards or sticks. One of them should be fixed to the outer, the second - to the inner side of the leg. To make this tire as efficient as possible, it is necessary to apply it from the heel to the hip. Strong fixation should be done near the knee and ankle.
При открытом переломе берцовой кости нужно maximally rinse the wound from dirt. However, one must try not to touch the fragments. After this, the wound is washed with an antiseptic and a bandage is applied. It should be dry, sterile and tightly knotted. Ointment is prohibited.
In the event that a trauma with blood loss, it is necessary to apply a tourniquet and detect two hours. At the end of the period, you should change the bandage. If the foot begins to change color and cool, then the tourniquet should be removed.
The victim should be transported only when lying down. This is the only way to protect the body from the appearance of further complications.
Diagnostic measures
Before starting treatment for a fractured tibiabone, you should conduct a detailed examination with a doctor. The faster the treatment is started, the faster the functions will recover. The first stage of the diagnosis consists of collecting indications and analyzes, as well as examining the deformation for the presence of wounds, bleeding, swelling, bruising, and so on. Sometimes there may be various protrusions.
After this stage, the patient is sent toX-ray. Thanks to him you can clearly see where the tibia is, the nature of the fracture, its course and complexity. X-ray also will allow to understand, the displaced damage or not.
If the doctor suspects having a more seriouspathology, or the picture did not give clear and complete information about the trauma, is assigned to CT. This method allows the tissue to be viewed in cross section. Thanks to this method of diagnosis, you can get the whole picture of trauma.
After the diagnosis is confirmed or refuted, you can begin treatment. The patient is referred to a surgeon or orthopedist.
Treatment of injury without displacement
How much to walk in a cast for a fracture of the tibia bone depends entirely on the severity and type of injury. Complications, if any, should also be taken into account.
Чтобы вылечить перелом без смещения, врач делает anesthesia and imposes a special cast bandage. After applying such a bandage, a repeated X-ray is done in order to understand how well the bones lie. It is important that the wreckage remain in place.
One week after fixing the patient's legs againsent to x-rays. Gypsum is allowed to remove at least 2.5 months. Rehabilitation while still lasting a month. If there are no complications, and the bones grow together well, then after four months it is possible to achieve maximum functioning of all the muscles.
Treatment of injury with displacement
If we are talking about the apparent displacement of debris at the tibia of the tibia, the therapy will be long, and it also differs slightly from the above.
After the patient is taken to the hospital,the doctor must anesthetize the injury, then the patient is sent to the traction. During the treatment, the muscles will come to their senses, and the displacement will not occur. In this condition, the patient will stay the whole course of therapy. The period depends on how fast the callus grows and how badly the bones are damaged.
Throughout the treatment, the doctor willperiodically sent to x-rays, so that a specialist can monitor the formation of corn. The traction will be canceled after 1.5-2 months, but only if the fracture of the tibia (large or small) grows satisfactorily. After removal, the limb is fixed with a tire made of plaster. The last x-ray, which will be indicative, is carried out after two to four months, depending on the speed of recovery. If the picture shows a bone in a normal state, then the use of a plaster splint will not be necessary, the doctor will remove it.
Surgery
The treatment is carried out by the surgical method only inseveral cases. These include improper accretion of the bone during drug therapy, open injury, where the wound condition should be constantly monitored, as well as an unstable fracture. The latter has a health risk or may consist of three fragments. Next, consider those devices that are used by surgeons.
Ilizarov apparatus
This method is considered the most reliable andeffective. Knitting needles are placed in the wreckage, which together with the main structure form a skeleton. As a result, the bones are fixed so tightly that the fragments are not able to move even one millimeter. During treatment, the doctor may change the location of each segment.
Screws
Doctors use the screwsrarely, however, they are also effective. They are installed during the operation. Screws are inserted into the bone, leading them out. They are mounted on a metal structure. Thanks to this fixation, the debris will remain in place. For children, this method of treatment is practically not used.
Rod and plate
There are two more surgical methods that will allow the foot to return to normal.
The core is placed in the bone. A skin incision is made, then a special device is placed in the bone canal. It is made of steel. The rod is removed only after recovery.
The plate is attached with screws.Holes are made on the skin. It is through them that the experts fix the plate. This operation is not done to children. Such a decision is due to the fact that during the installation and wearing of the plate, the periosteum can be damaged. This will affect further bone formation.
Rehabilitation process
After fracture of tibia (small or large)Be sure to go through a period of rehabilitation. It starts from the moment the plaster was applied, if the person has no complications of the disease. Be sure to follow the requirements and advice of a doctor. Most likely, he will offer to gently turn the foot and move his toes.
Limb should begin to develop immediatelyas soon as the specialist says that it can be done. Such a solution will allow you to restore all functions in the shortest possible time. The doctor must refer the patient according to a specific rehabilitation scheme, which includes massage, gymnastics and physiotherapy. In the design should pay attention to the load. If overvoltage occurs, complications can occur.
Full recovery occurs with a successful scenario and timely treatment after six months.
Outcomes
In conclusion, it should be noted thattibial injuries are quite complex and their treatment is also not easy. You should take care of yourself and try to protect your limb from damaging blows as much as possible. Prevention is easier than cure.
