At Home with Dr Christian Jessen - 317
| ORTHOPAEDICS|
*Compression (crush) fracture:
When the bone collapses (this
usually happens in the spine)
'Pathological' fractures are caused
by a disease that weakens the bones,
such as osteoporosis (see Brittle bones)
or bone cancer. In these cases, breaks
can happen with almost no force.
As well as the bone itself, a
fracture often injures the tissues
(muscles, tendons, ligaments), nerves
and blood vessels around it. There's
also a low risk of bone infection
(known as osteomyelitis).
WH AT TO LOOK F OR
It's not always easy to spot a broken
bone, especially a simple hairline
fracture. However, if you see any
of the following symptoms, get
the person to your local A&E
department as soon as possible:
*A misshapen or deformed
limb or joint
*Bone protruding through
broken skin
*A snap or grinding noise heard
during the injury
*Intense pain, numbness or a
tingling sensation
*Swelling, bruising and tenderness
*Limited mobility (including unable
to lift the limb in question)
In serious cases, you should call
an ambulance. Keep the patient as
still, calm and comfortable as you
can. Keep him warm (he may go
into shock), stem any bleeding and
apply ice packs if possible. Don't
allow the person to eat, just in
case they need surgery.
A first aider may be able to
immobilise a broken bone with
a split or sling. However, if you
suspect the injury is in the back,
neck, head or pelvis, do NOT try to
move the patient yourself, as this
could lead to permanent disability.
If you need to remove any clothing
at all, cut it off rather than trying
to force the injured limb out of it.
HOW EX AC T LY IS A
F R AC T U RE T REAT ED ?
If the doctor suspects a fracture, the
patient will be given an X-ray and/
or a scan to confirm the diagnosis.
Treatment then depends on the
severity of the break, and where
abouts it is in the body.
In some cases, such as a minor
cracked rib or collarbone, there's
often no treatment (as it's impossible
to use a cast or brace on the area),
and you simply have to rest and wait
for the fracture to heal on its own
(a collarbone fracture may involve
wearing a sling to keep it still).
With a more serious break, for
instance in the arm, leg or ankle, the
bone must first be correctly aligned.
This may involve surgery, and the
bone held in place with pins, wires,
screws and rods. The bone is held
immobile with a cast, brace, splint or
sling, so it heals in the right position.
If it heals in the wrong position, it
could lead to permanent deformity
and long-term problems, and the
bone may have to be rebroken and
repositioned at a later date. Casts are
increasingly made from lightweight
plastic and fibreglass, as well as
heavier plaster casts.
Patients may be given medication
to control the pain the break is
causing, especially during the early
stages, and the pain will usually
subside early in the healing process.
In some cases, such as a broken
leg, traction may be needed. This
stretches the muscles and tendons
Brittle bones
Osteoporosis (brittle bones) is
caused by thinning of the bone
tissue. Bones become weak and
fragile, and fracture much more
easily - even from a little knock, an
awkward turn or a sneeze.
It's particularly common in postmenopausal women, but anyone
can get osteoporosis, and it can
be very disabling. To learn how to
protect your bones, see Boning Up
On Osteoporosis on pg 72.
Protect your kids' bones
Bone fractures are common in children, due to their
rough-and-tumble lifestyles, and because their bones
are still forming and are more 'elastic'. They also have
'growth plates' at the ends of their bones, which can
be damaged. Children tend to heal more quickly,
though, so a broken bone may mend within a month.
A calcium-rich diet and lots of exercise will help
to strengthen children's bones. To reduce their
chance of an injury, make sure they wear protective
gear (helmet, knee/elbow pads, shin pads) when
involved in contact sports or activities such as skiing,
cycling or skating. Stay aware of safety risks around
the home and teach them safety measures, such as
not climbing on high surfaces or running on the stairs,
and using a non-skid mat in the bath.
around the broken bone, using a
system of pulleys and weights
positioned in a frame over the bed.
HOW L O N G W IL L
IT TAKE T O M EN D ?
Any swelling should go down within
about 72 hours. Go back to hospital if
this doesn't happen, or if you suspect
an infection has set in (burning, pus
or a bad smell), or the cast seems too
tight (causing numbness, coldness
or tingling in the extremities).
As the bone heals, new bone tissue
forms around the edges of the broken
pieces to connect them. The time it
takes to do this depends on the type of
fracture, and the age and health of the
patient. A simple fracture usually takes
six to eight weeks to mend, but it can
take several months in elderly people.
It's important to rest and follow
the doctor's instructions for a good
recovery time. The patient will then
have to go back to hospital to check
the bone has healed properly, and
have the cast or splint removed.
Once healed, most people are able
to return to their normal lifestyle,
although being immobile for some
time may mean they'll have to build
up their muscle strength again. This
may involve physiotherapy and an
exercise programme.
www.athomemagazine.co.uk MARCH 2015 | 09
8-9 Help bone broken FINAL.indd 9
22/01/2015 17:38
http://www.athomemagazine.co.uk
At Home with Dr Christian Jessen
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