According to statistics, every tenth skeletal injury is a fracture of the fibula or tibia. Damage is common in both children and adults. Further treatment and rehabilitation completely depend on the nature of the injury and the severity of the possible consequences. One thing can be said: if a fracture of the lower leg occurs, it is urgent to contact a traumatologist. The fact is that delay and extra workload can only aggravate the situation.
The concept of a fracture in terms of anatomy
First, let's talk about the structure of the lower leg, so that readers have an idea. The skeleton of this part of the leg includes two bones: the tibia and the fibula, which are interconnected by an interosseous membrane. It is logical that the main load falls on the tibia, since it is the supporting one.
Fracture of the lower leg is a violation of the integrity of the bone tissue, in this case, in the area between the knee and the foot. Quite often, a particularly difficult situation occurs when damage is accompanied by displacement. This means a shift of the broken piece of tissue to the left or right. In the event of an injury, a person will not be able toit is normal to walk for a while, it is better not to step on a sore leg at all until the doctor's permission. Treatment of a fracture of the lower leg is often carried out by establishing a fixing bandage and then applying a cast. In the process of rehabilitation, the patient needs physical rest, it is impossible to load the leg once again. It will be several months before a person with such damage can return to a full life, so you should be careful and take care of yourself.
Injury classification
There are many divisions of this injury into types and types. Consider the most popular classifications. Fracture of the bones of the lower leg can be single and multiple. In the first case, damage is present only in one area, and in the second case, damage is present in several places at the same time.
If we talk about the break line, three varieties should be noted:
- straight, when the bone breaks exactly across;
- oblique, meaning an injury in which the bone is damaged diagonally;
- spiral, that is, all situations where the fracture line is uneven.
As already noted, in medicine, injuries of this nature are distinguished with and without displacement. To determine this factor, the traumatologist evaluates the distance of bone fragments from each other. If the parts are located far away, and it is difficult to connect them together, then we are talking about a fracture of the lower leg with displacement. In another situation, when fragments can be easily joined together to form a whole bone, we are talking about damage without displacement.
Besidesthe above classifications, there is another, which is the most popular. Specialists distinguish two types of injuries:
- Closed fracture of the lower leg. The least dangerous option, in which there is no damage to the skin, and bone fragments are located in the leg.
- Open fracture. A more severe case, characterized by rupture of the muscles and skin by bone fragments.
The most common fracture in patients is the fibula. However, in some cases, both bones are damaged at once. The injury can be localized anywhere: in the lower, middle or upper parts of the lower leg.
Causes of fracture
Every day a person is exposed to the risk of injury. Often the patient himself is the culprit of the injury. Fracture of the lower leg in all cases is a consequence of the impact of force majeure. It should be noted that injuries of the tibia are divided into traumatological and pathological. The first option is characterized by an external effect of strong pressure on the bone tissue. Pathological damage occurs as a result of minor contact due to abnormal fragility. In addition, various diseases such as tuberculosis and osteochondrosis can affect bone softening.
So, back to the reasons for the fracture. The most common injury is the result of a fall during dangerous sports. Often there are such cases during a traffic accident. Moreover, a fracture of the lower leg with displacement in this situation is observed more often than without. Sometimes the injury occurs as a result of a fallheavy object. Bone yields to pressure and breaks easily under load.
Women suffer damage of this nature while wearing uncomfortable shoes with high heels. It is necessary to decide what is more important: beauty or he alth. Excess weight can also be attributed to the causes of fracture. In practice, there were cases when the injury occurred as a result of a fall on the street during black ice. In winter, you need to be especially careful. In such situations, a fracture of the lower leg without displacement is often observed. This injury will put you out of action for one to two months.
Signs
Symptoms may vary in case of injury to different bones, area of injury, etc. We will look at the common signs that are often found in the defeat of the lower leg:
- severe sharp pain at the site of injury;
- the appearance of a tumor and the rapid spread of edema around the affected area of the limb;
- in case of an open fracture of the lower leg, there is a rupture or a small tear of the skin with bone fragments;
- change in the appearance of the lower limb in the area of injury;
- when trying to start moving, the pain in the injured leg increases;
- unable to step on due to severe pain and broken bone.
If you find such symptoms, you must provide first aid and call a team of doctors. It is very important not to delay, but to do it on the day of the injury, so as not to receive unnecessary stress that can lead tocomplications.
First Aid
Often, a lot depends on the provision of assistance before the arrival of doctors, so you need to take this issue with all responsibility. First, if there is a suspicion of an injury of the nature in question, it is necessary to immobilize the person. Secondly, a homemade splint should be applied in case of a fracture of the bones of the lower leg. This is done quite simply: you need to take any long and even objects that come to hand, wrap them with a piece of clothing on the right or left side.
If we are talking about an open fracture, when bone fragments tear the skin, resulting in bleeding, other actions must be taken here. First you need to urgently stop the bleeding. Apply cold to the skin around the open wound, for this, use snow, ice from the street or a refrigerator. Before applying cold, wrap it with a piece of cloth. When the bleeding subsides, cover the wound with a clean bandage, you can use bandages.
If the patient has a very strong bruise, accompanied by a stream of blood, it is necessary to apply a tourniquet. In this case, it is possible to avoid profuse blood loss. The tourniquet is applied 15 centimeters above the wound and tightened tightly. After an hour and a half, it is necessary to loosen the craving to prevent the death of a part of the body. After a while, the tourniquet tightens again.
Sometimes patients show bones protruding from the wound. In no case should you try to set them back before the arrival of the doctors! Easier to provide first aidclosed fracture of the leg bones. However, you need to be ready for anything and be able to save a person in any situation.
Diagnostic measures
It is difficult to overestimate the importance of diagnostics in the problem under consideration. Based on the description of the injury, the doctor prescribes further treatment. As soon as the patient is admitted to the hospital, the doctor examines the patient, collects data on the circumstances of the injury and the nature of the damage. In any case, the doctor directs the victim to an x-ray, and the picture must be taken in two projections for the most accurate diagnosis. Sometimes additional tests are ordered. If you have a closed tibia fracture, an x-ray is often enough to make a diagnosis.
In case of intra-articular trauma, arthroscopy is necessary. This procedure is quite effective, because it allows you to determine the degree of damage to the condyles in the ligaments of the joint. The doctor examines the cavity of the lower leg with a special video camera. If the fears are confirmed, he prescribes a specific treatment. If intra-articular damage is suspected, magnetic resonance therapy is recommended. If the x-ray does not provide enough information, the doctor will perform a CT scan to see the full picture of the injury.
General principles of treatment
Fracture of the bones of the lower leg in any form involves the implementation of certain steps. Consider them in more detail:
- In order for the bone to heal properly, the fragments must be brought into the correct position. If the injury is not serious, this is not necessary. But in otherssituations, the doctor independently carries out the displacement under anesthesia. Sometimes it comes to perform surgery to get the right position.
- Next, you need to fix the fragments with one of the tools. Usually a knitting needle, a plate and side loops are used. This operation is called osteosynthesis.
- When a person has damage of this nature, it is necessary to walk in a cast. A splint for a fracture of the lower leg is applied only as part of first aid. Doctors fix the limb with a plaster cast. It must be worn until the bones are completely fused. It is difficult to say how long this will last, it all depends on the complexity of the injury.
- Methods and ways of fastening the fragments can be very different, the traumatologist chooses them. It happens that a certain option does not justify itself, then you can use another.
- Approximately one third of all fractures are displaced. In this case, an operation with the establishment of the plate is necessary. Rehabilitation can last up to one year, and the load is allowed to be given only after three to four months. It is worth noting an interesting fact: the most common injury of this nature is a closed fracture of the left tibia.
These principles are used by almost every traumatologist. Depending on the severity of the damage, some items can be skipped. The most severe injury for subsequent treatment is considered an open fracture with a displacement, because nerve fibers, blood vessels and joints are affected. Treatment modalities may depend on the circumstances in which you receiveinjury.
Not all situations need immediate action. For example, with an injury such as a fracture of the lateral malleolus of the lower leg, the foot often swells. Because of the swelling, doctors can only intervene after a few days.
Surgery
It should be noted that this type of treatment is rarely used in practice. To justify the intervention of surgeons, one of the following conditions must be met:
- lack of possibility of compiling bone fragments without opening tissues;
- trauma to the tibia in several places with serious displacement of fragments;
- deformation of muscle tissue;
- if there is a risk of a closed fracture turning into an open one;
- bone fragments pinch blood arteries and nerve fibers;
- open calf injury.
As we have already noted, there are situations when a patient has damage to two bones of the area from the foot to the knee at the same time. Then the intervention is performed only on the tibia, since the smaller one can heal itself. The essence of the operation for a fracture of the lower leg with displacement is to give the bone tissues the correct position and their reliable fixation.
If several breaks are found, special plates must be used. They are attached to the bone tissue with screws and pins, and then sutures are applied to the skin. In the process of subsequent treatment, the patient should regularly undergo x-rays to understand the process of bone fusion. It is worth noting,that the plates remain in the lower leg for a year. This is done to reduce the load on the already fused tissue. When enough time has passed, the patient will need another operation to remove the plate from the lower leg. A person can understand for himself when his bone has grown together. Remember: if you can control the movement of the foot and fingers, then all the tissues have fallen into place.
Injury Recovery
Proper rehabilitation is a very important component for restoring motor function. In order for the condition of the leg to return to normal, it is necessary to make every physical effort. A fracture of the lower leg is a very serious injury that affects not only the bones, but also soft tissues.
When bones coalesce, the muscles in the leg atrophy. Blood circulation in the tissues compressed by plaster is disturbed. However, if the rehabilitation is carried out correctly, then negative symptoms can be eliminated. The recovery process is long and difficult. The patient needs to be prepared for the fact that at first it will be painful to step on the foot. Despite this, you can not ignore the instructions of doctors. You may have to re-learn how to perform the simplest movements, but don't let that scare you. With a responsible approach to this issue, the recovery will be much faster than expected.
Fractured leg. Rehab
To return the leg to move, it is necessary to perform a whole range of activities. There are several recovery methods that the attending physician chooses in a particular situation:
- Therapeutic exercise. Certain tasks are selected for each patient individually. Many factors influence the choice of exercises: the severity of the injury, the rate of healing, etc. You need to do it daily, then the muscles will be in good shape, which will eliminate blood stasis.
- Massage and rubbing. It is necessary to develop a limb immediately after removing the plaster cast. The procedures are carried out daily, their purpose is to prevent the formation of scars on soft tissues.
- Physiotherapy. The doctor prescribes these measures to speed up the healing process and prevent the inflammatory process. It is worth noting that the most effective way would be to use complex therapy, which will include all the types of rehabilitation considered.
- Proper nutrition. There will be no diet with a limited list of products. However, doctors recommend eating foods rich in calcium, vitamins and iron.
Step-by-step rehabilitation
The recovery process can be divided into three stages. It should be said that any procedures are performed only after the removal of the plaster cast. Up to this point, the patient needs physical rest and avoidance of stress. So, rehabilitation in three steps:
- First, let's talk about massage and rubbing. As already noted, these activities help prevent scarring. Massage is carried out with the help of a special cream, the action of which is aimed at tissue repair. As part of the first stage, many doctors recommend taking baths with sea s alt, undergoing magnetotherapy sessions andmake wraps with wax. For now, you can forget about the loads on the limb, you should move around with the help of a crutch or a cane. At first, it is not recommended to do any exercises, first you need to develop a limb. Wiggling the toes, lowering and raising the leg will be enough.
- The second step is considered the most important in the recovery process. The goal is to return all possible functions to the leg. To achieve the desired result, you need to continue to perform massage and rubbing procedures. In addition, you need to exercise, walk more. If possible, you should hire a specialist who will do physical therapy with you, as not all tasks will be appropriate in a particular case. And a competent coach will develop a training program that will speed up the recovery process.
- The third stage is characterized by exercises aimed at strengthening the muscles of the ankle. It is then that a person stops limping, he will be able to freely step on the injured limb.
In addition, it is difficult to overestimate factors such as home regimen, following the doctor's recommendations and proper nutrition. Your character, perseverance and patience will only help you recover faster. No one is immune from a fracture of the lower leg, so if an injury occurs, do not panic. First aid, the application of a plaster cast and rehabilitation after an injury will make you feel like a full-fledged person again.
