What are the methods of fracture fixation, and how to fix fractures?

There are two types of fixation methods for fractures: external fixation and internal fixation.

Some people think that after a fracture, find someone who knows how to pinch it, and then paste it or find some medicine to rub it. With the continuous development of medicine, some of the practices that used to be pinched, kneaded, and then pasted have been denied, and some are still continuing. But no matter how it develops, as one of the three principles of fracture ** (reduction, fixation, and functional exercise), the principle of fixation is always the same.

Only if the fixation is really effective, the fracture can heal well.

At present, there are two types of fracture fixation, namely external fixation and internal fixation. The external fixation includes plaster, small splints, polymer materials, external fixation brackets, etc. There are various types of steel plates, screws, intramedullary nails, memory alloy materials, bioresorbable materials, etc.

When you are suddenly injured in daily life and there are no professionals around, the materials that can be obtained nearby such as umbrellas, wooden sticks, books, etc. can be temporarily fixed, and when the external fixation materials cannot be obtained in the field, the lower limb can be fixed with the opposite limb after injury, and the upper limb can be fixed with the chest wall, and sent to the hospital as soon as possible to ask for professionals. It is very dangerous not to try to walk or move a limb to determine if there is a fracture after the injury, as it may make the injury worse. (Sun Jianfeng).

1) The purpose of fracture fixation.

Analgesics, immobilization, relieves the pain of the wounded, prevents aggravation of the injury, prevents shock, protects the wound, prevents infection, and facilitates transportation.

2) Judgment of fractures.

Pain and tenderness, swelling, deformity, dysfunction.

3) Materials for fracture fixation.

Commonly used are wooden, iron, and plastic plywood. Temporary plywood includes wooden planks, sticks, branches, bamboo poles, etc. If a temporary splint is not available, it can be attached to the injured person's trunk or healthy limb.

4) Essentials of fracture fixation.

First stop the bleeding, then bandage, and then fixation; The length of the splint is commensurate with the length of the limb; The protruding part of the fracture should be padded; Tie the upper and lower ends of the fracture first, and then fix the two joints; exposed fingers (toes) on the limbs; Hang a logo on the chest; Rush to the hospital.

5) There are five common methods of fracture fixation.

Forearm fracture fixation.

Place the splint on the outside of the fractured forearm, padding the fracture protrusion, and then fix the wrist and elbow joints (wrist figure 8 fixed) with a triangular scarf.

Hang your forearms over your chest and use a triangular scarf to secure the injured limb to your chest.

Forearm fracture without splint triangular scarf: first use a triangular scarf to hang the injured limb in front of the chest, and then use a triangular scarf to fix the injured limb to the chest.

Upper arm fracture fixation.

First, the splint is placed on the outside of the fractured upper arm, the fracture protrusion is padded, then the elbow and shoulder joints are fixed, the upper arm is hung in front of the chest with a triangular scarf, and then the injured limb is fixed on the chest with a triangular scarf. Upper arm fracture without splint triangular scarf: first use a triangular scarf to hang the injured limb in front of the chest, and then use a triangular scarf to fix the injured limb to the chest.

Clavicle fracture fixation.

Forearm fracture: When immobilized with a splint, two splints can be placed on the volar and dorsal sides of the forearm respectively, and a ball of cotton can be placed in the palm of the affected side of the casualty, so that the casualty can hold one end of the volar splint to make the wrist joint slightly dorsiflexed, and then fixed, and finally hang the forearm in front of the chest with a triangular bandage.

Upper arm fracture: Different from forearm fracture, when the upper arm fracture is fixed, it is necessary to bend the injured limb to the chest, put a splint on the outside of the injured arm, and use two cloth straps to fix the upper and lower ends of the fracture and hang it on the chest after the pad, and then fix the injured arm on the chest with a triangular scarf.

Calf fracture: Place the splint on the outside of the calf, its length should be from the middle of the thigh to the heel, and fix it with a polymer bandage after the knee and ankle joints are cushioned, and then fix the two lower limbs up and down together, and fix the foot with a figure-8 bandage to make the sole of the foot and the calf at right angles.

Thigh immobilization: The polymer splint is placed on the outside of the injured limb, its length should be from the armpit to the heel, the two lower limbs should be aligned side by side, and the knee and ankle joints should be padded and fixed with polymer bandages in sections.

Clavicle fracture: Let the patient sit up straight, bandage the immobilizer with one knee between the patient's back and shoulder blades, and gradually pull the patient's shoulders back with both hands to make the chest as forward as possible, and then use a splint to fix it. The fixation method is to pad cotton pads under the armpits of the injured person, use two triangular scarves to wrap around the shoulder joints for two weeks and tie a knot at the shoulder, and the triangular scarf should be pulled tight when knotting, so that the shoulders are slightly stretched back, and the patient's elbow joints are flexed after the knot, and the two wrists are crossed in front of the chest, and another triangular scarf is used to bypass the chest at the flat elbow, and the upper limbs are fixed in the chest knot.

Spine fracture: vertebral fracture in the rescue process, the most important thing is to prevent spine bending and torsion, after the spine fracture, the wounded should lie on their back, the doctor should give the wounded a neck brace as soon as possible, when there is no neck brace, you can use sandbags or clothes to fill both sides of the head and neck to prevent the head from shaking left and right, and then fix it with a polymer bandage.

The fixation method after fracture is divided into two categories: internal fixation** and external fixation**, and internal fixation is suitable for more serious fractures that require surgery to maintain the stability of the joint. X-rays can be taken to determine the severity of the fracture and then a reasonable fixation method can be chosen.

The external fixation method is suitable for some relatively minor fractures, or fractures of special parts, such as rib fractures, pelvic fractures, etc., and also requires the use of some orthopedic consumables, such as rib fixation plates, medical fixation belts, etc.

Fixation is to maintain the fracture in the reduced position, so that it can achieve firm healing under the condition of good alignment and alignment. Immobilization is key to fracture healing. There are two types of fixation methods for fractures, namely external fixation

For fixation on the outside of the body, and for fixation on the inside: for fixation on the inside of the body.

1) External fixation: External fixation is mainly used for patients after manual reduction of fractures, and some fractures need to be fixed after open reduction and internal fixation. At present, the commonly used external fixation methods include small splints, plaster bandages, and medical educationThe education network collects and organizes abduction racks, continuous traction and external fixators, etc.

1) Small splint fixation:

Indications: Closed tubular fracture of the extremities, but femoral fracture requires continuous bone traction due to strong thigh muscle traction; Those with open fractures of limbs with small wounds that have healed after treatment; Old fractures of the limbs are still suitable for manual reduction.

2) Plaster bandage fixation.

Indications: After debridement and suturing of open fractures, small splints should not be used before the wound heals; Fractures of certain parts, small splints that are difficult to fix, such as spinal fractures; After open reduction and internal fixation of certain fractures, medical education |For example, after intramedullary nail fixation of femoral fracture or steel plate screw, it is used as auxiliary external fixation; maintenance of the orthopedic position after deformity correction and fixation after osteoarticular surgery, such as after wrist arthrodesis; Fixation of limbs affected by septic arthritis and osteomyelitis.

3) Abduction frame fixation: mainly used for upper limb fractures.

4) Continuous Traction Citation:

Indications: Cervical fracture and dislocation: occipitomandibular bracket traction or skull traction; Femur fracture:

femoral ** traction or tibial tuberosity bone traction; or open fracture of the tibia: calcaneal traction; open fractures with infection; Supracondylar humeral fractures with difficulty in reduction: olecranon traction of the ulna.

5) External fixator:

External fixators are suitable for: open fractures; closed fractures with extensive soft-tissue injury; fracture with infection and nonunion of fracture; After osteotomy or arthrodesis.

The advantages of external fixators are reliable fixation, easy wound management, no restriction of joint movement, and early functional exercises.

2) Internal fixation: Internal fixation is mainly used after open reduction, and the fracture segment is fixed at the position of anatomical reduction by using metal internal fixations, such as bone plates, screws, intramedullary nails or intramedullary nails with locking and compression plates.

Basic principles: stop bleeding first, then bandage, then fix, and then transport.

a.To prevent secondary infection, the fractured end of the piercing wound should be returned as soon as possibleWhen using splint fixation, it is advisable to fix the strip that can move up and down 1cm

In order to save rescue time, the splint should be fixed directly against the affected limbFor severed limbs, they should be wrapped in sterile tolins and kept at about 37 Check the answer analysis [Correct answer] b

Do not return the fractured end of the puncture wound to avoid causing infection. When using a splint for fixation, it is advisable to use the fixed strip to make a belt that can move up and down LCM. There must be padding between the splint and the limb to be immobilized.

In case of severed limbs such as severed hands and fingers, the severed limbs should be wrapped in sterile towels, placed in intact plastic bags, and placed with ice cubes around them to reduce the metabolism of the severed limbs.

Answer]: If there is wound and bleeding, the bleeding should be stopped and bandaged first, and then the fracture should be fixed, and if there is shock, anti-shock treatment should be given first; When dealing with open fractures, do not return the punctured bone end to the wound to avoid infection; The length and width of the splint should be appropriate to the fractured limb, and its length must exceed the upper and lower joints of the fracture; The splint should not be in direct contact with **, and cotton or other items should be padded during it; The fixation should be moderately tightened so as not to affect blood circulation; Avoid unnecessary movement during immobilization, and do not force the wounded to carry out various activities.