How is the immobilization in the hip fracture?
Immobilization during fracture of femur is used in those cases when a person is injured the neck of the femur bone. Such injuries account for 50% of the total number of fractures of the femur. For the rapid assist to the affected person doctors do in these cases, the plan for immobilization. According to it the patient gets to the emergency first aid and is then transferred to the hospital, where preliminary activities before handling the victim.
Different types of fractures of the femoral part of the leg
These types of injuries can be divided into 3 main types:
- Fractures of cervical and trochanteric area in the hip.
- Fractures in different parts of the diaphysis.
- Supracondylar or razmyshlyaya damage.
All the above lesions of the femoral part of the leg are accompanied by a severe traumatic shock, and they are referred to severe types of fractures.
If the injury of the femoral neck occurred in a patient in the so-called trochanteric region, the General condition of the patient can be complicated by large blood loss in case of massive damage. Such fractures are characterized by falling on the area of the hip joints. This occurs most often with persons aged 50 years and older in the development of osteoarthritis.
When impacted the damage possible eversion and shortening of the limb to 2 cm All of these types of fractures have common symptoms:
- Pain that is not intense in nature.
- Strengthening of pain when attempting to move the limb.
- The inability of the injured person to tear off a foot from the surface on which it is located.
- Possible cases with impacted by trauma, when the patient is able to move around a bit.
All of these factors must be taken into account when rendering first aid to the injured person.
If the injury is received as a result of direct impact to the hip, then there diaphyseal fractures, which are often accompanied by dislocation of a fragment. The state of a person with that kind of damage very difficult. He can't rely on a broken limb, and the thigh is experiencing deformation. Thus the fragments movable, they are crepitus. The leg is shortened, and its peripheral region is subjected to rotation. When the feeling of fingers patient feels pain in certain places. The same happens when the axial load on the injured limb.
How is vehicle immobilization?
If the fault occurred in the trochanteric area, the patient applied a splint. When transport immobilization is the fixation of the limbthe patient with simultaneous traction to a leg injury.
For these purposes often use so-called bus Diterihs. While transporting the injured person must be carried out very carefully. This is because in impacted fractures there is a danger at the slightest shaking their transition into a fracture with displacement of bone fragments. This can lead to damage to blood vessels supplying the thigh with blood.
When diaphyseal fractures first aid to the patient should be provided with the removal of shock and pain. To do this, give the patient pain medication. Then on the damaged limb is superimposed a pneumatic tyre or a device of Diterihs. If there is no such equipment, you can use homemade devices made from the material at hand. For this you can use any sticks, boards, plywood, or slats. They need to lock in a certain position of the knee, hip and ankle joints. In an extreme case, to immobilize, you can use the bandage, which to the healthy limbs tied to the damaged leg so it would not move.
If at this point, do doctors have the right devices, the patient must spend a blood transfusion and to introduce the antishock drug. Then they inject a respiratory analeptic. In order for the patient withstood the carrier, his cardiovascular system strengthen special tool. Transporterowych such a patient in the hospital on a stretcher made of a rigid material.
The rules applying improvised splint devices
For firm fixation of the injured extremity of an affected person doctors use two rigid elongated object, imposed from opposite sides.
If necessary, transfer the patient across large distances, it is recommended to use a third object. The imposition of a homemade splint device is adjusted to the anatomy of the injured area subject to the conditions:
- Securely locks the ankle, hip and knee joints.
- Bus device must not occur in areas exposed bone or skin defects.
- To stabilize the blood circulation in the joints it is necessary for them to put a layer of soft material.
The first tyre has to be imposed from the outside, and the second - from the inside.
If you need the third element, then it is placed on the rear surface and grab the foot. Bus parts privinchivayutsya tightly to the legs of the victim and hisbody.
To reduce pain to the patient it is necessary to give an anesthetic. It is desirable to use morphine or promedol, but most often at hand is a cold sores or cetanol. In extreme cases you can give the patient a small dose of strong alcoholic beverage.
The injured man was transported in the supine position, otherwise it may develop embolism, or begin bleeding. You cannot allow the patient to move independently. It is not recommended to tighten the bandages on bandages: this leads to violation of blood supply of the hip joint.
It is necessary to follow the color of the limb of the patient if he began to change, it is necessary to loosen the bandage.
It is impossible to prevent sagging stop, if they are not immobilized or fixed at an angle to the axis of the limb is greater than 90°. A layer of soft padding needs to be sufficient to avoid bedsores.
First aid to the injured in hospital
Initially, the patient with a hip fracture carried out sanitary processing, and then transfer him to the gurney. It (depending on the severity of the injury) are transported in an office with x-ray equipment. In the case where this is not possible, put the injured man on the bed and examined it using x-ray station. In the area of the fracture for eliminating pain syndrome injected 40 ml of a 1% solution of novocaine or make a subcutaneous injection of 1.5 ml of a one percent mixture of morphine.
Then over the thigh above the condyles impose exhaust installation for bones and gauze or lip traction hook for a shank.
To resolve the movement of different fragments doctors use cargo, which weight is 1/6-1/7 of the total weight of the patient. In all cases of diaphyseal fractures of the thigh-bones is recommended to use the so-called skeletal traction. It is seen as a preliminary event before surgery. Osteosynthesis (surgery) is done with the help of metal screws, plates or nails.
In the trochanteric fractures of the femur preparatory stage begins with the pain of the procedure by the means described above. Then, when the presence of blood loss to him is a blood transfusion. In the next stage overlaps with the exhaust system of the skeleton with a load no more than 5 kg Then 30-40 days, and the displacement of the debris - after 60 days, the unit is removed. The patient is sent for a course of physiotherapy and massage. Full load on the injured leg can be restored in 90-120 days.
When impactedfracture of the femoral neck measures of immobilization needed to prevent displacement of the fragments and their wedging. To do this, the injured leg of the injured person's doctors are placed on the tire fixture Böhler and strengthen the skeletal system drawing with the load of 2 kg. the Patient should be kept in this state for 60-90 days. Gradually loading the leg will be in six months. To prevent wedging of fragments can be applied osteosynthesis, which is performed by special screws made of metal.