How many people break an ankle
Every second boy up to the age of 16 breaks a bone. Older people who suffer from osteoporosis can also quickly suffer a fracture if they fall. Doctors treat simple fractures with plaster of paris or splint. With complicated fractures, you often have to screw a lot of metal into the bone
From the little toe to the skull, around 200 bones support the human body, giving it its shape and posture. However, if these struts are stressed too much during sport or in an accident, they can break. Statistically, every second boy up to the age of 16 suffers a fracture. If the bone breaks into only two parts with smooth fracture surfaces, doctors speak of a simple break. If it bursts into several parts, this is called a splinter or debris fracture. In the case of open fractures, the bone shifts so much that it tears an open wound through the surrounding tissue and skin and often emerges from it.
The symptoms of a fracture are usually clear: an audible crack can often be heard - the word bone is probably an onomatopoeic derivative of this sound. The affected area hurts immediately and continuously. The affected part of the body can no longer be stressed, for example if the ankle is broken, the injured person can no longer walk with this foot without pain. Fractures in the extremities often show up through misalignments such as bent forearms or twisted legs.
The surrounding tissue swells. The cause is the blood leaking from the bone. Later on, tissue fluid (the lymph fluid) also collects to form edema. If something presses on this swelling, “the cells burst like ripe cherries after a rain,” says Wolfgang Zenker, chief physician at the Clinic for Trauma and Reconstructive Surgery at the Vivantes Clinic in Friedrichshain. This further damages the swollen tissue, which prolongs the healing process.
The most common causes are twisting of the joints or direct acts of violence, for example from a fall, or direct trauma, as can happen, for example, in certain, more violent team sports. Depending on age and physical health, the bones resist external violence to different degrees. In children, the bones are still quite elastic. Accidents lead to what is known as green wood breakage - the periosteum bends and only the inside breaks. In older people, on the other hand, the bone decalcifies, becomes brittle and splinters more easily. Doctors call this natural decalcification process osteoporosis.
In Berlin alone, more than 39,000 broken bones were treated in the capital's clinics in 2010.
If a fracture is suspected, doctors X-ray the affected part of the body. Because bones are easy to see on X-rays. The computer tomograph is also frequently used, but the magnetic resonance tomograph is less common.
Simple fractures do not require surgery. Because the self-healing powers of the bone are strong and for healing it is sufficient to immobilize the affected extremities, for example with a plaster cast or a splint. This is especially true for fractures where the bone has not splintered or displaced. Instead of the classic plaster of paris, doctors also use plastic bandages for this. These weigh less and are therefore easier on the patient. Open fractures, on the other hand, in which the muscle and connective tissue have also been injured, or bones that have been shattered into many parts must be operated on. Even unstable fractures, in which the bones threaten to slip again, should be fixed surgically. To do this, surgeons connect the broken pieces with plates, screws, intramedullary nails or wires. Fractures requiring surgery, in which the skin was not damaged, can often also be treated in a minimally invasive manner, i.e. through only a few small openings in the skin. The advantage of this procedure is that it has smaller scars. But even with simple fractures, doctors and patients often decide to have an operation, as the metal-fixed bones can be subjected to greater stress - and above all earlier. A longer plaster treatment with frequent x-ray controls and corresponding radiation exposure can thus be avoided. The risk of thrombosis is also lower with a surgical intervention compared to a fracture immobilized with plaster of paris or splint, because the joints can be moved. With each contraction, the muscles pump blood through the veins - this reduces the risk of a blood clot. Are you too old for such operations at some point? Not really, says Zenker. "We recently operated on a 103-year-old."
Just like the skin, the human skeleton is very capable of healing itself. Once the trauma doctor or surgeon has brought it back into its natural position, “a so-called callus begins to form around the break like a pipe clip,” says chief physician Zenker. This initially cartilaginous tissue that becomes ossified over time stabilizes the bone from the outside until it has completely “remodeled” inside. That takes time, up to a year and a half. A fracture that does not require surgery is usually immobilized in a cast for 6 to 8 weeks. After the break has healed, the thickening of the callus also recedes. “The bones are economized,” says Zenker in technical jargon. Or in German: The body only ever uses as much substance as is necessary for the purpose of the respective organ.
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