Simultaneous fractures of the femur and tibia
Traumatology / / August 12, 2017
Simultaneous thigh bone and shin fractures occur mainly as a result of road and mototravm.Such fractures are also the result of falls from a height of victims.A feature of these lesions is the effacement of the clinical picture of hip fractures, as damage to leg bones break and even distort the features characteristic of the pathology in the hip.The severity of polytrauma determined by the presence of open diaphyseal fractures (at 72.3%).Most combine a closed fracture of the femur and tibia open fracture of bones.In 2/3 patients combined one of the femur and tibia fractures is open.When avtotravmah largely damaged soft tissue, nerves and blood vessels that causes the majority of victims (68%) state of shock.
Diagnosis of bone fractures of the femur and tibia
Diagnostics combined fractures of the thigh and shin bones is difficult for the following reasons: Of course, along with joint and foot is divided into 5 free "parts" that are very mobile and "fall apart in his hands" whentrying to reposition and
First aid for simultaneous fractures of femur and tibia
traumatic shock in patients with concurrent injuries femur and tibia is usually accompanied by large blood loss - up to 1500 ml or more.Therefore, intensive fluid therapy should begin as soon as possible.At the scene to help begin to stop external bleeding (open fractures).Then produce procaine blockade places fractures, complementing their "futlyarnoy" blockade blockade hip or cross-section of the proximal femur (over the wound, pressure bandage, tourniquet).The total dose administered novocaine should not exceed 1 g
Transport immobilization in trauma femur and tibia of one limb
well - the first stage (immobilization shin stair rails);
b - immobilization of the hip bus Diterikhs
- Conservative treatment for multiple fractures of extremities
- First aid for multiple fractures pelvis
- skeletal traction
- spinal cord injuries and cauda equina
- Principles of treatment of concurrent fractures femur bone and tibia
- damage to abdominal organs and limbs
transport immobilization is carried out in two ways: with fixing limb upright Diterikhs bus in combination with a stair rail or fixing limbin a bent position to a functional bus of the assembled ladder tires.In the second method, the limb is immobilized in a more physiological position, as is provided by the best muscle relaxation and creates a mild distraction as the thigh and shin bone fragments in the correct orientation along the axis segments.In the first method initially immobilized shin rear ladder bus, which had previously been carefully modeled on the contour of the rear legs.Aides gently lift the leg behind the knee area (with moderate distraction thigh) and stop at the same time supporting the middle part of the leg and moderate stretching it.Otmodelirovannuyu bus fed by foot, which gently, without interrupting distraction effort is placed on the bus and fix it with a bandage, starting from the lower third of the thigh down to the foot.Thereafter, the tire is applied Diterikhs conventional manner.When immobilizing the limb on the functional bus assistant lifts the leg of the knee joint, thereby creating simultaneous distraction of the femur and tibia.Second assistant holds the foot in the correct position.After laying the first limb of the tire is fixed to the bus area of the knee joint, then hip proximally and shin - distally to the capture of the foot.Complete immobilization strong fixing tires to the body in the lumbar region.
Transport immobilization in trauma femur and tibia components stair rails
Infusion therapy is started immediately after the bleeding stops.In 1-2 vein pressure jet poured 400 ml poliglyukina (zhelatinol), 500 ml bolus laktasola (ringerlaktata) with the addition of 0.25 g of hydrocortisone, 1 ml of a 2% solution of Promedol (4 ml dipyrone 50% solution), 1 ml 1%dimedrol solution.Then pour glyukozonovokainovuyu mixture (500 ml of 5% glucose solution + 500 ml of 0.25% solution of novocaine), infusion and continued during transport.It is shown that local hypothermia.