The word fracture means breaking (discontinuity) of a bone. If bone is fractured,it is known as “asthibhagna” in hindi while dislocation of a bone is known as ‘sandhimoksha’.These two terms are seperate from each other but have causes, symptoms and treatment.
An injury to musculo-skeletal sysem can result in damage to bones , joints, muscles and tendons. In addition to this neuro-msucular bundle and vessels may be damaged .This broad principle is usedin diagnosis of this injury and also used in management of musculo-skeletal injuries.
Causes:-
- Falling down
- Compression
- Trauma
- Jerk,Slip
- Bite
Other voilent injuries like road-accident ,crush injury, earthquake,industrial accident. Sometimes fracture may also be due to certain diseases as osteomalacia, rickets,hyperparathyroidism,tuberculosis and malignancy. In this condition, significant injury results into fracture is known as pathological fracture.Fracture may also due to constant pressure asin policeman,security guard,tetanus,epilepsyand contracture of muscles.
Clinical features:-
1.Tenderness
2.Restricted movements
3.Pain during movements
4.Crepitus(crackling or grating sound caused by bones rubbing against each other)
5.Loss of movements
6.Pain depends on the site & nature of fracture.
eg. in case of rib fracture, pain is maximum at inspiration while on case of femur fracture, slight movement of a limb results in unbearable pain & hence hip joint fracture is known as unsolved fracture.In case of skull fracture there is severe headache.
7.No relief from pain:- The word itself indicates that the patient is suffering from a severe pain & discomfort in all positions such as sitting, standing,elevation & sleeping.
8.Shock
9.Fever
10.Delirium
11.Insomnia & psychosis
12.Ecchymosis (discoloration of skin due to bleeding underneath)
13.Blister formation on 5th day after injury 7 mostly due to unsupoorted skin. To prevent this , immediate support(splint) should be given at the time of injury.
Treatment:-
- Immobilization for 12 weeks
- Anti-inflammatory
- Analgesics
- Avoid lifting weights
Complications of fracture:-
- Nerve injury
- Vessel injury
- Ischemic contraction due to tight POP
- Infection
- Joint stiffness
- Delayed union
- Mal-union
- Non-union
- Surgical shock
- Gangrene
Factors affecting fracture healing:-
- Age
- Sepsis
- Presence of diabetes mellitus & tuberculosis
- Timely management of fracture
- Mal-nutrition
- Administration of antibiotics
- Site of fracture (lower limb takes double time than upper limb)
- Type of bone (flat bones unite faster than tubular bones)
- Pattern of fracture (spiral fracture unites faster than oblique)
- Immobilization (some fractures need strictly immobilization eg. neck of femur)
- Month of fracture (In winter season , healing is faster than others)
Principle of treatment:-
- Rest & immobilization
- Support (splint)
- Cold therapy (reduces hematoma in 48 hrs.)
- heat therapy (reduces pain and inflammation)
- Exercise
- Traction
- Physiotherapy
- Drug- a) Anti-biotics b)Analgesics c)Anti-inflammatory d)Vitamin D
- Reduction- Bone fragment restored in its normal position
- Fixation- After reduction to maintain the anatomical position of bone fragments for a longer period.
Ayurvedic drugs for fracture:-
Prasni-parni churna 1 pinch for 21 days and with it Babul-twak churna with honey for 3 days. it will make your bones like a hard rod.
Some more ayurvedic medicines which are beneficial in fracture are:-
- Abha guggula
- Lakshadi guggula
- Rason vati
- Gandhak oil
Usable Herbs 