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Fracture of edges
Edges are the framework of a human trunk representing pair elements of axial part of a skeleton which connect to a backbone. They form a thorax in which the majority of vitals is located. A fracture of edges are one of the most widespread injuries of a thorax, the representing injury of costal bones with disturbance of their integrity. Fractures of edges lead to internal injuries of respiratory system, heart, pleura, intercostal vessels. The change in difficult cases can lead to a lethal outcome therefore you should not self-medicate.
Injuries of a thorax happen open, arising owing to blow of a thorax, wound from firearms and others. The closed damages arise at blows owing to which bruises, hematomas, fractures of edges, and also squeezings of a thorax are shown. The fracture of edges is the most widespread disease among the closed injuries of a thorax (67% of the closed injuries). The IV-VIII edges of the back and average axillary line most often suffer from changes.
Impacts on edges can life direct and indirect. At direct influences of an edge cave in inside, towards a pleural cavity, and its fragments can damage bodies, a lung or a pristenochny pleura. During indirect influence there is a squeezing of a thorax owing to what edges break in both parties from the place of squeezing. Usually break several edges at once. Bilateral changes lead to loss of stability of a thorax, and also to plevropulmonalny shock and disturbance of ventilation of the lungs. There are also fenestrated changes, i.e. on the one hand in two places. A fracture of edges are most often observed at people 40 years are more senior that is connected with age changes of a bone tissue. At children fractures of edges happen very seldom, because of elasticity of a thorax, and at elderly people small injuries can lead to multiple fractures. Divide an edge crack, a subperiostal change at which the bone tissue and a complete fracture of an edge which most often happens on site a bend of edges breaks, i.e. on lateral surfaces of a thorax, in all cases there can be same symptoms of a fracture of edges.
The direct and indirect injury of a thorax, for example, falling on the acting subject is the reason of a fracture of edges, at a direct stroke, when squeezing a thorax, arrival of the car, a car accident.
Symptoms of a fracture of edges
The main symptoms of a fracture of edges are:
- Severe pain at breath in the field of damage. At a pain breath acute, amplify at cough and deep breaths.
- Swelling in the field of a change, morbidity of a palpation.
- Hurried breathing, usually damaged part of a thorax lags behind in breath. There can be developments of stagnation that leads to development of posttraumatic pneumonia.
- Formation of bruise on site change.
- At palpation the poskripyvaniye of a fatty tissue is felt (crepitation).
- Bleeding through upper respiratory bodies in a thorax that can lead to death.
- At injury of a lung – a pneumorrhagia, hypodermic emphysema, accumulation of blood and air in a thorax.
It is important to note that at a change of back departments of edges respiratory frustration are expressed poorly.
Treatment of a fracture of edges
To diagnose a fracture of edges, the doctor will carry out percussion and auscultation, and also will appoint a X-ray analysis. These researches will allow to exclude availability of liquid in pleural area. On a x-ray film it will be visible, there is a change or not.
Treatment of a fracture of edges consists of several stages. First of all the damaged part of a thorax by carrying out novocainic (10 ml of solution of Procainum) or alcohol-novocainic (9 ml of solution of Procainum and 1 ml of alcohol) blockade is anesthetized. At a multiple fracture appoint juxtaspinal blockade Procainum solution, and in case of multiple bilateral fractures – skeletal traction for a breast.
In difficult cases apply surgical treatment of a change – a medical immobilization. If there is a need – carry out a puncture for a conclusion of the accumulated blood. Absolute rest is shown to the patient, and usually for rehabilitation in uncomplicated cases it is required of four weeks. Expectorants, methods of physical therapy and respiratory gymnastics which is directed to the prevention of developments of stagnation in bodies of a thorax are appointed.
At uncomplicated changes impose gypsum, and at multiple fractures carry out treatment in a hospital. If the patient is tormented by severe pains and to avoid development of posttraumatic pneumonia, novocainic and other blockade to the place of a change are appointed.
It is not necessary to conduct treatment of a fracture of edges independently, however it is possible to give first aid. It is necessary to put ice to a sore point, to accept an ibuprofen, to make a compressing bandage of bandage and a towel, in the provision of "half-exhalation" and to go as soon as possible to the doctor. Take to hospital of the patient in the semi-sitting or lying situation.
Injuries of a thorax lead to complications. Them are development of pneumonia, a hemothorax and pheumothorax, and also a bruise of a lung and heart. The fracture of the lower edges can lead to damages of abdominal organs, for example, of a liver and a spleen.
Section: Orthopedics and traumatology