The so-called fracture, as its name implies, refers to the complete or partial fracture of bone or bone structure. More common in children and the elderly, young and middle-aged also occur from time to time. Patients usually have one fracture, and a few have multiple fractures. After timely and proper treatment, most patients can recover their original functions, and a few patients can leave different degrees of sequelae. After the fracture, those close to the hospital can be sent directly to the hospital or called an ambulance. For patients who are far away from the hospital, simple treatment must be carried out to prevent their illness from getting worse on the way to the hospital, or even causing irreversible consequences.

(1) Etiology and incidence

The main causes of fracture are trauma, such as injury, collision, squeezing, falling, etc. Followed by systemic diseases and diseases of bones themselves. Such as chondroma, scurvy, osteomalacia, bone tumor, bone cyst, acute and chronic osteomyelitis, etc. Some fractures are related to fatigue and occupation, such as foot fracture caused by overwork, hand fracture of machine tool workers and so on.

(2) the patient's performance

After the fracture, the patient's expression was painful and local pain appeared. The child is crying. The fracture site may have swelling, congestion, deformation and dysfunction. When touching the local area, you can feel the bone deformation, obvious tenderness, abnormal activity and bone stubble rubbing sound.

(3) Family maintenance

1. Emergency treatment

(1) If there is any skin wound or bleeding, the visible dirt should be removed, and then the wound should be bandaged with clean cotton or towel under pressure.

(2) When the limbs are bleeding from an open fracture (the broken end of the fracture is exposed through the wound), ropes or steel wires should not be used to bind the limbs. You can wrap the wound with a wide cloth strip and a rubber hose. Don't tie it too tightly to avoid bleeding. Relax for l-2 minutes every 1 hour. The tourniquet should be tied to the upper arm 1/3 to avoid damaging the radial nerve.

(3) Upper limb fractures can be fixed with boards or wooden roots and cardboard, and then hung around the neck with bandages or ropes. Lower limb fractures can be fixed with wooden boards or roots, or both lower limbs can be tied together to achieve the purpose of fixation.

(4) Pelvic fracture, tie the pelvis with a wide cloth. The patient lies on his back with his knees half bent, and puts a pillow or clothes under his knees to stabilize his body and reduce shaking.

(5) After the above treatment, the patient can be transported to the hospital. Gently move the patient to avoid bending and twisting the injured limb. When transporting patients with thoracolumbar fractures, 2-3 people hold their heads, shoulders, hips and lower limbs at the same time, and put the patients on stretchers or wooden boards. When transporting patients with cervical vertebra fracture, 1 person pulls and fixes the head, others carry a stretcher on the trunk, and then fix the neck and head with cotton-padded clothes. When transporting patients with lower limb fractures, 1 one person can hold the injured limb, and others can carry the stretcher to the trunk. Most patients with upper limb fractures can walk by themselves. If transportation is needed, the method is the same as that of patients with lower limb fractures. After first aid and hospital treatment, patients need to go home to recover. Family members should pay attention to medication and nutritious diet, and pay attention to strengthening nursing and assisting early functional exercise.

2. Family medication

(1) Two cod liver oil pills, taken orally three times a day.

(2) Four calcium tablets, taken orally three times a day.

(3) Shenyang Yao Hong 2 tablets, taken orally, three times a day.

(4) Da Die Pill 1 pill, taken orally twice a day. Or take Hegu Pill L orally, twice a day.

(5) Qilisan is made into paste with yellow wine and applied to the fracture, and the dressing is changed daily. These drugs can be taken in combination or mixed.

3. Traditional Chinese medicine and folk prescription

(1) 500g of Podocarpus, 30g of Dipsacus, 30g of Jiegudan, 75% alcohol15ml, 5ml of turpentine, and a proper amount of cactus. Mashing and mixing the above materials into paste, and externally applying to the affected part with a thickness of 0.5 cm, and replacing within 5-7 days 1 time.

(2) 30g of Cortex Phellodendri and Radix Dipsaci, 65438 08g of Radix et Rhizoma Rhei, Sanguis Draxonis and Os Draconis, and 65438 05g of Carthami Flos, Rhizoma Corydalis and Achyranthis Radix. Grind the medicine into powder, mix it with honey or boiling water and apply it to the fracture, and change it every other day.

4. Nutrition and diet

Fracture patients can cause metabolic changes due to pain, bed inactivity and poor digestive function, the most obvious being the negative balance of protein (that is, the consumption of protein is greater than the intake of protein in diet). Blood loss caused by trauma is also the loss of nutrition in the body. Both fracture healing and soft tissue repair need adequate nutrition supply. If the diet is not well regulated and the nutrition can't keep up, it will not only affect the patient's tolerance to fractures and soft tissue injuries, but also affect the healing of bones and wounds and the rehabilitation of the sick body. Fracture patients need to eat some easy-to-digest, nutritious and light food, and should adopt a diet with high calorie, high protein and high vitamins. They should eat more animal liver, belly, ribs soup, chicken, eggs, fish and bean products, milk, and more vegetables and fruits.

5. Home care

(1) Most fracture patients need to stay in bed for a long time, so they need to take care of themselves in life and think more about physical recovery. So they need patient, meticulous and thoughtful care from their families. Don't show any unpleasantness in front of the patient, so as not to cause misunderstanding. Talk to patients often, give them more comfort, let them feel the warmth and goodwill of their families, and enhance their confidence in recovery.

(2) Skin care is particularly important for patients who have been bedridden for a long time, especially those who are fixed with plaster and paraplegic. Patients with plaster fixation should keep their skin clean and dry, and the sheets should be flat and wrinkle-free. Paraplegic patients should turn over every 2 hours and massage the compressed parts with 50% alcohol or talcum powder to prevent bedsores.

(3) the use of bedpans. Bedridden patients need to use a bedpan to urinate and urinate, and when using the bedpan, use a pillow to pad the upper body; If you need to stay in bed for a long time, you can open a hole by the bed. When defecating, put the bedpan under the hole, put a small piece of tarpaulin or plastic cloth under the hip, and lift it from the upper edge of the hole to keep the hole and its surroundings clean.

(4) to prevent foot drop, pay attention to maintain the functional position of the injured limb, and prepare a support frame on the bed to prevent local oppression and foot drop.

6. Rehabilitation measures

(1) Strengthen functional exercise. Patients who stay in bed for a long time, such as improper activities, often lead to muscle atrophy, joint stiffness and swelling at the ends of limbs. Therefore, the injured limb should maintain proper functional position and move in bed, such as thigh muscle contraction, toe and ankle movement. You can also tie a rope on the beam, bed or wall of the house to exercise the upper body and upper limbs, and try to let the patients wash and eat by themselves. You can exercise with a grip ring, fitness ball and fitness stick in your hand to achieve the purpose of activities.

(2) Without affecting the fixation and healing of fractures, patients can help others or use crutches, get out of bed early, exercise early, and carry loads at night. The amount of activity is from small to large, so don't be impatient.

(4) Precautions

1. When the patient is suspected of fracture, take local materials, stop bleeding simply, bind up and fix it, and send it to the nearest hospital in time. Never reset it casually.

2. During the treatment, you should obey the disposal of medical staff, take medicine on time, and never do it yourself.

3. Under the guidance of a doctor, exercise in time, mainly to exercise muscles, contract and relax rhythmically 1-2 weeks after injury; Strengthen joint activities in 3-6 weeks, gradually increase the amount of exercise, closely observe the situation of fixed parts and the color and sensory activities of distal limbs, and contact a doctor in time if there is any abnormality.

4. Pay attention to hygiene in bed for a long time to prevent the breeding of lice and maggots.

5. Avoid getting hurt again.

(5) common sense of prevention

Some patients can avoid fractures, which requires everyone to pay attention to safety in daily life and work to reduce fractures. Children walk unsteadily and fall easily, especially not playing at heights. We should educate and care for children and avoid falling. Teenagers play more and are curious. Parents and teachers should do a good job in education and don't climb the wall. Young and middle-aged people should concentrate on their work, ride bicycles and pay attention to safety everywhere. Old people are inconvenient, so try not to go out in rainy days and at night. Someone should hold hands or crutches when going out, and use lighting tools when going out at night. It's best not to ride a bike in the street or go to a crowded public place.

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