Health guide:
1. Exercise to strengthen the body: We should actively persist in exercise for a long time, increase outdoor activities, breathe more fresh air, and promote systemic blood circulation and metabolism. You can choose walking, jogging, Tai Ji Chuan, aerobics and other projects. More activities can make more calcium in the blood stay in the bones, thus improving the hardness of the bones and effectively reducing the occurrence of fractures.
2. More sunshine: sunlight can promote the synthesis of vitamin D, and the metabolism of calcium depends on the role of vitamin D; Ultraviolet rays in sunlight can promote the formation and absorption of calcium in the body, maintain normal calcium and phosphorus metabolism, increase calcium in bones and improve bone hardness.
3. Take preventive measures before getting sick: the elderly should not go to places where there are many people and cars. Don't go out when it rains, snows or there is water or ice on the ground, so as not to fall and break. Don't climb stairs or climb mountains, and don't walk on steep slopes, because the elderly are weak, unresponsive and prone to fall. When you go out, you must walk slowly. If you have dizziness, deafness, dizziness and other symptoms, you should try to reduce going out. When you have to go out, you should be helped to walk or walk with crutches. Before going to the toilet at night, you should sit on the edge of the bed for a while, so that the leg muscle strength is in an excited state to prevent the occurrence of temporary hypotension when the body position changes. When taking a bath, prepare a small stool, wear pants and shoes to prevent falling.
Diet adjustment: Eating more vegetables, protein and a diet rich in vitamins can prevent the occurrence and development of osteoporosis. The diet should be light in the early stage of fracture, which is conducive to removing blood stasis and swelling, and heavy in the later stage. Choosing a proper diet to supplement liver and kidney is beneficial to fracture healing and functional recovery.
5. Close observation: After the injury, if you suspect a fracture, you should go to the hospital for treatment in time. Necessary temporary fixing measures should be taken during the transfer. If the upper limb fracture is fixed with a wooden board, the length of the wooden board should exceed the upper and lower articular surfaces of the fracture site. You can also tie the broken arm and chest together and fix it. For lower limb fractures, the affected limb can be tied together with long wooden boards, the length of which exceeds the heel from armpit to bottom, or the affected limb can be tied together with another healthy limb for fixation. Spinal fracture should be moved to the board by two people in parallel and tied and fixed. For cervical spine fracture, sandbags should be placed on both sides of the head before being sent to the hospital to limit head movement. If there is bleeding, the wound should be temporarily bandaged with a clean cloth and then bandaged with a tourniquet. Generally, the ligation time of tourniquet should not exceed 1 hour at a time, and the tourniquet can be loosened 1 ~ 2 minutes every1hour to see the blood flow, which can prevent limb ischemia and necrosis caused by too long ligation time. After fracture fixation with plaster and other methods, it is necessary to closely observe the changes of skin color and swelling of the injured limb within 24 hours. If the swelling is aggravated and the skin is bruised and purple, you should see a doctor immediately, relax or remove the plaster to prevent limb ischemia and poor reflux caused by too tight plaster fixation. The fixed period of fracture should be reviewed regularly according to the doctor's advice.
Functional exercise: under the guidance of a doctor, actively exercise uninjured joints, every hour 100 times a day, to avoid joint stiffness, contracture and muscle atrophy. Self-massage combined with light massage can promote local blood circulation and is beneficial to the recovery of fracture.
Deputy Chief Physician of Donghua Orthopaedics
People who are suddenly injured and fractured, especially those who are in shock or even coma, have no greater mental burden psychologically. The conscious wounded, in the absence of preparation, suffered great pain, fell into extreme tension, and some felt uncertain about life and death and were very scared. At the scene of the accident, rescuers and the families of the wounded must remain calm and calm. On the one hand, we should try our best to rescue as soon as possible and try to send it to a nearby hospital. At the same time, comfort the wounded and relax. For those who are seriously injured. Use words, eyes and body movements to encourage them to be strong and eliminate despair. You know, panic, crying and tears are all malignant stimuli to the injured.
After the fracture patients are admitted to the hospital, they should also pay attention to psychological treatment and nursing during the first aid. Some doctors and nurses confess their illness in front of the patient's leaders or family members, saying that treatment is difficult and they will be disabled, and even say that they are dying and hopeless. This may be true, but it seriously hurts the patient's psychology and violates medical ethics. Even if it is critically ill, it should be explained separately to the unit and family. Medical staff should make patients feel trusted and safe through their own image and language. Patients should be comforted. Although his illness is very serious, it is not hopeless. It is unfortunate to be injured, but it is lucky to be admitted to the hospital alive.
After the initial treatment, the wounded may have a sense of psychological security and feel better, but most of them are afraid of pain and surgery. Pain is inevitable in early and late fracture reduction or surgical treatment. The more afraid you are ideologically, the more sensitive you are. Especially the groans and cries of other patients in the ward will irritate each other. At this time, the family members of patients should not excessively accommodate the unreasonable demands made by patients on medical staff. You can reflect the changes of the illness to the medical staff, at the same time give the patients spiritual comfort, and talk to them about things unrelated to the injury, so as to distract attention and reduce the pain. You should also look natural when visiting patients. If you pull a long face, patients will think that their condition has worsened, and the consequences will be bad, and a calm mood will easily lead to depression.
Some patients are anxious for the fracture to heal immediately after injury, "eager to seek medical treatment", seeking medical treatment everywhere and using drugs indiscriminately may interfere with the treatment process. In this regard, it is best for doctors to formulate a treatment plan as soon as possible, inform patients and their families, and make appropriate explanations. Fractures are different from ordinary flesh wounds, and stitches can be removed in a few days after suture. Different parts and types of fractures have different treatment time, but generally speaking, the treatment time is relatively long, ranging from 1 month to more than half a year. Let the wounded have a plan in mind and arrange their work and life reasonably.
The disability rate and deformity rate of fractures are high, some of them fully recover, and they may also leave trauma or surgical scars, which have a great impact on the appearance of the body. Patients, especially young women, are often particularly concerned about this. Sometimes I am unhappy about it and even lose confidence in life. Some patients worry that their disability will affect their career, marriage and family. So they frown all day; Some people become irritable. Medical staff should do a good job of explanation, and family members and relatives should also understand patients and be considerate from all aspects to comfort them: "Why worry about not burning firewood?" Don't worry too much. As long as it is treated in time and hard functional exercise is carried out in the future, it can return to normal and make up for the loss. Even if the injury left some sequelae and caused some losses, it can be minimized. For the wounded who are left paralyzed or physically disabled, we should use the deeds of Chinese and foreign celebrities and heroes, such as Pavel Colta King, Wu Yunduo, Zhang Haidi, etc., to inspire them, face the reality, establish confidence in overcoming disability, and ensure that the disabled are not disabled.
After the fracture enters the recovery period, the joints often become stiff after removing the plaster or splint, and feel pain or swelling after a little activity. Due to long-term inactivity, the muscles of limbs atrophy and the girth becomes thinner. Many patients are worried about whether they can recover, and some people speculate that the doctor has cured them. I'm afraid I'll be disabled for life, so I'm on tenterhooks all day and don't think about tea and rice. In fact, this situation is a normal phenomenon in the process of recovery, which can be explained to patients. This is caused by the adhesion inside, between muscles and around muscles when the joints are fixed, which may be eliminated after a period of rehabilitation exercise.
Functional exercise in the recovery period of fracture is very important and quite painful. Many patients are afraid of pain and difficulties, and some patients pin their hopes on drugs and medical devices. Some relatives and friends of fracture patients, starting from their feelings, refused to let them suffer, disobeyed functional exercise, waited passively and did not practice for a long time. It must be understood that some pain and swelling reactions are normal at the beginning of exercise. Functional exercise is the only way for limb rehabilitation, which can't be replaced by any oral, smearing and advanced instruments. If you don't practice today, you won't move tomorrow. The pain will continue and the swelling will go away. Family members should encourage patients to help overcome their fear of difficulties, and also praise and encourage small progress.
In addition, we must overcome the psychology of being eager for success. Some patients can't wait to remove the plaster and splint today and be free to move tomorrow. Some quack "doctors" cater to the psychology of these people, pulling the stiff joints with rough force, causing injuries and bleeding inside and outside the joints. If it causes pain, it will also cause serious adhesion and affect the therapeutic effect. Never fall for it.
Xu Donghua, fracture internal fixation instrument
The treatment of fractures can be divided into two categories. The first kind is to combine broken bones in various ways, and then fix and protect the skin with plaster or splint to heal the fracture. Here, plaster and splint are external fixation devices. If this method can't be used, "or the effect is not good, the second method-surgical treatment is needed: the doctor cuts the skin, aligns the broken bones accurately under direct vision, and then fixes them with bone plates, screws, steel needles and other bone-setting equipment. These bone fixation devices are internal fixation devices.
After the fracture healed completely, the internal fixation instrument lost its function. Is it better to leave the internal fixation device in the body or take it out at this time? After repeated tests and selection, the metal used to make internal fixation instruments is safe and non-toxic to human body and has good compatibility. However, they are fundamentally different from the living tissues of the body. After all, it is a foreign body, and staying in the body for a long time may cause a variety of adverse reactions.
First, it can induce delayed infection. Pathogenic microorganisms, such as bacteria, can often enter the human body with slight trauma to skin and mucosa and low local resistance. The living tissue of the body is covered with capillaries, which contain white blood cells that recognize and attack pathogens, and can quickly annihilate pathogens. Hard steel plates and needles placed in bones, because they have no blood vessels and lack this resistance, can easily become hiding places for bacteria. Bacteria grow and multiply, leading to infection.
The second is to cause osteoporosis nearby. The basic functions of bones are protection, support and movement, in short, stress. Within a certain range, the more stress, the stronger. Internal fixation equipment, especially steel plate, has the function of stress shielding. It bears the stress that the bone should bear, which is conducive to maintaining posture and restoring motor function in the early stage of fracture. But after the fracture healed, it had shortcomings. Due to the lack of stimulation, the nearby bones will become looser and looser. Osteoporosis is too loose, and the screw needle is not fixed firmly, which will lead to another fracture.
Thirdly, the internal fixation instrument placed outside the bone will stimulate the soft tissue and produce complications such as bursitis. For example, the tail of intramedullary nail for femoral fracture is located on the deep surface of hip skin and muscle. Due to joint fracture activity, synovial sac inflammation can be formed on the surface, leading to edema, which can cause pain or limit joint activity. In some cases, if the internal fixation device for children's fractures is not removed for a long time, with the growth and development of children, the position of the internal fixation device may change, compressing nerves and blood vessels, causing serious complications such as paralysis or hemangioma.
Fourth, individuals can have electrolytic reactions. Human blood, lymph and tissue fluid contain various ions, which are electrolyte solutions. Although the chemical properties of internal fixation steel plate are quite stable, it will also cause obvious electrolytic reaction over time, leading to tissue edema. Therefore, the internal fixation instruments for fractures should generally be taken out at an appropriate time after fracture healing. This timing is very particular. The time of fracture healing is related to the location and type of fracture, the patient's age, nutritional status and treatment methods, ranging from one month to more than half a year. But this does not mean that once the fracture heals, the internal fixation device should be taken out immediately. Early callus is hard osteoid, mostly spindle-shaped, covering the broken end of the fracture. Its appearance is rough, its internal structure is chaotic and its firmness is poor. It is too early to remove the internal fixation instrument at this time.
With the continuous movement and exertion of joints, the bones of those parts with great stress gradually harden, while the redundant callus is destroyed and absorbed by osteoclasts. After this transformation, the broken bones are fused up and down, which is very strong. At this point, the internal fixation equipment can be removed. The exact timing should be decided by the doctor. Except those that cause complications, in principle, it is better to postpone appropriately than advance. Pressurized steel plates are very strong. After fixation, it bears most of the stress of the bone, and the shaping period after fracture healing is often longer, so it is easy to fracture again when the steel plate is taken out early. Therefore, the removal time is longer than that of ordinary steel plates. Foreign experts suggest that the time to take out the internal fixation device is: tibia 1 year, femur 2 years, forearm bone and humerus 1.5-2 years. Individual patients with high surgical risk or elderly patients can also be temporarily removed and observed for a long time.
In a few cases, the position of internal fixation instruments is just close to nerves and blood vessels, and the anatomical level of the second operation is not as clear as that of the first operation, which increases the chance of injury. In addition, because the bone grows too fast, or the tail groove of the screw is damaged and shallow, or the nail, needle and steel wire are broken, it is difficult to find the internal fixation instrument, and it is troublesome to take it out, or even impossible to take it out. Experienced orthopedic surgeons will handle it appropriately according to the specific situation of patients. Generally speaking, the operation of taking out the internal fixation instrument is generally easier and shorter than the first contraposition fixation.
Finally, it should be mentioned that after years of exploration, the fracture internal fixator that can be absorbed in the body has been successfully manufactured, and now many hospitals are promoting its application. This material is a polymer organic compound, which is non-toxic to human body. Use it to fix broken bones. As the fracture heals, it will slowly degrade itself and become carbon dioxide and water. The use of this internal fixation device can be "once and for all" in one operation, and patients do not have to take the risk of a second anesthesia operation.