Skeletal injuries can be classified as sprain, strain, dislocation and fracture. Adequate treatment given at the time of injury is very important in good anatomical repair and functional recovery. If it is not given, it may lead to further injury, shock and permanent disabilities, Sprain and strain are joint injuries in which there is no displacement of joint surfaces. In a dislocation there is displacement of bones at the joint. A fracture is partial or complete break in the continuity of a bone (periosteum).
□ CAUSES OF SKELETAL INJURIES
Most of these injuries are the result of trauma, direct or indirect. A bone can be fractured directly at the point a blow is applied. An indirect force may cause the bone to break away from the spot of application of force (transmission offeree from one part of the body to another) e.g. fracture of clavicle after a fall on the outstretched hand. Violent contraction of a group of muscles may pull pieces of bone away from the point where the muscle is attached i.e. fracture of patella by powerful contraction of quadriceps muscles.
Wrenching of a joint can cause its ligaments to pull so hard at the bones forming the joint that one of the bones may fracture, e.g. fracture of lower leg bone at the ankle after stumbling. Pathological fracture is caused when the bone may be the seat of a number of diseases, which weaken it, and make it liable to break even with very minor injuries.
How to tell if there is a fracture
1. There is usually (but not always) pain over the fracture bone.
2. There may be swelling and/or bruising.
3. There is loss or severe restriction of use of the area affected.
4. Bone may poke through the skin.
5. There may be obvious deformity, bending angularity, or floppiness of the affected part.
How do I know it is not a fracture ?
You do not. It is often very difficult even for doctors to tell. Sprains can be extremely painful so the degree of pain in nothing to go by Often only an X-ray after careful medical examination will finally clear up the diagnosis.
If in doubt — treat as a fracture.
□ TYPES OF FRACTURE ?
1. Simple (closed) fracture : the skin surface over the fracture is intact.
2. Compound (open) fracture : the skin surface over the fracture is broken and fracture communicates with outside. There is risk of extensive blood loss and infection.
3. Complicated closed or open fractures : there is injury to nerves and/or blood vessels in addition to the fracture.
□ ANATOMICAL TYPES OF FRACTURE
Signs and Symptoms :
Pain, tenderness, swelling, loss of power, deformity of the limbs, irregularity of the bone, crepitus, abnormal mobility at fracture site, bluish discolouration of skin at site, cyanosis.