Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

Spinal fractures are extremely painful and usually happen when an external force applied to the spine exceeds the vertebral column s ability to bear the load. Many times, the bone fragments pinch and damage the spinal cord, which leads to an injury or dislocation of the bony vertebra. Although spinal fractures can develop anywhere along the spine, the most common site is the lower back.

What causes spinal fractures?

Spinal fractures can occur due to both minor trauma/falls and major accidents. The following are the probable causes of such fractures-

  Injuries sustained while playing a sport
  A traumatic injury
  Spinal instability
  Injuries sustained after falling from a height
  A whiplash
  Injuries sustained in an accident
  An underlying condition such as Osteoporosis, which causes the spinal bones to weaken

Symptoms observed:

Spinal fractures are characterized by the following symptoms-

  Muscle spasm and swelling
  Numbness
  Acute pain that worsens when you walk or stand for a long time
  A tingling sensation
  Restricted mobility of the spinal column
  Spinal deformity/disability
  Sudden onset of pain in the lower back region

What are the various types of spinal fractures?

Spinal fractures primarily fall into four categories, namely the following-

  Compression - Compression fractures are quite common in people with osteoporosis or bone cancer. The bones become fragile and brittle. If sudden force is applied with extreme pressure, the vertebra may not be able to support the load and that may result in a fracture.

  Burst - Severe trauma, such as a car accident can cause burst fractures. The external pressure is so much that the vertebra gets crushed. As a result, the bony fragments spread out and cause spinal cord injury. Unlike a compression fracture, where only a part of the vertebra is damaged, a burst fracture leads to multiple fractures in the vertebra.

  Flexion-distraction - This type of fracture is likely to happen if you are involved in a car accident. Normally, the spine is made to flex forward. However, a sudden jerk that pushes your body forward can put a lot of pressure on the spine and cause the vertebrae to break.

  Fracture-dislocation - This debilitating condition results from a torn ligament and broken bone.

What is the treatment for spinal fractures?

Treatment options for spinal fractures include both non-surgical and surgical methods.

  Non-surgical treatment - Most cases of spinal fractures can be treated with immobilization in a corset or brace for up to 10-12 weeks. Bracing will help prevent deformity and reduce pain.

  Surgical treatment - The doctor may recommend surgery in severe cases. The two standard surgical procedures are-

Vertebroplasty - The surgeon will insert a tube, known as a catheter, into the compressed vertebra. Through the catheter, he/she will inject bone cement into the fracture site. This will harden and stabilize the vertebral column. Vertebroplasty has proved to be an effective procedure to reduce pain. The surgery restores mobility and prevents loss of bone due to bed rest.

Kyphoplasty - During this procedure, the surgeon inserts a catheter into the spinal column under the guidance of an X-ray. Next, he/she makes small incisions along the back and inserts an inflatable bone stamp. The tamp, once inflated, bring back the vertebral body to its original height. It also creates a cavity to be filled with bone cement, which seals the cracks. The bone cement stops the vertebra from collapsing again. After the whole procedure, the surgeon will remove the catheter and stitch the incisions.

Following surgery, you will need to wear a brace for about 6-12 weeks. Physical therapy is strongly recommended initially to help you get back to your daily activities in a week or two.

Spinal Fractures - All You Should Know!

A broken wrist is known as a wrist fracture and it may occur due to a variety of causes starting from undue pressure on the wrist which can result in an injury as well as debilitating conditions like arthritis, which makes the bones and joints prone to fractures. There are also non displaced breaks, which are stable kinds of fractures and in which, the wrist remains in its place. Let us find out more about the kinds of fractures and the procedures for treatment of the same.

Type of Fracture: The wrist is basically made up of eight small bones that connect the two long arm bones, which are known as the radius and ulna and create the forearm. The broken wrist can take place in any of these bones. A hand surgeon will generally take a look at this kind of fracture and determine whether it is displaced, stable or open. As discussed earlier, a wrist fracture can be of various types. While a non displaced wrist fracture is a more stable kind that does not really require much more than rest or medication, a displaced wrist fracture is a non stable kind where dislocation happens.

Other Factors: There are a variety of other factors that will be taken into consideration in order to repair this kind of a fracture. To begin with, the Orthopaedic specialist will consider your age and the kind of job, hobbies and other kinds of activities that you indulge in. Also, the doctor will try to ascertain whether or not you are in good health on an overall basis. The presence of other injuries will also be taken into account for this kind of an injury in there has been a bike or car accident that has caused the fracture.

Treatment: The method of treatment will vary as per the considerations listed above. A padded splint may be installed in order to align and support the bones and wrist respectively, so that there is ample relief from the acute pain as well. Further, an unstable fracture will require a cast as to support the entire forearm and give proper rest to the region so that the bone can grow back together and get aligned again. Surgery may also be required for very severe cases, and pins, screws, metals and plates may also be used depending on the exact location and type of fracture.

Recovery: Remember to move your fingers as much as you can so as to prevent them from getting stiff while they are held up in a splint or a cast.
Hand therapy will be helpful in gaining back motion and function of the wrist.

Wrist Fracture Procedure - Facts You Should Know About 

Your spine or backbone is composed of 26 bone discs, known as vertebrae. The vertebra shields your spinal cord and allows you to bend forwards and backwards, and stand. However, a number of problems, such as the following can change the structure or cause the vertebrae and its surrounding tissues to become damaged  

  Injuries
  Infections
  Tumours
  Changes in bone formation due to ageing   herniated disks, spinal stenosis
  Conditions like scoliosis and ankylosing spondylitis

Spinal disorders often lead to pain and discomfort when bony projections put pressure on the spinal nerves or cord. Over time, spinal disorders limit movement and reduce flexibility.
Treatment varies depending on the disease, ranging from medications and therapy to bracing and surgery.

Endoscopic Spine Surgery: what is it?

Contradictory to traditional open surgery, the new age endoscopic surgery is a minimally invasive procedure used to detect and treat a disorder. Unlike open surgery, minimally invasive endoscopic surgery does not require the patient to undergo general anaesthesia. The procedure is possible under local anaesthesia, considering the fact that it can be performed without cutting open the portion of the surgery site.

How does surgery work?

During the procedure, the surgeon first administers local anaesthesia to numb the site of the operation. You will be awake during the entire procedure but will not feel any pain. Then, he/she will make a small incision and insert a slender, tubular instrument   known as an endoscope   with a camera attached on one end through the soft tissues and skin, down to the spinal column. This allows the surgeon to get a clear view of the spinal tissues and understand where the problem exists. The endoscope holds the muscles open, allowing the surgeon to remove the damaged tissues or disk.

Endoscopic spine surgery preserves normal mobility, as the spine is not fused with rods and crews. When performed under an experienced surgeon, the procedure takes less than an hour.

Benefits of the Procedure

The advantages of going for an endoscopic surgery are the following  
  Local anaesthesia
  Surgery and discharge on the same day
  Microscopic incisions
  No removal of bone or muscles
  Zero or minimal blood loss
  Preserves spinal mobility
  Immediate recovery
  Reduced intake of pain medicines
  The high rate of success
  Improved quality of life

Minimally invasive endoscopic surgery has made it possible to rectify spinal problems and disorders without having to go under the knife. With less pain and quicker recovery, you can improve your spine health and get back to your usual activities in a day or two.

Consult a specialist and discuss the procedure in detail before opting for the same.


Endoscopic Spine Surgery Under Local Anaesthesia!

Spinal fusion is a surgery in which two or more vertebrae in the vertebral column or back are fused or joined to treat a slew of spinal problems and diseases, which cause debilitating back pain. This surgery helps to remove bone and tissue that are narrowing the spinal canal, squeezing the spinal cord and nerves, reducing pain and improving function.

There are many different causes of back pain like injury, poor posture, age, osteoarthritis, herniation of disc between two vertebrae, degenerative disc disease, narrowing of spine called stenosis, and spondylosis or lessening of space between the vertebrae- most of these can be treated using spinal fusion.

All of these causes put tremendous pressure on the vertebrae and pinch spinal nerves that pass through the back and radiate out into the arms, legs and torso. Apart from the pain, patients experience nerve and muscle weakness and irreversible damage affecting normal life.

Spinal fusion started off as just a treatment for fractures but now it has become the surgery of choice for a number of spine problems. Though it can be done anywhere in the spine, it is very effective when done in the lower part of the spine called lumbar spinal fusion or arthrodesis.

Spinal fusion is done by forming a direct bony connection between the vertebrae surrounding the painful discs, the cushioning between the vertebrae. Pain is stopped by stopping the motion of the painful discs.

There are different methods of spinal fusion each with its own advantages and limitations.

Techniques include fusion approached from the front, the back, or both of the vertebral column. Sometimes surgeons decide to use intervertebral cages or metal screws to provide internal structural support while the bone fuses. These cages may be placed between the vertebrae and packed with bone graft material taken from the patient or constructed out of synthetic materials.

What to expect?
Spinal fusion is not a risk-free procedure. It is a major surgery lasting several hours and carrying a number of risks like-

Failure of the vertebral fusion and breaking of metal implants
The vertebrae above and below the fusion can wear away aggravating problems
Blood clots may be formed that can travel to lungs causing embolism
Injury to spinal nerves causing permanent weakness in legs and problem with bladder and bowel function
Infections and blood loss
Heart attack or stroke during surgery
The patient has to be kept in hospital for a couple of days for post-operative care after which he will have to undergo rehabilitation for months. Hence, one should really think before going for spinal fusion. And when it is recommended, seek a second opinion before making a decision. 

Spinal Fusion Surgery - What To Expect?

An orthopaedic fracture is a serious issue that will require lots of care for the bones to heal and re-join. A broken bone is usually plastered so that the tissue may grow back together by fusing eventually, over a period of weeks. When these bones begin to rebuild in an effort to come together, the new bones are called soft callus. This will require lots of energy, which primarily comes from calories. This ensures that essential proteins like amino acids can be taken from the right type of food which would stimulate good blood flow. 

So, let us take a look at the best diet that one can follow in order to recover from a fracture.

Kale: Leafy green vegetables and herbs like kale can help in supplying good amount of protein and iron as well as calcium, which is highly important for good and strong bones. One can also find plenty of calcium in salmon and other kinds of sea food like sardines; consuming these can speed up the process. Sea vegetables like seaweed can also help in the process.
Yogurt: Calcium can be supplied by various other kinds of food including yogurt, which has two kinds of amino acids. These amino acids are lysine and glutamine, which can assist the bones in swift calcium absorption for better recovery of the broken bones.
Spinach: This is a very important ingredient in the bone healing process thanks to its dual elements of calcium and zinc, which come together to cause the appropriate chemical reaction for bone rebuilding. Other zinc heavy food items include pumpkin seeds and wheat germ as well as red meat.
Broccoli: Ingredients like broccoli are rich in Vitamin K1, which is known to very good for the bone recovery process. This vitamin helps in mineralisation of the bone so that they may fuse with each other and form a new mass. One can have up to one cup of this green vegetable per day for a quick and effective fracture recovery process. Other ingredients like cheese and raw dairy products are known to have plenty of this vitamin as well.
Green Bell Peppers: High on vitamin C which helps in producing the skin and tissue structuring element called collagen, green bell peppers are an excellent ingredient that can help you in your fracture healing process. Vitamin C can also be found in citrus fruits like oranges, strawberries as well as tomatoes.
Milk: While milk has plenty of calcium, it also has another important ingredient called vitamin D. When calcium and vitamin D come together, the bones tend to heal much faster as vitamin D helps the bones in absorbing the calcium at a much high rate.

Recovering from Fracture - 6 Foods You Must Consume

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