Bone structure is a partial or a complete break in your bone. Fracture mostly acknowledged as broken bone takes place with the change in contour of any bone. The basic symptoms of bone fracture are abnormal swelling, high pain or deformity in the structure. You won’t be able to move the injured part of the body. Often in severe cases, you might experience bone poking inside your skin. Basically bone fracture takes place if you get hurt severely or even slip and hit something heavy. Bone can also get fractured if you fall down from height like while climbing a tree, or slipping down from stairs. There are various categories of bone fracture that includes complete and incomplete bone fracture and compound and simple bon structure. Complete fracture indicates that the bone got snapped in two or moreparts whereas incomplete fracture is where the bone gets a crack but do notface a complete breakage.
On the other hand, compound fracture is where the bone tries to break through the skin of the patient. For simple bone fracture, the bone undergoes breakage but does not penetrates through the skin. The treatment often requires surgery and long term medication.Even in some cases, psychotherapy is also required to recover completely.
If you experience symptoms that indicate bone fracture in any part of your body, do not avoid it. Go to doctor right away and he would prescribe you to undergo a X ray test. The X ray report will provide the exactcondition of the bone and its injuries. Depending on the report of your X ray, the doctor would decide whether to conduct a surgery or using immobilizer, slings would do the needful. In can of surgery, devices like rods, plates and even screws are utilised. On the other hand, in case of cases that do not require surgery, they are advised to use sling that would not allow any movement of broken arm and let it heal eventually. After surgery, the patients are advised to take complete rest for few weeks so that the patient gets habituated with the external object in the body. However, the surgery is completely dependent on the health conditions of the patient. For instance, high blood sugar and pressure highly influences the surgery. Without normal sugar and blood pressure, surgery conducted is highly vulnerable to risk and may lead to adverse situations. Often closed reduction is done in case of misplacement in the alignment. In this case, a general anaesthesia is done and a cast is placed to hold the bone in that alignment. However, depending on the patient nature of the case, the external objects to be inserted are chosen. These objects are required to remove after a certain period of time like 2 or 3 years when the fracture is cured. Along with that, the patient needs to be under medication that would escalate the curing process.
There remains so such eligibility for bone fracture. It may take place to people of any age structure. Often children get their bone fractured while playing and on the other hand middle aged and old aged people even meet accidents and severe fracture may lead to surgery. However, the treatments are conducted in respect to the age of the patient like hildren recovers faster than teenagers and middle aged patients. Again, conducting surgery for old aged patients often turns risky.
If you seem to meet an accident and get your bone fractured, you will either be prescribed to use slings or undergo surgery depending on the intensity of the injury. After getting your surgery done, you might face several side effects.
Some of these are over swelling, pain or even bruising. Added to that, you may face complications while conducting surgery for bone fracture that is rare and that would include bleeding, blood clots, and severe allergic reactions for patients who suffer from anaesthesia. You also remain vulnerable to infections if you had complications during the surgery.
After you are done with the surgery of your fractured bone, you must follow few strict rules in your daily life. Along with that, you must maintain a frequent coordination with the doctor and continue medication. It is extremely necessary to abide to these rules otherwise it may lead to adverse effects.
You are not allowed to pull heavy things like rearranging furniture, carrying luggage bags etc. You are advised not to take up much physical work and make your daily tasks easier.
The recovery span is entirely dependent on how severe the fracture is. In case of small cracks, it gets recovered within 2 to 3 weeks. However, children recover faster within 3 weeks whereas teenagers and middle aged people takes around 6 weeks to attain full recovery. In some cases of severe injury full recovery takes around 10 weeks.
The average cost of bone fracture treatment in India ranges from 700 INR to 500000 INR. It basically depends on the severity of the condition.
The results of the treatment on bone fracture is permanent only if you follow the post-surgery regulations. Along with that, proper medication and psychotherapy is required to adopt.
Some alternative treatment for bone fracture is to avail Ayurveda process of medication that are entirely prepared from natural products. Even home remedy like using turmeric, constant use of ice, black caraway and sesame seeds and castor seeds acts as a catalyst in the recovering process. A complete rest is essential during this time.
Of all the joints in the body, the knees probably see the maximum wear and tear. In cases of severe osteoarthritis, or injuries which destroy the knee joint, a total knee replacement surgery may be advised. This procedure involves the replacement of diseased cartilage and bone in the knees with artificial materials.
In cases of osteoarthritis and other such degenerative conditions, this procedure is performed only when the adjacent joints such as the hips are strong and healthy. Before the procedure, you may be advised to discontinue any blood thinning and anti-inflammatory medication. Your doctor will also conduct blood and urine tests to check for signs of anaemia, abnormal metabolism and infections. You may also be asked to lose weight if you are on the heavier side to reduce the pressure on your knees.
A total knee replacement surgery is usually performed under general anaesthesia. The lower end of the femur bone or thigh bone and the upper end of the tibia or calf bone are removed and replaced with a metal shell and plastic piece respectively. In some cases, a plastic ‘button’ may also be placed on the surface of the knee cap. If the posterior cruciate ligament in intact it is left as is or it is replaced by a polyethene post to stabilise the joint and prevent the calf from slipping backwards.
In most cases, a patient is discharged after 3-5 days of hospitalisation following the surgery. Post-surgery, it takes about a month for the patient to experience notable improvements. For optimal results, total knee surgery must be followed by physiotherapy and regular exercise. This helps prevent scarring and keeps the muscles strong enough to maintain joint stability. Exercising can also reduce recovery time. However, not all exercises are advisable. Avoid running, jumping, climbing stairs and contact sports which have a high risk of knee injury. Swimming is highly encouraged as it boosts endurance and muscle strength without putting any pressure on the joint.
In some cases, a second surgery may be required in cases of total knee replacement to fix fractures, loosening or complications of the artificial joint. As with any other surgical procedure, a total knee replacement surgery also has risks. Some of these are:
In case you have a concern or query you can always consult an expert & get answers to your questions!
When we speak of bone health, calcium is usually the hero of the story. However, by itself, calcium is not enough for healthy bones. Vitamin D is equally important for healthy bones and the prevention of orthopedic conditions.
What does Vitamin D do?
Vitamin D helps the body absorb calcium from the food being eaten. It also controls the calcium and phosphate levels in the body. This is critical for the growth and development of new bones. Vitamin D also controls how much calcium and phosphates are being expelled by the body. In this way, vitamin D helps strengthen the bones and improve overall bone health.
Vitamin D Deficiency
Vitamin D is not commonly found in food. It is present only in certain types of oily fishes, egg yolks and mushrooms. Most of the vitamin D we eat comes from fortified cereals, breads and dairy products. The sun is an important source of vitamin D but exposing yourself to too much sunlight could cause various skin problems. Thus, vitamin D deficiency is very common. When it comes to bone health, vitamin D deficiency can cause low-density bones. This, in turn, can cause rickets and osteoporosis. People with vitamin D deficiency are likely to suffer frequent fractures. Vitamin D deficiency can also cause skeletal deformities such as bow legs and a stooped spine.
Vitamin D and Osteoporosis
Osteoporosis is a musculoskeletal condition that is marked by low bone density. Studies have shown that people with osteoporosis have lower levels of vitamin D as compared to others. Some studies also suggest that fractures are more common in winter as compared to summer. The winter sun is often hazy and many days can go by without strong sunlight. Thus it can be inferred that people do not get their required quota of vitamin D from the sunlight in winters leading to a deficiency and aggravated osteoporosis-related fractures.
Who is most susceptible to bone conditions caused by vitamin D deficiency?
Vitamin D deficiency is a very common condition across the globe. Some surveys have claimed that approximately 30% of the global population suffers from vitamin D deficiency. People with dark skin, women and elderly people are most susceptible to this deficiency. People suffering from kidney diseases may also be affected by vitamin D deficiency. Vitamin D supplements are usually very helpful in combatting this deficiency. These can be taken by young children as well as adults.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Both young and old are vulnerable to fractures. While the former gets them during intense physical activities, the latter experience fractures due to less bone density. Thus, quite common, they are, however, if you experience a persistent pain in the fracture spot even after undergoing treatment, you must visit your doctor without delay as it might be a case of nonunion.
Despite modern treatment methods that heal most fractures, sometimes new bone tissue doesn't begin to form and repair the broken pieces. This hindrance to the healing of bones is known as ‘nonunion.' Patients suffering from nonunion of fractures usually feel pain in the fractured area even after the fracture disappears and can last for months or years. In some cases, these pains may get triggered, if pressure is applied to the fractured area.
Why does a nonunion occur?
The three most important aspects of bone healing include stability, blood supply, and nutrition. If the broken bones that have been put together are moved out of place before they fully heal, it can lead to complications. Cases, where surgical fixation is involved, can be disrupted due to various reasons, including ineffective surgery which can happen due to unforeseen complications and can cause nonunion.
Treatment of A Nonunion
As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.
In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.
Morbidity & consequences of spinal fracture:
Results / Outcome
Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.
Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.
Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.
Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.
In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.
Morbidity & consequenses of spinal
Morbidity and complication of spinal surgery
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.
In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.
Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.
Pain relief is by virtue of different mechanisms postulated :
Breaking a bone no matter how small is painful. This pain is caused both by the actual break in the bone and the damage to surrounding muscles, ligaments, nerves and other soft tissue. There are three stages of pain caused by a fracture:
Any kind of fracture can cause these types of pain. However, it is not essential for everyone who has had a fracture to experience all the three kinds of pain. Many people experience pain only when the fracture occurs but in few cases, a person may break a bone and not realize it. Each type of pain needs to be dealt with in a different way.