Is a pelvic comminuted fracture serious?

Written by Cheng Bin
Orthopedics
Updated on September 19, 2024
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For comminuted pelvic fractures, the condition is very serious, demonstrating that the external force involved was quite significant. It causes a disruption in the continuity and integrity of the bone. The patient will exhibit localized pain and swelling, and restricted movement in the affected area. Pressing on the area will produce a distinct bone crepitus or feel, and there might be extensive subcutaneous bruising. For comminuted pelvic fractures, the primary treatment is usually surgical. It is essential to conduct thorough preoperative examinations to exclude any surgical contraindications, and then proceed with the open reduction and internal fixation surgery under general anesthesia.

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Will a comminuted patella fracture cause limping?

Patellar comminuted fractures, as long as treated promptly and correctly, and if the surgery poses no issues, generally heal in about six months, thereby not causing any significant impact. Thus, there's no need to worry about limping. Limping usually means that when walking, one leg appears longer than the other. Under what circumstances can limping occur? If the difference in leg length is within one centimeter, it's imperceptible and won't have any effect. If the difference exceeds two centimeters, then there is a noticeable tilt in the lower limbs, and only then can limping be observed during walking; however, even if limping occurs, it is not severe. It just means that while walking, there is a tilt towards the shorter side. After treatment, patellar comminuted fractures have a complete chance of healing and once healed properly, it's almost like before the injury. Even in severe cases where the fracture is critically fragmented and requires removal, even without patellar replacement, by reinforcing the patellar tendon, it typically does not result in limping. It only impacts the strength in knee extension, possibly creating a mild impediment compared to the other side, and might make walking appear slightly abnormal, but it definitely does not lead to limping. Hence, patellar comminuted fractures do not result in limping.

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Why can't it rotate five months after a comminuted fracture of the humerus?

Five months after a comminuted fracture of the humerus, the inability to rotate is due to the lack of early functional exercise post-fracture, leading to severe adhesions in the joint and upper arm muscles, which significantly restrict rotation. This condition can be gradually recovered through later functional exercises, slowly tearing apart the adhered muscles, and increasing the range of motion of the humerus. It is recommended that patients seek rehabilitation treatment in the physical therapy department of a hospital. Additionally, various physiotherapy methods can be used to improve local blood circulation, promote muscle healing, relieve joint and muscle stiffness, and methods such as electrotherapy and magnetotherapy can also be applied to assist in improving the rotational capacity.

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Orthopedics
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Post-traumatic sequelae of femoral head comminuted fracture

A comminuted fracture generally refers to a fracture with more than three fragments. When a comminuted fracture occurs in the femoral head, it is also a type of intra-articular comminuted fracture. Generally speaking, after the fracture is reduced and stabilized, there can be some damage to the joint surface as well, leading to unevenness of the joint surface and a higher chance of developing postoperative traumatic arthritis. There is also a possibility that the comminution of the femoral head fracture could affect the blood supply to the femoral head, leading to ischemic necrosis of the femoral head. After treatment for the fracture injury, there will inevitably be some impact on postoperative function. Therefore, after a comminuted fracture of the femoral head, the first sequelae to appear is usually traumatic arthritis, followed by ischemic necrosis of the femoral head, and thirdly, symptoms of restricted movement in the hip joint may occur.

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Written by Su Zhen Bo
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Why are elderly people prone to fragility fractures?

In clinical settings, elderly individuals commonly experience comminuted fractures, primarily due to their reduced levels of physical activity, which can lead to the loss of proteins, calcium, minerals, and moisture in the bones. This reduces bone strength and density, and if they have osteoporosis, bones can easily break into pieces when subjected to external force. Therefore, it is crucial to apply proper treatment methods promptly after a comminuted fracture occurs. This can involve manual reduction, external fixation, or surgical treatment such as open reduction and internal fixation. Postoperatively, treatments like electrotherapy and physical therapy, along with oral calcium supplements and bone-healing medications, can facilitate recovery. Nutritionally, it is beneficial to consume foods rich in proteins and calcium to aid in the healing of fractures.

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How long does it take for a comminuted tibial fracture to heal?

The healing time for comminuted fractures of the tibia generally takes about three months, but it still depends on the method of treatment. Generally, there are two methods for treating a comminuted fracture of the tibia: The first method is conservative treatment, which involves using casts or braces to immobilize the affected limb. Generally, the healing time for this method is about three months. The second method is used when there is significant displacement at the fracture site, such as obvious shortening, rotation, or deformity, which then requires surgical treatment. After surgery, the healing time may take about three to four months. Additionally, severe comminuted fractures can disrupt the blood circulation at the fracture site, leading to poor local circulation and a condition called delayed union, where healing might take about six months. Another scenario involves extremely severe disruption of the blood circulation at the fracture site, leading to nonunion where the fracture ends do not heal together at all. Generally, this requires about a year of observation. If after one year the fracture ends still haven't healed, a second surgery might be necessary. However, for most comminuted fractures of the tibia, the general healing time is about three to four months.