X-RAYS DEFINE THERAPY
X-ray film is basis for further treatment planning
Bone fracture is a condition when bone is disconnected due to force impact. The force impact can be indirect (a hit or pressure), or direct/transferred (line pressure, bending, sprain, stretch reverse pressure).
The bone can be broken, cracked (split) or smashed.
There are two types of bone fracture conditions well known in medical practice: open/complicated fracture( followed by skin wound, which can be caused by sharp or blunt object, or sharp piece of fragmented bone from skin inside) and closed/under skin fracture(skin is untouched).
Typical signs of fracture are first of all pain on fractured place or high sensitive reaction on touch or pressure. Broken limb is hard movable or not movable at all.
In addition, on the broken spot we can see swelling, blood flooding under skins, limb becomes curved or bent. On bones that are close under skin, we can touch gradual structure and limb or part of limb on the break place is abnormally movable.
It is very rare case when all signs appear together. In serious and dangerous cases there are few external marks/signs or the marks are rare (spinal fracture, pelvis fracture).
The only one way to find the right diagnosis is X-ray of injured bones, which shows the precise extent and type of fracture.
For correct X-ray diagnosis the film should be made in two directions, as often in one direction there are no visible changes, while on the other direction it is clearly visible both fracture and moved parts. Sometimes even that is not sufficient, so it is necessary to make special films determined by a radiologist.
X-ray film immediately after the trauma is necessary as a diagnostic document and basis for therapy planning. If not taken immediately after the trauma, later x-ray film will show only deformity after healed fracture, often non adequately treated.
The immediate x-ray is necessary also after repositioning and because of control of broken parts position. Later x-ray filming serves as control of different period of time, depending on clinical findings, types and place of fracture, whether the reposed parts stay in correct position or it is necessary to strait their position or the position of whole limb.
There are some cases when the changes cannot be seen immediately after the trauma, or these are visible only by magnifying glass as crack or split, even though it is clinically justified to suspect fracture. When x-ray is repeated after a week, two, or three, it shows widen crack and signs of healing which is often case in broken ribs.
Healing of fracture can be seen in the initial phase after 10 to 14 days as creation of new bone tissue, while in case of larger dislocations longer time period is needed. When parts heal irregularly so they bring to deformity and limitation of limbs function, or when invalidity is increased, we can call it ‘badly healed fracture’.
Every injury demands taking a good anamnesis, adequate examination of orthopedist and radiologist, as well as possible including of other specialties doctors, depending on place and seriousness of a fracture.
IT IS EASIER FOR CHILDREN
Children bones are more elastic so fractures are less frequent in spite of more often falls. X-ray for children should be performed only in case of clear fracture or vague fracture, after the examination of a pediatric orthopedist.In adults, diagnosis is set by radiologist based on x-ray film and anamnesis and the patient is sent to orthopedic examination aiming appropriate therapy.
MOST OFTEN FRACTURES
- radius fracture on typical spot,
- fracture of internal or external side ankle of tibia and fibula,
- clavicle(collar bone) fracture,
- rib fracture,
- small finger bones fracture,
- tibia fracture,
- upper leg fracture in elderly persons
- upper arm fracture
radiology specialist
