Traumatology in any case of Fracture.Symptoms and Complications of a fracture

Fractures usually due to trauma which may be :
-direct trauma which is inflected to the bone itself for exemple in case of car accident.
-indirect trauma: trauma is not inflicted to the bone which is broken indirectly.

Less commonly is Pathological Fracture : the bone weakened by disease (osteomyelitis,metastasis) that leads at minor trauma.

Classification of Fracture:
1.According to the presence of skin wound:
-Simple (close) fracture :Overlying skin is intact.
-Compound  (open) fracture: associated with overlying skin wound.

2.According to displacement and deformity:
-displaced (angulation,over-riding,rotation,anterior or posterior,lateral).
-undisplaced fracture.

3.According to the shape of the fracture:
-transverse fracture
-longitudinal fracture
-oblique fracture
-comminuted fracture
-spiral fracture
-impacted fracture.

4.Stable or unstable
5.Complete or Incomplete Fisure Fracture
6.Complicated or uncomplicated fracture.

Complications of Fractures:
1.General Complications: (only in fracture femur,pelvis or spine).
-Shock : neurogenic due to severe pain and haemorrhage
-Paralytic ileus and acute gastric dilatation
-Fat embolism
-Complications of prolonged bed rest especially in old people.
-Traumatic anuria in crushing injury
-Urinary calculi
-Tetanus.

Local Complications:
-injury of the skin leading to compound fracture and infection.
-injury of vessels leading to haemorrhage,spasm.
-injury of nerves: may be immediate injury or delayed injury
injury of muscles: loss of muvement,deformity
-injury of joints:ligament injuries,effusion,dislocation.

Symptoms of a fracture:
-Inability to move the part and loss of function
-Pain and tenderness
-Deformity
-Swelling
-abnormal mobility

For investigation is necessary plain X-ray.

Rickets-disease of growing bones on children

Rickets is a disease of growing bones,characterized by defective calcification of osteoid and epiphyseal cartilage.
Rickets is a deficiency problem of infants and young children between age of 4-6 months and 18-24 months (1 year and half-2 years).
Rickets is caused by Vitamin D deficiency.Vitamin D id needed for absorption,utilization and retation of ingested calcium and phosphorus,and so deficiency influences bone formation.

Predisposing factors:

1.General Factors:
-poor housing and slum areas as: deprived of satisfactory sunning,dust in polluted aircuts ultraviolet rays of the sun
-inadequate feeding and malnutrition
-recurrent diarrheal disease of infants and young children.

2.Maternal Factors:
-malnutrition of the pregnant
-repeated unspaced pregnancies
-defeciency of lactation on mather
-nutrition ignorance of mother.

3.Child Factor:
-insufficient exposure to sunlight (baby is kept indoors or is totally covered when going out)
-nonsuplimentation of diet with vitamin D (milk is poor).

Manifestations:
-softening of skull bones
-bossing of parietal and frontal bones
-enlarged metaphyseal areas of long bones.
-closing of anterior fontanell and eruption of teeth.
-skeletal pains
-deformation of long bones and pelvis in severe cases
-weak flabby muscle
-in severe cases softening of ribs interferes with normal respiration and predisposes ti onfection that may be serious and fatal.