Introduction
Bone fractures can come in the form of segmental fractures. They occur when a bone is cracked in at least two locations, leaving a section of the bone completely detached. Any long bone in the body is susceptible to these fractures. Usually, a high-energy hit, such as that which could happen in a car accident, being thrown from a car, or falling from a height, etc., can result in segmental fracture. None of these situations is ideal because they frequently lead to several injuries, some of which may be life-threatening and require medical attention before the bones fracture.
What Are the Symptoms of Segmental Fractures?
Segmental fractures are often accompanied by severe trauma symptoms that caused them. Depending on the various injuries, the symptoms may vary. Although generally speaking, the signs of a segmental fracture can be:
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Severe pain.
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Being unable to move an ordinarily mobile body portion.
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A body part that looks visibly altered or is not in its normal location.
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Bone is visible through the skin.
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Swelling.
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Bruising.
The most commonly affected bones are:
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Femur (thigh).
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Tibia (shin).
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Fibula (calf).
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Humerus (upper arm).
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Radius and ulna (forearm).
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Clavicle (collarbone).
How Are Segmental Fractures Diagnosed?
To assess the severity of the patient's injuries and to assist the trauma team in prioritizing which injuries need to be treated first, imaging studies such as CT scans, X-rays, and MRI scans will be suggested.
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X-Ray: Any segmental or other fractures will be confirmed by an X-ray, which will also reveal the degree of bone damage.
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Magnetic Resonance Imaging (MRI): To gain a thorough image of the damage to the bones and the environment around them, the doctor may use an MRI. This will also show them the tissue surrounding the bones. Finding out how the trauma affects the muscles, connective tissue, and organs is very essential.
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Computed Tomography (CT) Scan: An X-ray can only provide a generalized view of the bones and the surrounding tissue; a CT scan, however, will provide the doctor or surgeon with a more accurate picture.
What Is the Treatment for Segmental Fractures?
Surgery is most often used to treat segmental fractures. The procedure the surgeon chooses depends on the extent of the injuries, which bones are shattered, and whether there have been any further problems after the event.
1. Internal Fixation: To allow the bones to mend and grow back together, the surgeon will realign (set) them in the proper position and then secure them. Typically, they carry out a procedure known as "internal fixation," in which the surgeon inserts metal into the bone to keep it in place while it heals. Techniques for internal fixation include:
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Rods: A rod that goes vertically through the bone from top to bottom.
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Screws and Plates: Metal plates secured in place by screws driven into the bone.
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Pins and Wires: Bone fragments that are too tiny for other fasteners are held in place by pins and wires. Usually, they will be utilized in conjunction with either rods or plates.
Some people have these components permanently implanted in them. The removal of these may require additional procedures.
2. External Fixation: Some patients may require an external fixation. This is frequently a short-term fix that stabilizes the fracture until the other wounds are healed. To attach a brace or bracket around the bone on the outside of the body, the surgeon will first place screws on each side of the fracture inside the body.
Before performing more extensive operations to treat the segmental fracture, doctors occasionally advise external fixation as a first step. If there are numerous additional wounds, it may take some time for the body to heal enough to withstand internal fixation surgery. While they wait for internal body swelling to subside, the surgeon may also utilize external fixation to stabilize the bone.
Segmental fracture surgeries alone are outpatient operations, so one might be able to return home the same day. Yet, it is possible that the stress that resulted in the segmental fracture also caused other injuries, necessitating hospital stay while patients heal.
The site of the bone fracture will be immobilized after surgery before one can start putting any weight on it again or using it the way they did before the injury. Based on the site of injury, patients may need a combination of a brace, splint, or cast.
3. Medications: NSAIDs (non-steroidal anti-inflammatory drugs) that are available over the counter, such as Aspirin or Ibuprofen, might cause bleeding and other issues after surgery. The drugs to lessen discomfort following surgery will be discussed by the surgeon. The side effects of NSAIDs are:
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Bleeding.
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Ulcers.
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Stomach pain.
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Bowel complications.
What Are the Complications of Segmental Fracture Surgery?
Complications following segmental fracture surgery include:
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Acute Compartment Syndrome (ACS): When pressure builds up in the muscles, it may prevent blood from reaching tissue, which may result in long-term damage to both muscles and nerves.
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Malunion: This occurs when the shattered bones do not align properly throughout the healing process.
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Bone Nonunion: The bones might not regrow completely or not at all.
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Osteomyelitis: If a person has an open fracture, where the bone has broken through the skin, people are more likely to get a bacterial infection.
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Additional Internal Damage: Fractures can harm the muscles, nerves, blood vessels, tendons, and ligaments in the vicinity of the injury.
How to Reduce the Risk of Segmental Fractures?
The following guidelines may help in reducing the risk of segmental fractures:
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When rollerblading, skiing, biking, or playing contact sports, wear safety equipment. This entails wearing a helmet, as well as elbow, knee, wrist, and shin protectors.
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Make the house a secure place for youngsters. Keep windows locked and place gates at stairways.
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Children should learn how to take care of themselves and stay safe.
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Kids need to be closely watched. No matter how secure the surroundings or circumstances seem to be, supervision is always necessary.
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Avoid falling by not standing on stools, counters, or other shaky surfaces. Electrical cords and throw rugs should not be left on the floor. Put non-skid mats in the bathtub and railings on the stairs. For older persons, these actions are vital.
Conclusion
Segmental fractures develop as a result of potentially fatal trauma. These injuries are particularly terrifying since individuals can often not anticipate them. The good news is that segmental fracture procedures have extremely high success rates.
