The demolition fracture is a special type of fracture and is also referred to as an avulsion fracture or bony tendon tear. Especially common are demolition fractures on the outer malleolus and on the fingers.

What is a demolition fracture?

Athletes are particularly often affected, as the ankle, which has a certain susceptibility to demolition fractures, is subject to greater stress.

It is a fracture of tendons and ligaments in which a bone fragment is torn out of the bone by a strong pull of a tendon anchored in the bone. Athletes such as football players or skiers are particularly often affected, since in these sports the ankle, which has a certain susceptibility to demolition fractures, is subject to greater stress.

Furthermore, the wrist joints are very often affected. Bony outbreaks in this area are mainly due to the completion of household activities such as putting on sheets. Because of this, the demolition fracture in the area of ​​the finger has also been given the nickname "housewife's finger".

causes

A fracture fracture occurs through the action of a mechanism that results in a sudden onset of tension in a tendon anchored to the bone or a ligament anchored to the bone. By the strong train then a piece of the bone, so a fragment of the same, torn out of the bone.

The torn out bone fragment can have a different size. It may be a small, flat piece consisting of a bark-like outer layer of the bone. Then it is an outline of a so-called cortical shell.

Depending on the type and condition of the affected bone, however, a larger fragment may be torn out. The fact that in such a case the tendon or the ligament does not tear itself is due to the fact that the substance of tendons and ligaments is very resistant. This does not apply equally to the bone substance.

Bones are less strong than intact tendons and ligaments. In particular, tendons and ligaments can respond much better to a sudden change in tension because, unlike bone, they are more flexible and ultimately work precisely through changes in tension.

Symptoms, complaints & signs

An avulsion fracture causes swelling in the area of ​​the tear site, where the tendon or ligament is attached to the bone. In addition, a demolition fracture brings with it the abolition of the function of the affected tendon or the affected band. Stress can no longer be built up because the anchoring to the bone has been removed by the eruption.

A tear fracture often causes little pain. This is because bone fracture pain is usually due to the fact that the separate pieces of bone meet and rub against each other. However, this does not happen with a bony tear, because the tendon or ligament keeps the ragged bone fragment away from the remaining bone

Diagnosis & History

A demolition fracture is - as usual for bony injuries and other fractures - made the diagnosis by X-ray or confirmed. Since movements are still often possible even after the injury as such, a detailed history and physical examination is essential.

Only in this way can a distinction be made between a pure tendon or ligament injury and an involvement of the bones or the bony approach. The former would not be imageable by X-ray, but only recognizable by magnetic resonance imaging.

Precisely because a fracture fracture very often causes only little pain, the pain should not be used as an indication of the severity of the injury. For example, it is not uncommon for the person concerned to travel long distances on foot after a bony eruption around the outer ankle has occurred.

complications

Of course, it can also come in conjunction with a demolition fracture to various complications, which should be generally all medically and medically supplied. Since a demolition fracture is rather less painful, sufferers go to the doctor relatively late. Not infrequently, even sports are continued, so that the corresponding spot can ignite very quickly.

If such inflammation remains untreated for a long time, an abscess may develop. In addition, the formation of pus, so that an appropriate treatment is inevitable. In some cases it can even lead to blood poisoning, if bacteria, pus and other pathogens get into the blood.

In other cases, this may lead to overstretching of ligaments if the affected ligaments and tendons continue to be strained. In the worst case, the ligaments may rupture, requiring surgery. If there is a particularly high calcium deficiency, the bones grow together very slowly.

Even minimal movements prevent a speedy recovery, so that the affected joint must be completely immobilized. Therefore, if you want to avoid all complications in connection with a demolition craze, you should seek early medical treatment. Only in this way can a quick and complete recovery be guaranteed.

When should you go to the doctor?

A tear fracture does not always have to be treated immediately by a doctor, because the affected person can first take their own measures for healing. Usually a demolition fracture makes itself felt by sudden onset of pain, which will continue for a long time afterwards. Even in the absolute state of rest pain occurs in a demolition fracture. Therefore, if symptoms occur for no apparent reason, the visit to the doctor should not be put off.

A doctor can make an explicit diagnosis as to whether or not it is a demolition fracture. If there really is a demolition fracture, then an appropriate doctor will recommend absolute rest to the affected person. So that the existing demolition fracture can heal calmly, the affected region should be moved as little as possible. However, those who refrain from treatment by a doctor who exposes himself to a great danger. Especially if the affected area continues to be burdened, fast and complete healing is virtually eliminated.

Thus, as soon as unexplained pain occurs, a doctor should be consulted immediately. Thus, a quick diagnosis and appropriate treatment can be initiated. Serious complications are avoided early by medical treatment so that a full recovery can be guaranteed.

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Treatment & Therapy

An avulsion fracture can be treated in different ways. The treatment depends on the extent of the fracture. The size and location of the affected bone play a role, the size of the torn bone fragment on the other hand.

In smaller bones and smaller torn bone fragments often a splint is sufficient. As a result, the bone is relieved and the parts can independently grow together again. This form of treatment is chosen in particular in demolition fractures of the finger joints.

However, if it is a larger bone and a larger bone fragment, which is regularly exposed to greater tension, surgery must be performed. There are two methods in question: Either a screw osteosynthesis is carried out as part of this operation - the torn bone fragment thus connected by means of a screw again with the associated bone.

Or else a connection of the separated bone parts by means of so-called Kirschner wires is brought about. This ensures that stress does not lead to a prevention of the healing, ie the growth of the fracture, or that the just growing bone part is torn out again and again.

Outlook & Forecast

It is very difficult to predict the exact healing process of a demolition fracture because many different complications occur with this disease. However, anyone who seeks medical treatment for an existing demolition fracture has a very good chance of recovering quickly and completely.

If the affected joint is kept still and quiet, then the healing process is likely to begin after a few days. However, if the affected area continues to be subjected to severe stress and vibration, there is a risk of serious and serious complications.

Individual tendons and ligaments can break during a fracture fracture and thus require surgery. The healing process is made more difficult in such a case. A doctor's visit is absolutely necessary, because only the right treatment can guarantee a complete recovery. It always depends very much on the existing individual case, so that a visit to the doctor should never be put off the bench. Only with a quick treatment by a doctor can a complete recovery take place.

prevention

There is no special form of prevention in this area. In general, injuries in the musculoskeletal system, which includes the demolition fractures, can be prevented by strengthening the musculature as well as the tendons and ligaments.

In addition, it is advisable, regardless of belonging to a risk group, such as the football players, to promote bone health at a young age. This requires a calcium-rich diet, for example with dairy products, as well as a healthy and nutritious diet. A new injury can also be counteracted by a bandage.

aftercare

With the follow-up doctors want to prevent another demolition fracture. With a few exceptions, patients alone are responsible for this. Those who are dismissed as cured should refrain from an early burden. A calcium rich diet is advisable. Athletes and football players are considered as a risk group.

Professional players can sometimes support recovery with physiotherapy. This will make them faster to use. If pain and restricted mobility occur after treatment, it is important to consult the attending physician. It often shows that the healing process is not yet complete.

It is recommended to store the affected parts of the body calmly. A splint and plaster cast guarantee that recovery will be complete. Only in severe cases, surgical fixation of the bones is necessary. After a demolition fracture there is no immunity to a disease. Those affected can always suffer from the special bone fracture. Doctors use an X-ray for diagnosis.

In most cases, a magnetic resonance imaging is performed to rule out further injuries. Persons can prevent a demolition fracture. Abrupt and heavy loads should be avoided. Athletes should stretch their tendons and ligaments before use. Muscle building is also considered an important aspect of prevention.

You can do that yourself

An avulsion fracture is completely curable. However, sufferers should suddenly consult their family doctor or a surgeon in case of sudden onset of pain. The demolition fracture is particularly treacherous, as it often causes little or no pain.

However, it is important that the affected area - the foot or finger joint - is completely immobilized. This is done with smaller fractures by means of a rail, which should be worn constantly. For the treatment of mild to moderate pain, the use of over-the-counter painkillers such as acetaminophen or ibuprofen is possible. Nature also offers pain- and anti-inflammatory substances: These include arnica, turmeric, ginger, frankincense and devil's claw, which are available as a powder, in capsule form or as an aromatic oil.

Those affected can also support the healing process from within. It is helpful to strengthen the immune system through a balanced diet. Attention should be paid to increased calcium intake. Many green leafy vegetables, as well as bananas and dairy products, contain larger amounts of good salable calcium. These strengthen the bones. Micronutrients also reduce inflammatory processes in the body. It is also conceivable to take supplements over a limited period to further support the body.

Urgent avoidance of too early stress on the corresponding joint. Depending on the severity of the injury, it will take some patience, but it pays off because of the prospect of a full recovery.

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