Conservative treatment of fractures

Prijelom ili fraktura kosti nastaje prekidom kontinuiteta kosti kao posljedica djelovanja sile koja može biti izravna ili ne izravna, odnosno direktna ili indirektna. Ova definicija prijeloma kosti odnosi se na traumatski prijelom kosti, jer se radi o djelovanju mehaničke sile koja prevladava fiziološku granicu elastičnosti zdrave kosti. Pojam patološkog prijeloma kosti označava da se radi o oslabljenoj ili ''bolesnoj'' kosti (etiopatogenetski mehanizam u podlozi može biti različit), a trauma kosti nastaje pri djelovanju sile smanjenog intenziteta ili do frakture dolazi kod jače kontrakcije mišića pri normalnoj kretnji. Također postoji i pojam ''stress frakture'' tj. prijelom zbog zamora kosti, a najčešće se takav tip prijeloma nalazi na metatarzalnim kostima pri duljem hodanju (nastaje uslijed zamora kostiju zbog ponavljane mehaničke sile na istom mjestu u kosti). Svaki prijelom ima biološku tendenciju zarastanja. Kako bi zarastanje prijeloma (odnosno srastanje koštanih ulomaka prijeloma) bilo završeno ponovnim stvaranjem fiziološke kosti potrebno je učiniti repoziciju i imobilizaciju na mjestu prijeloma, a to se može učiniti konzervativnim ili operativnim načinom liječenja. Svaki od oblika liječenja prijeloma ima svoje prednosti i mane, a konzervativno liječenje smanjuje opasnost od postoperativnih infekcija te ne utječe na krvnu opskrbu u području prijeloma (ako se naravno pravilno provodi). Najočitije mane konzervativnog liječenja su dugo trajanje imobilizacije uda te ponekad nemogućnost postizanja pravilne anatomske dužine i osovine ozlijeđene kosti. Uspostavljanje ponovne fiziološke funkcije uda cilj je svakog liječenja prijeloma kostiju, pa tako i konzervativnog načina liječenja prijeloma kosti.Bone fracture appears as a discontinuity of bone matter due to direct or indirect mechanical force activity. This definition refers to traumatic bone fractures, because they occur when the mechanical force applied to the bone is much greater than the elastic force of the healthy bone. The definition of pathological bone fractures labels weak or ''sick'' bones (etiopathological mechanisms for this can be various) and the bone fracture occurs even when a much smaller mechanical force is applied to the bone. Pathological bone fracture can also appear with muscle contractions during normal motion. The last term we need to define is ''stress fracture''. It appears because of the bone and muscle fatigue. The most common etiopathological mechanism of stress fracture is metatarsal bone fracture during long distance walks (because of bone fatigue as a result of overuse). Every bone fracture has a biological tendency to heal by itself. In order for the healing process to end up in a result of physiological bone ''regeneration'' we need to do reposition and immobilization of the bone. This can be done with conservative or operative type of treatment. Every form of bone fracture treatments has its pros and cons, and conservative type of treatment decreases the incidence of postoperative infections as it doesn't affect the blood supply of the bone fracture if it is done according to standard guidelines. The most obvious flaw of conservative bone fracture treatment is longlasting immobilization of the injured limb and sometimes inability to regain anatomical length and axis of the fractured bone. Establishment of the physiological limb function is the goal of every bone fracture treatment and it implies conservative bone fracture treatment as well