How dangerous are injuries? Consequences and complications of injuries

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Traumatology is the science of damage to human organs and tissues. She is engaged in the study of injuries, its prevention, the organization of trauma care and the treatment of injuries. musculoskeletal system.

Injury, or damage, is a sudden impact of environmental factors (mechanical, thermal, chemical, etc.) on tissues, organs or the body as a whole, leading to anatomical and physiological changes, accompanied by a local and general reaction of the body.

Damage, depending on the application of force, is divided into direct and indirect. They are isolated - with damage to one anatomical and functional formation of the musculoskeletal system; multiple - with damage to two or more anatomical and functional formations or damage to blood vessels and nerves in various segments of the limbs; combined - damage to internal organs in various cavities with trauma to the musculoskeletal system - and combined - the simultaneous presence of two etiologically heterogeneous injuries in the victim (for example, a fracture of the humerus and body burns).

The mechanical factor can manifest itself as pressure, stretching, tearing, torsional moment of application of force or counter-blow. At the same time, the force of the impact of an external factor on tissues and organs is directly proportional to the direction (directly or at an angle), speed and duration of exposure, which leads to varying degrees of injury severity. The most common injuries include bruises, wounds, dislocations, bone fractures, limb avulsions, burns, frostbite, electrical injuries, etc.

To bruises(contusio) include mechanical damage to tissues or organs, often without violating the integrity of the skin. In this case, the subcutaneous fatty tissue is destroyed, and hemorrhages occur with impaired arterial, venous circulation and lymph flow. Soft tissue edema, local temperature increase, skin redness (reactive hyperemia) occur. With bruises in the limbs involving muscles, tendon-ligamentous apparatus, joints, the musculoskeletal function is disturbed, with bruises of organs (heart, lung, brain, etc.), functions specific to these organs are violated. The severity of the bruise depends on the strength of the external impact and the localization of damaged tissues and organs.

compression(compression)- damage to organs or tissues caused by pressure from outside or from adjacent organs or tissues. A serious danger to life is the compression of the brain (hematoma, edema, tumor), heart (hemopericardium), lungs (hemothorax, pneumothorax). Long-term compression of the soft tissues of the extremities, less often of the trunk, is identified as a separate nosological group, with the syndrome of prolonged compression (crushing) or crash syndrome occurring. In its development, the main role is played by traumatic toxicosis caused by decay products and impaired metabolism of compressed or crushed soft tissues.

The severity of the condition of the victims is aggravated by the development of acute renal failure.

Wound(vulnus)- any violation of the integrity of the skin or mucous membranes under the influence of external mechanical impact or internal impact - a bone fragment. Distinguish superficial wounds and deep - with damage to large vessels, nerves, internal organs.

Dislocation(luxatio)- complete separation of the articular ends of the bones, with subluxation, partial contact of the articular surfaces remains, but with deformation of the contours of the joint and joint space (excessive expansion, uneven narrowing, etc.). Distinguish fracture-dislocation (intra-articular fracture of the dislocated end of the bone) and dislocation of the bone with an extra-articular fracture. A dislocated bone is considered distally located. A dislocation is considered fresh up to 3 days from the moment of injury, stale - up to 3 weeks, chronic - more than 3 weeks. According to the etiological basis, dislocations are divided into traumatic, habitual, congenital and pathological. traumatic dislocations occur more often with indirect trauma with forced violent movement in the joint, exceeding the amplitude of its normal movements. Habitual dislocation occurs mainly in the shoulder joint after an undertreated or improperly treated primary traumatic dislocation. Repeated dislocations can occur with varying frequency due to minimal external violent influences and even normal movements in the joint with a large amplitude. Congenital dislocation is formed as a result of dysplasia (underdevelopment) of the joint. The predominant lesion of the hip joint has been and remains a serious orthopedic problem. Pathological dislocation is the result of the destruction of the joint by some pathological process (arthrosis, tuberculosis, osteomyelitis, tumor).

fracture(fractura ossis) is called damage to the bone with a violation of its integrity. Most fractures occur under the influence of a mechanical force that exceeds the strength of normal bone. Less commonly, a fracture occurs from minor efforts (from the weight of a limb, body) and is considered pathological (in the area of ​​a tumor, cyst, inflammatory process). More often, fractures are closed, less often (1:10) - open (the fracture area communicates with the wound). If the wound arose from external violence, then the fracture is considered primary open. If the skin is perforated by a bone fragment (fragment) from the inside, then the fracture is considered secondary open. This division is of fundamental importance, since in a primary open fracture, soft tissue destruction and microbial aggression can significantly affect the surgical tactics and method of fracture treatment.

traumatism- a social phenomenon, as a result of which certain groups of residents who are in the same working and living conditions are injured. There are the following types of injuries.

I. Industrial injuries.

1. Industrial.

2. Agricultural.

II. Non-productive injury.

1. Household.

2. Outdoor:

a) transport;

b) non-transport.

3. Sports.

III. Intentional injury (murder, suicide, self-mutilation).

IV. Military injury.

V. Children's traumatism.

1. Generic.

2. Household.

3. Street.

4. School.

5. Sporty.

6. Other accidents.

work injury arises as a result industrial accident when workers are exposed to various production factors. All employees are subject to compulsory social insurance against accidents and occupational diseases.

The causes of accidents at work are divided into objective and subjective. To objective reasons conditionally include technical and sanitary-hygienic, to subjective - organizational and psychophysiological.

To technical reasons include equipment failure; uncoordinated inclusion of electricity and other energy sources; lack of fencing of the danger zone, etc.

To sanitary and hygienic reasons include poor lighting; air pollution; increased radiation, etc.

organizational reasons are the wrong organization of work; poor-quality briefing on labor protection issues; admission of unskilled workers to work of increased danger.

psychological reasons are fatigue and inattention during monotonous work; weakening of self-control; arrogance; unjustified, unjustified risk.

Up to 80% of accidents occur due to erroneous or belated actions of workers. The main cause of accidents and injuries is the risk factor. The risk is legitimate (permissible) and illegal (unacceptable).

Investigation and accounting of accidents. All accidents that occurred at work are subject to investigation:

• during the performance of labor duties, as well as actions in the interests of the enterprise without instructions from the employer;
• at the workplace, on the territory of the enterprise or in another place of work during working hours, including the established breaks;
• when putting in order the tools of production, clothing before or after the end of work, as well as for personal hygiene;
• during the journey to or from work, including on their own transport used in the interests of production;
• during accidents (fire, explosion, collapse) and their elimination at production facilities.

About an accident, as a result of which the employee, according to the medical report, lost his ability to work for one day or more, or it became necessary to transfer him to another, easier job for a period of at least one day, an act is drawn up in the form H-1.

The head of the enterprise, having received a message about the accident, by order appoints a commission of investigation in the following composition: head (specialist) of the labor protection service (chairman of the commission), head of a structural unit or chief specialist, representative of a trade union organization, sanitary and epidemiological supervision specialist (acute poisoning), authorized labor team on labor protection issues.

The owner of the enterprise approves five copies of the act in the form H-1 within 24 hours. One copy of the H-1 act, together with the materials of the investigation, is kept for 45 years at the enterprise where the accident was registered. Copies of the act are kept until the implementation of all measures to eliminate and prevent a hazardous production factor.

The fight against injuries is usually carried out in three directions:

1) prevention;

2) organization of trauma care;

3) qualified and specialized treatment.

This problem is still one of the most acute problems in traumatology, since injuries annually claim a significant number of human lives, turn even more affected people with disabilities and thereby cause enormous moral and material damage to the state.

Traumatology and orthopedics. N.V. Kornilov

Classification of injuries and selection of drugs for their treatment

Text:

Roza Ismailovna Yagudina, d.f. n., prof., head. Department of Organization of Drug Supply and Pharmacoeconomics and Head. Laboratory of Pharmacoeconomic Research of the First Moscow State Medical University named after A.I. I. M. Sechenov.

Evgenia Evgenievna Arinina, Candidate of Medical Sciences, Leading Researcher, Laboratory of Pharmacoeconomic Research, First Moscow State Medical University named after I.I. I. M. Sechenov.

Currently, injuries, especially when spring ice begins, is one of the main causes of disability, disability and mortality, and therefore is of great socio-economic importance.

Injuries accompany a person throughout life. Almost 30% of the total number of trips of ambulance crews are related to accidents. Injury rate in Russian Federation is 8730.3 cases per 100 thousand of the adult population, that is, annually there are about 9 injuries per 100 people.

Classifications and types of injuries

Term injury(from Greek. trauma- wound) means a violation of the integrity of tissues and organs as a result of exposure to environmental factors.

There are several classifications of injuries. One of them divides injuries according to the time of their occurrence into acute and chronic.

• Acute injury is a simultaneous effect of various external factors (mechanical, thermal, chemical, radiation, etc.) on the human body, leading to a violation of the structure, integrity of tissues and their functions.
• Chronic injury is damage resulting from repeated and constant non-intensive exposure to the same traumatic factor (the majority of occupational diseases belong to them).

According to the type of damaging moment, all injuries can be divided into:

• mechanical,
• thermal (burns, frostbite),
• chemical,
• barotrauma (damage due to a sharp change in the pressure of the external environment),
• electrical injury,
• combined (a combination of mechanical and non-mechanical damage, for example, a fracture and a burn, etc.).

Separately distinguish the circumstances of the injury:

• household,
• production,
• sports,
• combat, etc.

Also, injuries can be divided according to the volume of the lesion:

• isolated (damage to one organ or within one segment of the musculoskeletal system);
• multiple (damage to several organs or several segments of the limbs, that is, there are simultaneous fractures of two or more segments or sections of the musculoskeletal system);
• combined (simultaneous damage to internal organs and the musculoskeletal system).

Any injury is accompanied by bleeding or swelling with the development of local inflammation and with possible subsequent tissue necrosis. Severe and multiple injuries are usually accompanied by traumatic shock and are very life-threatening.

Top list of injuries

The most common in the world are the following types of mechanical injuries: bruise, sprain, dislocation, rupture of ligaments, muscles and tendons, as well as bone fracture. Among them, the leading position, undoubtedly, is occupied by a bruise: not a single person can claim that he has never received such an injury in his life.

Bruises: distinctive features and treatment

Injury- this is a closed mechanical damage to the tissues and organs of the body without a visible violation of the outer integument, which occurs when struck by a blunt object with relatively low kinetic energy or with a significant impact surface. A bruise sometimes accompanies other injuries (fracture, etc.).

As a rule, a bruise is accompanied by a rupture of small vessels, followed by hemorrhage, which develops as a result of a violation of the integrity of the subcutaneous tissue. The clinical picture of a bruise depends on the mechanism of injury, the force and place of application of the traumatic agent, the age and condition of the victim. Most often there are external bruises of unprotected parts of the body - the head, limbs (especially in children).

A bruise of the superficial soft tissues is always accompanied by swelling of the injury site as a result of skin soaking with lymph, blood and developing local aseptic inflammation. The amount of edema depends on the severity of the violation of the subcutaneous tissue at the site of injury. In the region of the cranial vault, the fiber layer is insignificant, and therefore the edema here is usually small, and massive edema develops on the face even with a relatively slight bruise.

A bruise is usually accompanied by pain of varying intensity. So, with bruises of large nerves and their endings, the pain is always sharp, shooting. The hematoma itself can develop at the site of the bruise both after a few minutes, and after several hours and even days, which is determined by the depth of the injury. The color of the hematoma depends on the duration of the injury: the fresh one has a purple-cyanotic color, after 3-4 days it becomes blue-yellow, and on the 5-6th day it becomes yellow. Bruises of the trunk and limbs (shoulder, thigh) are accompanied by intense hematomas, arching pains, sometimes with superficial numbness. When the joint is bruised, pronounced edema is observed, sometimes hemarthrosis develops. A significant accumulation of blood or synovial fluid in the joint is an indication for puncture.

With a slight bruise, small hemorrhages and swelling resolve on their own within a few days. The degree of contusion of the brain and spinal cord should be assessed by a neurologist or neurosurgeon.

Tears and stretches

stretching and gap- closed damage to the bursal-ligamentous apparatus of the joint without disturbing its anatomical continuity, affecting all elastic structures of the human body. Allocate sprain of the ligaments of the joint, muscles and tendons. As a rule, stretching itself occurs as a result of movements that are not characteristic of a given joint or exceed them in strength and direction and is accompanied by a temporary divergence of the articular surfaces beyond their physiological norm, exceeding the allowable elasticity and strength of tissues. Most often, the ligaments of the knee and ankle joints are injured, less often - the elbow, shoulder and clavicular-acromial joints.

The clinical picture of stretching is a sharp pain at the time of injury, an increase in the volume of the joint (hemorrhage in paraarticular tissues), dysfunction of the joint. Stretching, like a bruise, can be accompanied by hemarthrosis. A physical examination reveals a sharp soreness of the damaged ligament, sometimes non-physiological joint mobility. In some cases, immediately after the sprain, the joint or limb is still functioning, but after a while there is intense constant pain that limits mobility.

There are 3 degrees of sprain:

I - simple sprain without anatomical damage to the collagen fibers, with moderate pain and slight swelling of the soft tissues.

II - partial rupture of the ligament, with severe pain, rapid hemorrhage into the soft tissues, hemarthrosis, edema and dysfunction of the joint.

III - complete rupture of the ligament, with very severe pain (sometimes with a crash at the time of injury), hemorrhage into the tissue surrounding the joint, hemarthrosis, pronounced edema, a sharp dysfunction of the joint with a change in the axis of the limb.

Dislocation of the joint: treatment and signs

Dislocation- this is a persistent displacement of the articular ends of the bones beyond their normal mobility, often accompanied by a rupture of the capsule, ligaments and the exit of the articular end of the bone from the articular bag. Dislocations can be acquired (traumatic, habitual, etc.) and congenital. According to the degree of displacement of one articular surface in relation to the other, complete and incomplete dislocations, or subluxations, are distinguished - the preservation of partial contact of the articular surfaces. Traumatic dislocations, in turn, are divided into fresh (up to three days), stale (up to three weeks) and old (more than three weeks).

Dislocations, as a rule, are accompanied by muscle damage: ruptures of whole muscles or individual muscle fibers, stretching of some and relaxation of others with a sharp violation of muscle synergy. Extra-articular fractures are also possible.

At the moment of dislocation, a characteristic sound is usually heard, resembling cotton. On physical examination, swelling, sharp pain, deformity of the limb, its unnatural position, difficulty and limitation of movement in the joint and limb are noted. Concomitant pallor and numbness indicate damage to the nerves and blood vessels. Palpation determines the place and degree of displacement of the articular end of the bone and a characteristic sign of resistance (after the cessation of physical impact on the limb, it takes its original position).

After elimination of the dislocation, the limb is fixed in the mid-physiological position. This favors the rest of the muscles, the gradual restoration of their tone, the healing of the capsule. The duration of joint fixation depends on its anatomical and physiological characteristics. Functional treatment of dislocations begins with immobilization followed by rehabilitation measures.

NB! It is not recommended to engage in the reduction of a dislocation without a specialist!

Bone fractures: treatment and symptoms

fracture- violation of the integrity of the bone with a sudden impact of a force that exceeds the elasticity of the bone tissue and is applied both directly at the site of damage and away from it. With fractures, damage to the muscle fibers adjacent to the bone, surrounding vessels, and nerves almost always occurs. If the integrity of the skin is violated under the influence of a traumatic object or a sharp piece of bone, an open fracture is formed. If the integrity of the skin is not broken, then the fracture is called closed. The most common are fractures of the long bones of the extremities (shoulder, forearm, thigh, lower leg). The main signs of a fracture are bone crunching at the time of injury, a rapidly developing tumor at the site of injury, unnatural deformation of the injured area, pain during careful palpation, and the inability to move the injured limb. However, the final diagnosis is usually established only after X-ray studies, so the main task for fractures is to prevent the victim from worsening the state of health until medical assistance is provided to him.

NB! AT unlike a bruise, with a fracture, the function of the limb is impaired at the time of injury (the exception is incomplete fractures - cracks).

First aid for fractures consists in transport (temporary) immobilization of the injury site. The main type of transport immobilization of limbs is splinting (Kramer, Dieterikhs tires, medical pneumatic splint). Standard transport tires can be either complex or simple - made of wire or plywood, but factory-made (they are used exclusively by medical workers - ambulance personnel, etc.).

In cases of first aid, improvised splints can be used - made of plywood, hard cardboard, pieces of thin boards, sticks, bundles of rods, etc. In the absence of suitable improvised means, the injured arm can be fixed to the body with a scarf or edge of clothing (shirt, hollow jacket), and bandage the leg to a healthy leg. It is also necessary to fix at least two joints located above and below the damaged area in order to completely exclude the mobility of the damaged area. Transport immobilization immobilizes a broken bone or a dislocated joint, reduces pain and prevents further development of the injury, so it must be done as early as possible. Sometimes splints are placed over clothes and shoes. If there are no bandages, then the splint can be fixed with a ribbon, tie or any elastic material: the main thing is that the bandage should not be too tight and impede blood circulation. In the cold season, in order to prevent sudden cooling or frostbite, the limb with the splint is covered with warm clothes.

In the presence of an open wound with a fracture, an aseptic dressing is first applied, and only after that immobilization is carried out. It is also advisable to apply cold to the wound area and the entire affected segment. A pressure bandage on a victim with an open fracture should be applied by 2 people - one of them fixes the injured limb, pulling it along the axis, and the other fixes the bandage (necessarily on a naked body). On top of a sterile or medicinal napkin, several folded sterile napkins or a sterile folded bandage are placed on a bleeding wound, with which the bleeding tissues are pressed down. Each tour of the bandage is applied with a uniform, sufficiently large effort. It is not allowed to constrict the limb with separate rounds of the bandage (this can lead to impaired blood circulation in it). Feeling of numbness, goosebumps, cyanosis of the fingers are signs of compression of blood vessels, as well as circulatory disorders. In these cases, the bandage is cut or replaced, and the splint is applied again. With prolonged compression, crush-syndrome develops, or "myorenal syndrome" (prolonged compression syndrome). In this case, in addition to the above symptoms, pain appears, then shock develops. These symptoms decrease after 1-3 hours, but then increase again when the limb is released. Separately, the positional compression syndrome is distinguished, which develops in people who are in the same position for a long time, while individual parts of the body are squeezed by their own body (with alcohol, drug poisoning, etc.).

With an open fracture, the introduction of tetanus toxoid is also indicated in accordance with the instructions. Good transport immobilization prevents an increase in the displacement of fragments, reduces pain during transportation of the victim, and, consequently, reduces the possibility of traumatic shock, especially with a hip fracture.

NB! If a fracture is suspected, transportation of the victim even for a short distance without immobilization is unacceptable!

Fracture symptoms

Spinal injury- pain in the back, legs, spinal deformity, hypersensitivity at the site of injury, numbness and paralysis of the limbs. If there are no symptoms (in the presence of an obvious injury), then most likely the victim is in shock (excitation, rapid breathing and heart rate, vomiting and loss of consciousness). Compression fractures of the vertebral bodies occur mainly when falling on the legs, buttocks, and with forced flexion of the torso. When falling upside down, the cervical and upper thoracic vertebrae are damaged. When falling on the legs and buttocks, the bodies of the lumbar and lower thoracic vertebrae are damaged mainly. Clinically, compression fractures are manifested by constant pain in the area of ​​damage, limited mobility in the spine, pain when pressed along the axis of the spine, muscle tension at the site of injury with irradiation to the abdomen, and difficulty in breathing. Paresis, paralysis and dysfunction of the pelvic organs are observed mainly in fractures of the vertebral bodies with displacement.

NB! If a spinal injury is suspected, the victim must not be moved independently (movement of the head, neck, back can cause or exacerbate paralysis, etc.).

Traumatic brain injury- headache, tinnitus, dizziness, nausea, vomiting, possible loss of consciousness and memory. In such cases, emergency specialized medical care is needed.

Pelvic fracture- pain at the site of injury, moderate swelling and bruising that appears on the second day after injury, a positive symptom of "stuck heel".

Injury treatment

Treatment of all types of injuries has almost the same algorithm of care. First of all, this is the so-called first aid:

• cooling the affected area;
• analgesic therapy (if necessary);
• local anti-inflammatory and resolving therapy;
• immobilization (if necessary);
• transportation of the victim to a specialized medical facility (if necessary).

Specialized trauma care includes: surgical debridement (if any), tetanus toxoid vaccination, pain and antimicrobial therapy, plaster cast, surgery. More often than others, at various stages of trauma care, a group of non-steroidal anti-inflammatory drugs is used. Table 1 presents the classification of non-steroidal anti-inflammatory drugs (NSAIDs) by INN, used both systemically and locally.

Table 1. Classification of NSAIDs by chemical structure

Subgroup
Salicylates	Acetylsalicylic acid Diflunisal Lysine monoacetylsalicylate
pyrazolidins	Phenylbutazone
Derivatives of indoleacetic acid	Indomethacin Sulindac Etodolac
Derivatives of phenylacetic acid	diclofenac
Oxycams	Piroxicam Tenoxicam Lornoxicam Meloxicam
Propionic acid derivatives	Ibuprofen Naproxen Flurbiprofen Ketoprofen Thiaprofenic acid
Alcanones	Nabumeton
Sulfonamide derivatives	Nimesulide Celecoxib Rofecoxib
Anthranilic acid derivatives	mefenamic acid etofenamate
Pyrazolones	Metamizole Aminophenazone Propyphenazone
Para-aminophenol derivatives	Phenacetin Paracetamol
Derivatives of heteroarylacetic acid	Ketorolac

Also, for various types of injuries, anti-inflammatory and absorbable ointments, gels and tinctures containing substances of plant and animal origin (horse chestnut, troxerutin, lemon balm and eucalyptus oils, camphor, pork fat, turpentine, menthol, methyl salicylate, rutoside, carbomer 940, disodium EDTA, benzalkonium chloride, lidocaine, heparin, sperm whale acids). Their use can significantly reduce the duration of treatment by reducing edema, local inflammation and improving local peripheral circulation in the affected areas.

Even the smallest injury at first glance can have serious complications. Therefore, at the slightest suspicion of a dislocation, fracture and other serious injury, it is necessary to urgently seek help from a specialized medical institution.

Injuries, according to statistics, account for 9% of total deaths worldwide. This is one of the most common reasons for hospitalization of patients and seeking medical help. A significant proportion of patients who survive after severe injuries receive a temporary or permanent disability.

Sudden short-term or long-term impact on tissues / organs, resulting in anatomical and physiological changes of varying degrees, is called trauma. This impact, depending on the type of damaging factor, can be different, in particular, mechanical, chemical, etc. The causes of injuries are diverse. For example, a mechanical factor can be pressure, rupture, stretching, etc. Electrical injury occurs as a result of tissue contact with electric current, and burns as a result of interaction with open fire or high-temperature liquids. Separately, it is worth noting chemical burns, which can be obtained by contact with aggressive chemicals. The severity of the injury depends on the speed and duration of the external impact. Many injuries require emergency medical attention, and the prognosis for patients depends on the timeliness of the treatment started.

What is trauma?

Injury is a term that implies the degree of prevalence of various types of injuries among certain groups of people who are in approximately the same conditions, both at home and at work. According to statistics, among the male population, injuries most often occur between the ages of 20-49, and among the female population between 30 and 59 years. At the same time, at any age, men are more prone to injury than women. Injuries are the third leading cause of death and primary disability. It is also worth noting that in terms of the frequency of mortality, injuries rank first among people of working age.

Huge efforts are currently being made to study the causes of injuries and the causes of its occurrence, the frequency of various types of injuries, their nature, as well as the characteristics of the existence of certain groups of people. According to generalized data, approximately 6% of the population is exposed to various injuries per year.

There are different types of injuries:

• industrial injuries, divided into industrial and agricultural;
• non-production, including street, household and sports;
• intentional injury that occurs against the background wrongful action one person in relation to another with the aim of injuring him or depriving him of his life;
• military injuries, the name of which speaks for itself and implies injuries due to military operations or in the service;
• children's, including birth (injuries received during childbirth), street, household, school, sports and injuries associated with various accidents.

Accidents at various enterprises are often the cause of industrial injuries. That is why social insurance at manufacturing enterprises is mandatory for each employee. Such insurance covers various industrial accidents and so-called occupational diseases. Causes of injury at work can be:

• Objective, in particular technical and sanitary-hygienic.

The former include the faulty condition of the equipment used, an unexpected power outage, improper arrangement of the working area, etc. Among the sanitary and hygienic reasons, it is worth noting poor lighting and polluted air at the enterprise, an increased level of radiation, etc.

• Subjective.

These include mainly organizational and psychological causes of injuries. The organizational reasons for which an industrial injury may occur are the illiterate distribution of the work process, the absence or non-compliance with established rules, and the involvement of unskilled employees in especially dangerous work. Psychological causes are purely individual. These include the arrogance of employees, the weakening of self-control, inattention, fatigue, etc.

According to statistics, in about 80% of industrial injuries are the result of erroneous and untimely actions of employees. The negligent attitude of the management of the enterprise and its employees themselves creates dangerous working conditions and increases the likelihood of injury. Officially investigated cases that occurred:

• in working time directly at the enterprise itself or in another place where the employee fulfills work obligations;
• in the performance of duties assigned by the employer;
• when bringing in the proper form of work equipment, overalls, as well as during the establishment of personal hygiene before and after the start of working hours;
• on the way to work or home;
• in case of accidents at work or in the liquidation of their consequences.

Occupational injury is one of the most important problems in modern traumatology, taking many lives or causing disability from year to year. The main methods of combating industrial injuries are the prevention of its occurrence, the organization of qualified trauma care, as well as professional treatment for employees.

Types of injuries: classification

According to the nature of the impact, all types of damage are usually divided into:

• Mechanical, arising against the background of a sharp mechanical effect on the tissue. These types of injuries can vary in severity. Mechanical damage also includes operating, birth and accidental injuries.
• Thermal, occurring when tissues are exposed to excessively low or high temperatures. So, they include both burns and frostbite.
• Electrical, arising from exposure to the body of electric current discharges, domestic or natural.
• Chemical, appearing upon contact of body tissues with alkalis, salts of heavy metals, acids and other aggressive chemicals. Chemical types of injuries can lead to local damage or, being absorbed through the skin, poison the body.
• Radiation, which is the result of prolonged exposure to ionizing radiation. This type of injury does not always have an immediate manifestation, since the protective functions of the body are not activated immediately during radiation exposure.

In addition to the above types of injuries, mental and biological traumas are distinguished. The latter are the result of exposure to the body of microbes, viruses and other pathogens, as well as toxic substances of various origins. Mental trauma occurs against the background of exposure to nerve centers, visual and auditory analyzers of stress factors and stimuli.

According to the nature of the impact, all types of possible injuries are usually divided into:

• isolated, implying various kinds of damage to one organ or anatomical department;
• multiple - similar in terms of damage to various parts of the body, lower and upper limbs or head;
• combined, including damage to one or several organs at once, parts of the musculoskeletal system, as well as brain injuries;
• combined, caused by the action of mechanical, as well as one or several non-mechanical traumatic factors at once.

According to statistics, one of the most common causes of death and disability, in particular by persons young age, is a traumatic brain injury. The main risk group is citizens under the age of 50 years. The frequency of TBI is approximately 300-400 cases per 100,000 people annually. On the territory of Russia, about 400 patients per 100,000 people are annually diagnosed with a traumatic brain injury. At the same time, approximately 50 thousand people out of the above number of patients die or become disabled. The most common causes of TBI in Russia are domestic and industrial accidents, as well as traffic accidents (traffic accidents).

This type of injury is damage to the bones of the skull, blood vessels, brain and other intracranial formations. There are other options for TBI:

• severe trauma, due to which the bones of the skull retain their integrity, and intracranial structures are damaged;
• violation of the integrity of the skull with minimal brain injury.

Among the main causes of TBI are falls from a height, traffic accidents, domestic, industrial and sports accidents. The severity of TBI and the individual prognosis for the patient depends on the degree of brain damage.

What is a head injury?

According to the type of impact, head injuries are divided into:

• acceleration injuries accompanied by diffuse brain damage;
• local injuries arising from a blow to the head with an object with a certain force;
• compression damage.

Different types of injuries have their own characteristics of occurrence, clinical picture and prognosis for the patient. Allocate different types TBI:

• closed head injuries, including bruises, concussions, compression, as well as damage to the skull, provided that the integrity of the soft tissues surrounding it is preserved;
• open - injuries in which skull fractures are accompanied by a violation of the integrity of soft tissues, bleeding of varying intensity or liquorrhea (outflow of cerebrospinal fluid).

It should be noted that open brain injuries are divided into penetrating (accompanied by damage to the hard shell) and non-penetrating (respectively, without it).

According to the type of injuries received, the patient can be diagnosed with:

• isolated head injury - an injury not accompanied by other extracranial injuries;
• combined craniocerebral injury, in which damage to the internal organs and bones of the skeleton is also noted;
• combined TBI - damage that occurs against the background of exposure to the body not only mechanical, but also one or more non-mechanical factors.

Specialists distinguish three stages of TBI according to its severity. So, patients can be diagnosed with mild, moderate and severe stages of traumatic brain injury.

Taking into account the form and nature of TBI, the age of the patient and his state of health, as well as a number of other factors, acute, intermediate and remote periods of its course are distinguished.

In addition, there are primary and secondary TBI. Primary occurs under the influence of mechanical factors that are not caused by any cerebral disorders. The cause of secondary TBI is falls and mechanical blows to the head, for example, in people diagnosed with epilepsy, stroke and a number of other diseases.

Secondary brain injury is the result of a severe head injury. Its frequency is approximately 20% of all patients with this diagnosis. Secondary trauma is a particular danger to the health and even life of the patient. Among the main causes of this pathology, it is worth noting cerebral hypoxia, which develops due to the lack of oxygen supply through the respiratory tract, arterial hypotension and a sharp increase in intracranial pressure.

Severe head injury

The consequences of a severe head injury for the health and life of a patient depend on the quality and timeliness of the medical care provided. With this type of damage, the victim may experience a number of characteristic signs, in particular:

• repeated vomiting that cannot be overcome;
• prolonged loss of consciousness;
• confusion and memory loss;
• an overwhelming desire to sleep and double vision;
• convulsions and bleeding from the nose, etc.

The patient's condition with a severe head injury is deteriorating rapidly. To provide first aid for a head injury, you must:

• put the patient in a room with subdued light, providing him with complete peace;
• put something soft under the head and shoulders, while slightly lifting the victim;
• try to stop bleeding from an open wound on the head (pressing a bandage or a clean cloth to the wound, you can not put pressure on it if there is a possibility of a skull fracture).

All these actions must be performed by first calling an ambulance. Before the arrival of doctors, it is important to monitor the consciousness and the presence of breathing in the victim. If there is no breathing, start cardiopulmonary resuscitation.

The main actions in the diagnosis of TBI include interviewing the victim, collecting an anamnesis, examining and assessing his condition. If a person has lost consciousness, it is necessary that doctors receive information about the incident from eyewitnesses and employees of the ambulance team that arrived at the scene. When assessing his condition, it is important to verify the presence or absence of violations of the integrity of the soft tissues and to perform a neurological examination.

One of the most informative instrumental diagnostic methods is computed tomography. Using it, specialists can assess the degree of damage to the bones of the skull, brain and other intracranial structures, the presence of pathological processes and the nature of their course. CT can be used for injuries of any severity. Such a study makes it possible to do without a number of previously used diagnostic procedures, in particular, craniography, cerebral angiography, echoencephaloscopy, etc.

If it is not possible to immediately conduct a CT scan, magnetic resonance imaging is used for diagnosis. Before MRI, craniography is mandatory to exclude the presence of metallic foreign bodies.

In some cases, echoencephaloscopy is used, which allows the most accurate assessment of the displacement of intracranial structures. When examining children and patients with defects in the bones of the skull, ultrasound can also be used. Less accurate than computed tomography is craniography (X-ray examination without the use of contrast agents). When examining a patient with a head injury, it must be performed in several projections at once. Such a study allows to determine fractures of the skull bones, radiopaque foreign bodies, as well as pneumocephalus.

eye injury

Quite vulnerable to various damages is the main organ of the visual system. It would seem that minor eye injuries can lead to deterioration or complete loss of vision. The cornea, vitreous body or lens are most susceptible to injury. In severe eye injury, the retina and optic nerve may be damaged. According to statistics, eye damage is 10% of the total number of pathologies of the organ of vision.

Among the main causes of eye injuries are penetrating (accompanied by a violation of the integrity of the membranes of the organ) and non-penetrating injuries, as well as blunt injuries, exposure to high and low temperatures, and various chemicals. According to statistics, in about 90% of cases, damage to the main organ of the visual system is microtrauma and blunt trauma. The total number of penetrating injuries is approximately 2%, and approximately 8% of eye injuries are thermal burns. Let's take a closer look at the main types of eye injury:

• Penetrating injuries are injuries in which foreign body can violate the integrity of various departments of the main visual organ. Foreign body particles can remain in the eye, causing severe pain and profuse lacrimation, photophobia, and a sharp decrease in visual acuity. With a penetrating wound on the eyeball of the victim, you can see the wound itself and the bloody spot around it. Such damage to the eye can lead to destruction of the eyeball and lens, as well as partial or complete blindness.
• Non-penetrating injuries are usually the result of bruises and so-called blunt blows. Blunt trauma - the result of damage to the eyeball various subjects. There are three degrees of severity of such an injury. In this case, the injury of the I degree is mild, the most severe is the III degree. Such injuries can be characterized by intraocular hemorrhage, retinal detachment, violation of the integrity of the vascular membrane of the organ and retina, as well as the development of traumatic cataracts.

Various parameters are used to classify damage to the main organ of vision. According to the field of activity of people prone to certain types of injuries, injuries can be industrial (obtained at work), agricultural (possible in the performance of work and domestic duties), household (injuries received at home, on the street, etc.) , sports or combat origin. The latter is by far the rarest. The main reasons leading to damage to the main organ of vision include:

• small objects, for example, sand, motes, midges, etc .;
• various chemicals, in particular, household chemicals, building compounds, cosmetics, etc.;
• a wide variety of sharp objects, for example, metal shavings in production or when performing household repairs;
• blunt blows that occur when a stone or snowball hits the eye, for example, when punched or falling from a height;
• thermal effect, implying eye contact with hot liquids, objects, etc.

In order to avoid the negative consequences of an injury and preserve a person’s vision, it is important to provide him with competent assistance in time. So, first aid for eye injuries should be to eliminate the irritating factor, if any.

Treatment of injuries of the organ of vision

Any damage to the main organ of the visual system requires immediate medical attention. Only a qualified specialist using the appropriate equipment will be able to determine the extent of damage and its nature. At the first examination of the victim, the ophthalmologist examines the fundus using a special mirror or ultrasound, assesses the condition of the retina. If the injury is penetrating, radiography is used to assess the patient's condition, which allows to determine the presence of a foreign body in the wound. Also, with such injuries, it is important to assess the state of the optic nerve in the injured eye and predict the possibility of maintaining vision when using a certain tactic for treating the injury.

The choice of tactics for the treatment of injuries should be carried out exclusively by a specialized doctor and may depend on various factors. Its selection is the task of an experienced ophthalmologist. For example, if the integrity of the walls of the orbits and eyelids is violated, the victim needs urgent surgical treatment of the damage. It may also be necessary to restore bone structures and surgical closure of wounds. If the injury is the result of blows and contusions, anti-inflammatory treatment is required, as well as the use of therapy aimed at resorption of hematomas and prevention of hemorrhage. First aid for injuries resulting from a blow requires the immediate application of cold to the affected area. If the injuries are penetrating wounds and a foreign body remains in the organ, the treatment of injuries requires surgery.

Most eye injuries occur due to the ingress of foreign bodies of various sizes and types, which can be very diverse. Basic first aid for injuries of this type can be provided to the victim, as they say, on the spot. The first thing to do is not to let the victim rub his eyes, because this can only aggravate the situation. A small foreign body should be removed with a clean piece of tissue (for example, a handkerchief). To carefully remove an object that irritates and injures the eye, you should pull down the lower eyelid or try to slightly twist the upper eyelid. If you cannot do this yourself, you should immediately contact a specialist.

Spinal injury

The causes of spinal injuries can be very diverse. As a rule, various injuries are caused by strong mechanical impacts as a result of a fall from a height, an accident, impacts, heavy objects falling on a person, etc. Traumatic factors in such situations, for the most part, determine the type of damage received. For example, injuries to the spine of passengers staying in cars involved in an accident most often represent injuries of the cervical spine - the so-called whiplash injuries. The reason for their occurrence is a sharp bending of the neck forward and the same sharp tilting of the head back, which is typical for sudden braking of transport. According to statistics, whiplash injuries are much more common (about 2.5 times) in females who have poorly developed cervical muscles. Also, damage to the cervical spine is often observed in divers who do not adhere to the basic rules of immersion in water. For people injured as a result of a fall from a height, a combined fracture of the spine with damage to the lower thoracic or pelvic region, as well as the heel bones, is characteristic.

Spinal injuries account for approximately 1% of all types of injuries. Such a pattern of damage includes lesions of the spine and spinal cord. Depending on which area is affected, spinal injuries can be:

• damage to the vertebrae in various parts of the spinal column
• violation of the integrity of the transverse process
• damage to ligaments, which is their sprain or rupture
• traumatic dislocation
• intervertebral disc damage

There are also uncomplicated and complicated injuries. Uncomplicated are injuries in which there is no violation of the integrity of the spinal cord and its roots.

Allocate closed and open injuries of the spine. The former are more common. With closed injuries, the integrity of the skin and soft tissues that cover the vertebrae is not violated. There are also stable and, accordingly, unstable traumatic injuries. The former include bruises, ruptures of the spinal ligaments that are not accompanied by displacement, whiplash injuries (injuries to the cervical region), as well as fractures of the transverse and spinous processes. Unstable injuries mean various injuries that lead to the appearance of pathological mobility of the damaged spine at the time of injury or the progression of pathological deformity in the long-term period after injury. These specialists include dislocations, spondololisthesis, injuries associated with shifts and sprains, etc.

Depending on the type of damage, their symptoms may differ, as well as the consequences of injuries for patients. So, the signs of stable spinal injuries may look like this:

• bruises of the spine are characterized by diffuse pain in the area of ​​the injury, swelling and hemorrhage, slight limitation of movement;
• distortions are accompanied by sharp pain, tenderness on palpation and restriction of movement;
• a fracture of the spinous processes causes severe pain, and, in addition, the damaged process is often distinguished by palpation;
• fractures of the transverse processes, which are more common, are characterized by a number of symptoms, including Payr's symptom, the so-called stuck heel symptom, diffuse pain in the area of ​​the damaged area, etc .;
• whiplash injuries of the cervical region are accompanied by headache, pain in the neck, memory impairment, neuralgia and numbness of the extremities are also possible.

Symptoms of damage depend not only on the type of injury itself, but also on which part of the spine is affected.

Consequences of spinal injuries

The type of injury, its severity, localization of the affected area are the main factors that determine the prognosis of treatment and the consequences of injury for the patient. According to statistics, severe spinal injuries are the most common and lead to disability in almost half of the cases. If injuries of the spinal column are combined with a violation of the integrity of the spinal cord, their consequences for patients are almost always quite serious and in about 80-95% of cases lead to disability.

The most dangerous are injuries of the cervical spine, combined with damage to the spinal cord. They often lead to respiratory arrest and blockage of blood circulation, which causes almost instantaneous death of a person. In addition, with such an injury, the death of the victim is possible as a result of the development of hypostatic pneumonia, urological pathologies and bedsores, leading to blood poisoning.

The most promising in terms of treatment are spinal injuries in children, including injuries received during childbirth. This is due to the fact that the child's body is most susceptible to adaptation after various spinal injuries.

What will be the consequences of injuries depends not only on their type, but also on the timeliness and quality of assistance provided to the victim. If help is provided to a person incorrectly, this can only aggravate his condition and make the prognosis for treating injuries less favorable.

Treatment of spinal injuries is a long and complex process. As a rule, its implementation is the task of such specialists as a traumatologist, a rehabilitation specialist and a neurosurgeon.

The causes of leg injuries are varied. These can be both strong blows and falls, accidents, excessive physical exertion, etc. These include:

• Bruises or injuries resulting from compression.

Bruises can cause cracks and even fractures of bones, damage to the joints. At the site of bruises, as a rule, a hematoma occurs. It is also possible the formation of edema.

• Dislocations, which can be congenital (obtained during fetal development) or acquired as a result of various leg injuries.

The main symptoms of a dislocation are severe pain, limitation of joint mobility and the adoption of an unnatural position by it.

• Sprain or complete rupture of the ligaments is a leg injury that involves damage to the ligamentous apparatus of the ankle or knee joints, as well as damage to the menisci.

These injuries are usually caused by excessive stress on the ligaments. At the site of injury with this type of injury, a hematoma forms and edema appears, and there is also a sharp unrelenting pain.

• Fractures are injuries of the lower extremities, which can be closed and open, accompanied by complications or proceed without them.

The causes of such injuries can be excessive loads on the legs, accidents, falls, etc. Signs of fractures are pain, rapid formation of edema, hematoma in the area of ​​the affected area, its deformation, a characteristic crunch during movement, limited movement. An open fracture is an injury in which, without special diagnostic methods, you can see the damaged bone.

Knee injury

People of all ages are susceptible to various types of knee injuries. Even with normal walking, such damage is possible if certain factors accompany it. For example, natural wear and tear as a result of aging, as well as a number of diseases, such as arthritis or osteoporosis, can increase the likelihood of knee joint injuries. Most often, a leg injury in the knee area occurs in athletes. But people are also often exposed to it during active entertainment (skiing, roller skating, etc.). No less likely is industrial and domestic injury.

The knee joint is the largest joint in the human body. Between its upper, called the femur, and the lower (larger and fibula) bones, cartilaginous formations are localized, called the menisci. The main bones of the legs are connected to each other with the help of ligaments, tendons and muscles. Inside, the joint is covered with the so-called articular hyaline cartilage, which ensures the smoothness of its movement and is an elastic tissue with a smooth surface. Knee injuries most often represent damage to one or more of the structures listed above.

Acute knee injuries often occur as a result of a sudden direct blow to the knee, unnatural bending, twisting of the lower limb, or falling and hitting the knee. Such damage is accompanied by an almost instantaneous occurrence of pain, swelling and bruising. Acute injuries can damage nerves and blood vessels. Victims may notice numbness in the area of ​​injury, coldness, weakness, pale skin and blueness at the site of injury, as well as slight trembling in the knee. Among the main varieties of leg injuries in the knee area are:

• damage to ligaments and tendons, in particular their sprain;
• meniscus tear;
• cracks in the patella, greater and fibular bones in their upper part, the femur in its lower part;
• dislocation of the patella, most common in girls 13-18 years old;
• dislocation knee joint- an injury that can occur as a result of a blow of great force.

Excessive exercise can also cause injury to the knee, leading to irritation and inflammation of the knee joint. Such damage occurs due to repeated actions or prolonged heavy loads. Among the consequences of such influences, it is worth noting:

• bursitis, which is an inflammatory lesion of synovial bags;
• tendinitis, which is an inflammatory lesion of the tendons, as well as tendinosis;
• Plick's syndrome, which consists in twisting and thickening of the knee ligaments, etc.

The applied treatment for knee injuries should include immediate medical attention, complete rest for the injured limb, professional splinting, various physiotherapy procedures, medication, and in some cases surgery. The choice of treatment method depends on various factors, in particular, on the area of ​​the lesion, the type of injury and its severity, the age of the patient, his state of health and his usual lifestyle.

Among the main injuries of the hip are fractures and dislocations. The former are a particular danger to human health and full mobility. These types of injuries include:

• fracture of the upper part of the femur, accompanied by a violation of the integrity of the femoral neck, trochanteric fracture;
• fracture of the lower part of the femur;
• diaphyseal fracture.

The main risk group for hip fracture is the elderly. To a greater extent, female representatives are susceptible to such an injury, often suffering from osteoporosis and weak muscle tone. The main cause of injury to the upper thigh is a fall, a sharp blow, an accident, etc. Elderly people can get such an injury from a direct blow or a fall on the hip joint. Also, a fracture of the femoral neck in elderly people can be with an unsuccessful fall, when a person stumbles and abruptly transfers his body weight to one leg.

The symptoms of a hip fracture are:

• Sharp and pronounced pain in the hip joint, radiating to the groin. With an intra-articular fracture, pain may be mild at rest and increase with movement. There is also pain on palpation.
• Inverted position of the lower limb. If a hip fracture is accompanied by displacement, the injured leg appears to be significantly shorter than the healthy leg. With an impacted fracture, this feature is not observed.
• A fracture of the upper thigh makes it impossible to lift and straighten the leg in a supine position.
• If the fracture is trochanteric, the soft tissues around the injured area swell and bruise.

Separately, it should be said about open fractures, in which heavy bleeding is possible.

With an injury such as a fracture of the femoral neck, blood circulation is disturbed in it and in the femoral head, which greatly complicates the process of bone tissue fusion. The consequences of such an injury depend on the location of the fracture. So, the higher its location, the less favorable is the prognosis for the patient.

hip dislocation

Hip dislocation is a fairly common injury today. The causes of its occurrence are direct strong impacts, falling from a height, compression as a result of landslides, road accidents, etc. Hip dislocations can be anterior and posterior. More common is a posterior dislocation resulting from sudden rotation or flexion of the hip towards the inside. In this case, the posterior part of the joint capsule is damaged by the head of the femur. Depending on the location of the dislocated articular head, iliac and ischial dislocations are distinguished.

Anterior dislocation is rare. With such an injury, the head of the femoral bone is displaced downward, as a result of which the joint capsule is torn. Anterior dislocations are divided into obturator and pubic. Also, such an injury can be congenital, due to defects that have arisen during fetal development.

With a dislocation of the hip, there is a visible deformity of the lower limb. In this case, patients feel severe pain. With a posterior dislocation, the limb bends with the knee to the inside and turns out. With strong flexion, there is a high probability of ischial dislocation. Anterior dislocation is accompanied by an outward twisting of the knee. With such an injury, flexion of the lower limb in the region of the hip and knee joint, as well as complete limitation of movement, is observed.

First aid for an injury, which is a dislocation of the hip, consists in the introduction of an anesthetic and immediate hospitalization of the victim. It is important to provide the victim with complete rest and immobilize the injured leg.

When treating an injury of this kind, it is important to correctly set the joint. This procedure is performed using anesthesia, which will help the muscles surrounding the injured joint to relax as much as possible. The reduction of dislocations can be done in various ways. The most in demand today are the methods of Depre-Bigelow, Janelidze-Kollen and Kefer-Kocher. After reduction of the dislocation, the patient needs to apply a special retractor splint, which must be worn for about one month. After removing the overlay splint, with a favorable course of the applied treatment, the patient is recommended to undergo a special rehabilitation course. Sometimes it may be necessary to use crutches to reduce the load on the injured leg during movement. Among the complications of hip dislocation, it is worth noting the development of degenerative changes in the damaged joint, called coxarthrosis.

Everyone has been injured at least once in their life. Whether it was minor or extensive - there are many variations. Electric shock, fractures or just sprains, small cuts and large lacerations - in such situations, you should definitely seek medical help.

The classification of injuries is extensive, with any division highly dependent on a large number of factors. In case of injury, there may be a violation of the integrity of all tissues in the human body: soft, bone, connective. The skin will also suffer. The cause of injury is usually an external influence.

Various injuries literally accompany a person, as if nature itself reminds that no one is perfect. Common violations are, first of all, mechanical injuries, after them - electrical and psychological. By all indications, radiation injury is recognized as the most difficult: the effect of radiation on the body is almost impossible to reverse.

Even food or any other poisoning is considered an injury. In today's world, you cannot find a person who has not been injured at least once in his life. It is very important to diagnose the type of injury and provide appropriate emergency care, because the life of the victim may depend on it.

Common terminology consists of only two parts:

• trauma - damage to the integrity of the human body (organs, skin, tissues), resulting in changes in human anatomy and physiology. Such shocks are accompanied by the reaction of the body, in other words, by the symptoms;
• traumatism - a complex of repetitive or entailing injuries. Characteristically: the same conditions, causes and time.

Types of classification

You can classify the main types of injuries according to various symptoms, types, etc. Many of the characteristics are confirmed by the medical practice of trauma doctors.

Type of damage

As already mentioned, injuries have multiple confirmed classifications. That is why the classification according to the type of injury comes first.

The type of damage characterizes the integrity of the skin. The following injuries are diagnosed immediately:

• closed - the skin is not damaged;
• open - the skin is damaged. As a result of internal pressure, in response to external influences, the skin begins to break down.

The first "affected" open type will be the mucous membranes. As a result of mucosal ruptures, cracks can occur, into which it is easy to infect the infection. This will lead to many complications. Open-type injuries occur with bone fractures, a different manifestation is a rather rare occurrence.

Severity

The severity is a very important criterion for assessing any violation. Damage is evaluated from top to bottom - from simple to complex.

• Light type.

AT human body no significant disruption occurs. Signs, such as fighting, are immediately obvious - abrasions, scratches, bruises and minor sprains. There is no incapacitation.

Medical assistance is still needed to process even the slightest scratches. It is recommended to reduce physical activity during treatment and rehabilitation.

• Medium type.

Injuries cause pronounced problems to the body - serious bruises, cuts, open wounds, dislocations, etc. The victim begins outpatient treatment, in some cases hospitalization is required. Sick leave lasts from 2 weeks to 1 calendar month. Physical overvoltage is contraindicated, but performance is partially preserved.

• Heavy type.

Serious injuries that entail cardinal changes in the body of the victim - most often, these are various fractures, internal bleeding, ruptures, etc. The victim is urgently hospitalized, the period of treatment and rehabilitation starts from 1 calendar month.

The degree of injury affects the order of clinical treatment, the physical activity of the victim. Seeking medical help is necessary - a bruise, for example, can be much deeper than it seems, and besides, accompany more serious damage. Lack of attention to the symptoms manifested can cause serious consequences for the body in the future.

Impact on the body

There is a well-established characteristic of injuries by type of impact - acute and chronic. Acute injuries arise from the sudden appearance of a damaging factor. Chronic exposure characterized the periodic nature of the injury factor on a certain part of the body or body.

Sports

For people professionally involved in sports, a separate category of injuries has been made: sports. They are all characterized by the fact that injury occurs at the time of active sports.

Constant physical activity can lead to the following changes in the body:

injury statistics

Physical injuries of the sports type are common among professional athletes, as well as people who are actively involved in sports.

In most cases, gymnastics is characterized by a violation of the upper body, hands are often injured - 70-75%. Injury to the lower body during athletics accounts for 66% of injuries in this sport. Boxers suffer face and head injuries in 65% of cases. Athletes who often handle the ball often injure their hands - 80%, and those involved in tennis - the elbow in 70% of cases. Those involved in football, respectively, knee - 47-50%.

Damage localization

Classification according to the location of the injury:

• isolated - one of the organs or part of the motor apparatus is injured;
• multiple - characterized by many identical injuries;
• combined - violations occur in several areas, intersecting with each other. Another name - polytrauma, occurs most often in car accidents. In the case of more than 5 areas of injury, a traumatic shock develops, leading to death;
• combined - violations that appear with a certain sequence or at one moment. The nature of the appearance - mechanical, chemical and thermal - interact with each other, combining into one injury.

Penetration depth

Another principle for characterizing various injuries is the depth of the lesion:

• superficial - only the skin and small blood vessels are affected, small cuts, bruises, abrasions, etc. occur;
• subcutaneous - connective tissues (tendons, ligaments), muscle tissues, joints and bones are injured;
• abdominal - a severe type of damage, characterized by extensive lesions of internal organs.

Certain types of injuries

Take out from general classification should be the most dangerous species injuries, entailing complete deprivation of legal capacity in some cases.

• Spine

Spinal injuries often result from falls from great heights, traffic accidents, and power sports. However, you can get hurt just by lifting a weight.

The number of such cases led to the creation of a separate classification according to the type of damage.

1. Compression - the spinal column is damaged as a result of pressure or fracture of the vertebral bodies. The cause can be cracks, violations, often multiple: several vertebrae are damaged at once.
2. The actual one is due to the frequent flexion and extension of the column, which entails an increased load on all parts of the spine. It is typical for accidents, often occurs when safety is not observed when playing sports or in professional activities associated with the transfer of heavy loads.
3. Ridge bruise - characterized by deep tissue damage, however, it is often mistaken for a simple bruise and proper treatment assistance is not provided. Growing edema, internal bleeding affect the spine, starting to squeeze the vertebrae together, and this leads to a compression type of injury.
4. Rare for the layman gunshot wound damages both tissues and bones of the spine at once.

In addition, there is distinguishing feature spinal injuries - at the location. In the case of the spine, these are different sections - cervical, thoracic, lumbosacral and coccyx. Characteristically, shocks thoracic occur rarely, while the lumbosacral spine is injured more often.

And, of course, there is a classification by type - open and closed injuries. A separate type of spinal cord injury or its absence is distinguished.

• Muscle

Muscle injury occurs, perhaps, most often and is characterized by completely different symptoms.

Contracture is characteristic of increased muscle tone, resulting in a spasm - severe pain is felt and radiates to the entire area of ​​\u200b\u200bthe muscle, while there is no specific localization for pain. Krepatura also belongs to this type - as a result of overload, irreversible consequences occur.

Muscle strain - some fibers of muscle tissue are damaged. Connective tissues (tendons and ligaments) remain intact. This also includes the rupture of part of the fibers, only in this case the surrounding connective tissue also suffers.

Muscle rupture is the most serious injury, since muscle tissue also comes off, touching the connective tissues. The pain is pronounced, it is impossible to strain the muscle - it is torn. In particularly difficult cases, muscle detachment occurs.

• Joints and bones

Slight damage to the articular and bone tissues occurs often even in everyday life. It includes a variety of bruises, disorders within the joints, dislocations and subluxations, intra-articular fractures and simply fractures.

They are divided by type: open (intra-articular fractures and wounds) and closed.

Risk Factors for Damage

There are many reasons that can result in any type of injury:

1. Lack of attention when moving - a person may fall, stumble, or hit something static;
2. Careless movement, exaggerated assessment of possibilities. A common reason for young people doing parkour, skateboarding, etc.;
3. Non-observance or ignoring of safety regulations. It is typical for athletes involved in self-study, as well as for people employed in heavy production;
4. Untreated injuries lead to repeated damage to the weakened area;
5. Lack of warm-up, improper exercise during sports.

There are a huge number of reasons, but they are all related to the human factor. With the exception of injuries during a natural disaster, at this point a person is injured, because nothing can oppose nature.

Types of injuries

Injuries are injuries of the same nature in similar conditions. Since any damage to the anatomical integrity of tissues and organs due to external factors is considered traumatism, there are types of traumatism.

Mechanical injuries are grouped according to the nature of their occurrence.. Injury is inflicted at rest or during movement - when falling.

There are different types of injuries:

• production - arise in industry and agriculture;
• transport - additionally divided into road, rail, aviation, shipping, etc.;
• street - as a result of a fall in an open space;
• domestic - injuries that occur at home due to a combination of common causes or intentionally inflicted;
• military - injuries that appear during military operations;
• sports.

Each of the species has distinctive features that are directly related to the character, as well as to the reasons for obtaining it. With industrial types, for example, open wounds occur more often, and on the street - fractures and dislocations. Sports are characterized by bruises and stretching of tissues. All types are treated by doctors in an ordinary hospital, except for the military. The military falls within the competence of military hospitals.

Mechanical damage can be caused by cold weapons, tools of labor and production, and household damage can be caused by various objects, tools. Instruments of damage are divided into blunt and sharp.

Diagnosis of injuries

Any damage needs timely diagnosis to start proper treatment and prevent consequences. First of all, after the appeal, an initial examination is carried out: the victim is examined, the causes of the injury are found out. This helps to exclude internal damage and prescribe further studies.

The main types of diagnostic studies are as follows:

• x-ray - gives an idea of ​​the state of the skeleton;
• computed tomography (CT) - allows you to assess the condition of bone tissues and joints;
• ultrasound examination (ultrasound) - is necessary to determine the damage to internal organs and soft tissues: cartilage, tendons, etc.;
• magnetic resonance imaging (MRI) - assesses the condition of the periarticular tissue, connective and intervertebral discs;
• endoscopy - is used only with a combination of tissue injury to accurately assess the injury and the presence of a tumor.

Diagnosis is very important in case of injuries, because only according to its results, treatment and rehabilitation of a person can begin.