What are the principles of treatment for fractures

  1.Resetting: ① anatomical resetting: the contact surface of the two fracture ends (alignment) and the relationship between the two fracture ends in the longitudinal axis (alignment) are completely good, restoring the normal anatomical relationship; ② functional resetting: the alignment of the two fracture ends is poor, but the alignment is basically good, and the limb functions normally after healing.  2.Fixation: manual repositioning and external fixation (commonly used small splint or plaster bandage fixation method); continuous traction (bone traction or skin traction); incisional repositioning and internal fixation and others.  (1) Small splint fixation: mainly applicable to the more stable fractures of the long bones of the limbs, the fixation range does not include the upper and lower joints of the fracture, which is conducive to early functional exercise, but the binding is too loose to easily displace the fracture or deformed healing, and the binding is too tight to affect the blood flow of the limb or the occurrence of ischemic muscle contracture.  (2) Plaster bandage fixation: it can be shaped according to the limb and fixed reliably (10-20 minutes for initial hardening and 2-3 days for complete hardening), but it is inelastic and cannot be adjusted for tightness with the increase or decrease of limb swelling, and the range of fixation is large, which is not conducive to functional exercise.  (3) Continuous traction: bone traction is more direct and powerful, which is conducive to open wound observation and dressing change and functional exercise, but cannot be used to get out of bed early; skin traction is more indirect and less powerful.  (4) Incisional repositioning and internal fixation: accurate repositioning and secure fixation, but has the disadvantage of invasive treatment.  3.Functional exercise: principles: ① early stage (within 1-2 weeks after injury), the main focus is on muscle stretching and contraction of the affected limb; ② middle stage (2-3 weeks after injury), the main focus is on distal and proximal joint movement at the fracture; ③ late stage (6-8 weeks after injury), the main focus is on joint functional exercise of the whole body.  Patients with fractures are encouraged to progress gradually, from light to heavy, from small to large, with the principle of active functional exercise as the main focus and passive activities as a supplement. Patients with limb paralysis perform passive joint activities, supplemented by massage and physical therapy.