What are the common complications of fractures? How can prevention and rehabilitation be carried out?

  The common complications of fracture are divided into early complications and late complications.  1. Early complications (1) Shock: It is caused by severe trauma, hemorrhage caused by fracture or injury to vital organs.  (2) Fat embolism: It is due to excessive tension of the hematoma in the medullary cavity at the fracture, the bone marrow is destroyed, and fat droplets enter the ruptured venous sinus, and with the need to reach the lung and brain cause fat embolism in the lung and brain, which seriously affects life.  (3) Important visceral organ injury: such as liver, spleen rupture, lung injury, bladder and urethra injury, rectal injury, etc.  (4) Important peripheral tissue injury: including extremity vascular injury, peripheral nerve injury, spinal cord injury, etc.  (5) osteofascial compartment syndrome: due to severe limb trauma, causing local osteofascial compartment pressure increase, resulting in peripheral nerve soft tissue ischemia and hypoxia, leading to limb necrosis in severe cases, often resulting in serious consequences such as amputation. It most often occurs on the palmar side of the forearm and lower leg. Once the diagnosis of osteo-fascial compartment syndrome is confirmed, the fascia should be immediately cut and decompressed.  2. Late complications (1) Pneumonic pneumonia: long-term bed rest leads to reduced lung activity, causing inflammation of the lungs due to long-term congestion, bruising, and edema.  (2) Pressure sores: common sites include the sacrum, hip, and heel.  (3) Deep vein thrombosis of the lower extremities: mostly seen in pelvic and lower extremity fractures.  (4) Infection: Infection may occur in open fractures with severe injury, residual necrotic tissue or poor soft tissue coverage. Improper treatment may lead to septic osteomyelitis.  (5) Traumatic arthritis: After any joint trauma, especially lower limb joint injury, the joint surface is damaged or the intra-articular fracture is not anatomically repositioned and the deformity heals, causing traumatic arthritis due to uneven joint surface and long-term wear and tear.  (6) Joint stiffness: the most common complication of fracture and joint injury. The affected limb is fixed for a long time, the venous lymphatic system does not return smoothly, and the exudate causes local soft tissue adhesions, and is accompanied by contracture of the joint capsule and surrounding muscles, resulting in joint movement disorders. Timely removal of fixation and active functional exercise are effective methods to prevent and treat joint stiffness.  (7) Disuse bone atrophy (8) Ischemic osteonecrosis: common ischemic necrosis of the femoral head after femoral neck fracture.  (9) Ischemic myoclonus: one of the most serious complications of fracture, which is a serious consequence of the occurrence of osteofascial compartment syndrome.  (10) Osteoporosis.