Fractures - Medical Negligence Lawyers

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Multiple Fractures - Medical Negligence

People with multiple fractures generally have suffered injuries from a great fall or from a motor vehicle accident. These are serious injuries in which multiple forces in different directions have led to many different fractures.

Common fractures in the above accidents include the following:

  • Skull fractures - these can be comminuted or simple fractures
  • Cervical spine fractures - these can be from lateral forces or downward forces
  • Thoracolumbar fractures - seat belt injuries can cause some of these
  • Upper extremity fractures - these are more common in motor vehicle accidents than in falls
  • Pelvic fractures - from extreme forces
  • Hip fractures - from an upward force
  • Femur fractures - these can come from lateral or upward forces
  • Tib/fib fractures - these are common fractures in falls and car accidents
  • Rib fractures - these are also common fractures in falls and car accidents

Skull fractures are serious fractures that generally come from sudden impact between the skull and a hard surface. In a car accident or motor vehicle accident, the impact is often between the skull and the asphalt when the victim is ejected. It can lead to an extradural hematoma or a subdural hematoma, both of which involve bleeding on the brain that exerts pressure on the brain. This causes further brain trauma and an increase in the intracranial pressure. An increased intracranial pressure can result in brain herniation and sudden death.

Skull fractures are treated expectantly or are treated by surgically lifting or depressing segments as needed.

Spinal fractures are common fractures in both falls from great heights and in severe automobile accidents. Forces in both types of injuries act to fracture the vertebrae in the C-spine or the thoracolumbar spine, resulting in a high frequency of paraplegia and quadriplegia. There can be simple fractures of the vertebrae with preservation of the spinal column or severe fracture dislocations that involve damage to ligaments and bones. These are often treated surgically using bone grafts, plates and screws to fuse the injured bones with healthy ones.

Upper extremity fractures are more common in motor vehicle accidents than in falls unless the fall is to the outstretched hand. The driver often braces himself with the steering wheel in anticipated accidents and there is a force extending from the steering wheel through to the proximal humerus. Fractures can occur at any point from the wrist to the radius and ulna and through to the humerus and shoulder. These are often displaced fractures that need closed or open reduction and casting. Humerus fractures can be treated with gravity or with surgery, depending on the age and degree of displacement.

Pelvic fractures are often found in falls from great heights due to the extreme forces involved. They are less common in car accidents in which the individual is properly seat belted. The pelvic bones are thick and well protected within body but when a person is ejected from a motor vehicle, in a motorcycle, or has fallen from a great height, there is a good chance that the pelvic bones can be fractured. Pelvic fractures can be stable, meaning they aren’t likely to damage internal structures, or unstable, in which damage to internal structures is likely. Pelvic structures easily damaged are female reproductive organs and urinary tract organs in both men and women. The unstable fractures often need surgery to seal the ends together so they don’t get out of place.

Hip fractures can happen with falls on a level surface as well as falls from great heights. The driver or passenger can brake with their foot so that they put force between the front of the car and their hip. This can lead to a hip fracture. Hip fractures vary according to the part of the hip involved but most of the time, the fracture needs to be treated with a hip replacement. This involves removing the broken proximal end of the femur and replacing it with an artificial hip. Sometimes the socket of the joint is damaged and needs to be replaced as well. The person is usually ambulatory the next day if they have no other fractures and they recover in several months.

Femur fractures are fractures of the femur bone lower down on the femur. They can happen when the leg receives a blow from the side or from a force traveling up from the foot. Femur fractures can be associated with crush injuries of the leg and require open reduction and internal fixation using a rod that extends down into the bone on both sides of the fracture. The person then recovers over a period of six to eight weeks.

Tibia and fibula fractures are common in falls and in motor vehicle accidents. These are lower leg fractures and the commonly fracture at the same time and at the same level unless there is torsion of the leg. These are treated by open reduction and internal fixation of the tibia while the fibula is just approximated.

Vertebral fractures are common because they are so thin and there are a lot of them. Vertebral fractures can be minor or can cause a punctured lung. Punctured lungs can be life threatening if they interfere with the oxygenation of the person.

There are many challenges facing patients with multiple fractures. Often they are bedridden because they cannot use assistive devices to ambulate. When both legs are broken, the person is often wheelchair bound and cannot leave the bed or wheelchair for 6-8 weeks. If upper and lower extremities are affected, things like crutches and walkers cannot easily be used. People with multiple fractures have a high mortality rate from complications and immobility.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here