경골 골절, Fractures of tibia(Tibial fractures)

• 상황에 따라 베개, 판지, 하드보드, 돌돌만 담요 등으로 골절된 경골이 있는 아랫다리와 그쪽의 발목과 넓적다리 전체에 부목을 대고 병원 응급실로 이송할 수 있다.
• 병원에 가는 중 발과 다리의 혈액순환이 정상적으로 잘 되는지 자주 체크해보고 이상이 생기면 의사에게 즉시 보고하면서 이송한다.
• 경골 골절이 있는 아랫다리를 끌거나, 밀거나, 비틀어서는 절대로 안 된다.
• 병원 응급실에서는 경골 골절의 정도에 따라 수술로, 부목 고정으로, 석고붕대 고정으로, 또는 천 붕대 등으로 치료할 수 있다
  .
  
  

Fractures of tibia(Tibial fractures) 경골 골절

• There is one tibia and one fibula on one lower leg.
• Only one of the tibia and fibula in the lower leg may be fractured due to safety accidents, play, exercise, etc.,
• or both tibia and fibula may fracture at the same time.
• Particularly, it is easy to fracture the tibia or fibula when it falls from somewhere or when the lower leg is hit hard.

• When the tibia of one lower leg is fractured, the fibula in the lower leg is often fractured simultaneously.
• Since there is a thin layer of skin and subcutaneous tissue in the area just in front of the tibia, when the tibia is fractured, it is common for the entire skin layer and the subcutaneous tissue in the area in front of the tibia to be simultaneously damaged.

Symptoms, signs of tibia fracture

• Symptoms and signs differ depending on whether one of the two bones of the fibula or tibia in the lower leg is fractured, which part of the fibula or tibia is fractured, and the degree of fracture.
• The fractured shin area may be very painful and swollen, and the skin may also be injured.
• When you press the fractured lower leg with your hand, it hurts and your child cannot move the fractured leg well.

Diagnosis of tibia fracture

• If you suspect that your child’s tibia is fractured by combining your medical history, symptoms, signs, and examination findings, you can diagnose it with a tibia and fibula x-ray image.
• When the tibia or fibula in the lower leg is severely fractured, the end of the fractured tibia or fibula may penetrate the skin layer and subcutaneous tissue and protrude out of the skin.
• When the tibia and fibula are severely fractured at the same time, the lower leg may be bent.
• At this time, anyone can easily diagnose the fracture of the tibia and fibula of the lower leg by looking at the lower leg with their eyes.

Tibia (shin bone) fracture treatment

▴ Figure 1-118. If you suspect that your child’s lower leg’s bones are broken, Place a splint on the upper and lower leg where the fractured bone is located. It is transferred to the hospital. When you apply the splint, Do not press, push, pull, or twist, but apply a splint. Copyright ⓒ 2011 John Sangwon Lee, M.D., FAAP

• Treatment is performed according to the fractured tibia area and the degree of fracture. Emergency phone consultations with medical paramedics, hospital emergency rooms, or regular pediatricians are initiated on-site according to their instructions.
• As with many other types of bone fractures, severe pain can occur.
• First of all, it is good to stabilize the patient and keep the lower leg on the fractured tibia as it was first seen before the medical paramedic or doctor arrives at the scene as much as possible without moving any more than necessary.
• Check whether the blood circulation in the lower leg where the tibia fracture is located is normal and whether the peripheral nerves in the area are damaged.
• Depending on the situation, it is possible to transfer to the hospital emergency room by attaching a splint to the fractured tibia’s lower leg with a pillow, cardboard, hardboard, or blanket, and the entire ankle and thigh.
• While going to the hospital, check frequently to see if the blood circulation in the feet and legs is normal, and if any abnormalities occur, report to the doctor immediately and transfer.
• Never pull, push, or twist the lower leg with a tibia fracture.
• In the hospital emergency room, depending on the degree of tibia fracture, it can be treated with surgery, splint fixation, bandage fixation, or cloth bandage.

출처 및 참조 문헌 Sources and references

• NelsonTextbook of Pediatrics 22ND Ed
• The Harriet Lane Handbook 22ND Ed
• Growth and development of the children
• Red Book 32^nd Ed 2021-2024
• Neonatal Resuscitation, American Academy Pediatrics

• Quick Reference to Pediatric Emergencies, Delmer J. Pascoe, M.D.