Accidents break bones—and damage blood pipes too
Nowadays there are many road accidents. As new highways and national highways are being built, the number of scooters and vehicles is increasing tremendously. Along with this, the speed of vehicles has also increased. This is a common observation, majority of two-wheeler drivers drive at high speed in a haphazard manner on roads, disregarding traffic rules. A significant number of car drivers also do a reckless driving. The result of this is that road accidents are increasing. But two-wheeler drivers are bearing the maximum brunt of physical injuries and losses in road accidents. Often these people break the bones of their legs or hands. Sometimes even the ribs also get fractured.
Not only the bone breaks, something else also breaks
You people should know that if someone’s leg or arm bone breaks in a road traffic accident, then not only the bone breaks, something else also breaks. Along with this, the blood pipes (blood vessels) of the leg also get injured. These damaged blood pipes of leg or hand are of two types. One is the tube that carries oxygenated pure blood to the legs, which is called artery. The other tube, which carries oxygen-free impure blood, is called veins. In our country, in majority of cases, the entire focus is on joining bone fracture by applying plaster and fixing the fracture with steel nails. But unfortunately, till a few years ago, no one paid attention to the injured or completely broken blood pipes of leg or hand in an accident. But now the situation has started improving a little but overall scenario is still pathetic.
If an artery carrying pure blood also gets injured along with the bone fracture
This is a very dangerous situation. Because the survival of hands and feet depends on this pure blood pipe i.e., artery. It is very important to know that the movement of hands and feet i.e., the survival of muscles depends on the supply of pure blood. Oxygen is required to move the fingers of hands and feet and this oxygen is supplied only through the pure blood vessel i.e., artery. Now you must have understood that if the artery is also injured or completely broken along with the bone of the foot or hand, then the hands and feet will become lifeless and in the absence of immediate treatment, gangrene will occur in the hands and feet. Then there is no use in joining and fixing the bones.
If the vein carrying the impure blood is broken along with the bone fracture
If the impure blood pipe (vein) of the hand and foot is damaged, the colour of the foot and hand will not turn black but there will be swelling, because blood clots will accumulate in the injured vein and the upward flow of impure blood will stop. If these blood clots move upwards and reach the blood pipes of the lungs, they will block these lung pipes. The injured person will then suddenly start having breathing problems and the chances of death will increase. If the vein is completely broken, there will be severe bleeding and there will be heavy accumulation of blood in the area of the broken bone and that will result into a severe swelling in the hands and legs. Even if the fractured bone is joined, there will be permanent swelling in the hands and legs because of permanent deposition of blood clots in the vein.
What to do if a bone of leg or hand is broken in an accident?
First of all, understand that if the bone alone is broken, then you can wait for two to three days by applying a temporary plaster and as per convenience, the broken bone can be joined and fixed with a permanent plaster and steel rod and nails, but if along with the broken bone, the blood pipe is also damaged, then you cannot wait because every hour becomes precious in saving the hands and legs. Immediately contact an experienced vascular surgeon. Always remember that a patient with a bone fracture in an accident should go to a hospital where a vascular surgeon along with a bone surgeon is available 24 hours a day. Also ensure that there is facility for some special tests, such as vascular doppler study and CT angiography etc.
Methods of treatment
If along with the bone, the blood pipes are also broken, then first the blood pipe repair or vascular bypass surgery must be done to restore the blood flow so that the hand and leg can be saved. After this, the operation of fixing the fractured bone should be started. Remember that even if the bone fracture is fixed without having first joined the disrupted blood pipes and restoring the blood flow, then there is no benefit and the hand or leg will not then survive.
Pay special attention to some important things
If ever in the past years your bone was broken in a road traffic accident and the fractured bone was fixed and joined through surgery. Even after this, if there is swelling in the feet or hands, then it is possible that there is a blockage in the injured impure blood pipes i.e., veins and blood clots have accumulated. If there is pain and tingling in the hands and feet even after the bone heals, then it is possible that there is a constriction or blockage in the artery carrying pure blood. Immediately consult an experienced vascular surgeon.
Dr K K Pandey is Senior Vascular and Cardiothoracic Surgeon, Indraprastha Apollo Hospital, New Delhi
