Fractures of the head and neck and spine:
Fracture of skull bones belongs to the field of neurosurgery and has no place in orthopedic injuries. In relation to spinal fractures, these fractures are very important due to the dangerous complication of spinal cord and spinal nerves damage, which are caused by the pressure of broken bone fragments or due to dislocation of vertebrae or bleeding. will be Damage to the spinal cord and its nerves causes sensory and motor disorders and paralysis in the area below the affected area. The spine is made up of three parts: cervical vertebrae, thoracic vertebrae and lumbar vertebrae, here we briefly describe the fractures of each part:
1- Fracture of the cervical vertebrae:
1-1: Definition of neck fracture: The fracture of any of the seven cervical vertebrae is called a neck fracture.
1-2: Cause of neck fracture: Neck fracture usually occurs due to very strong blows. Such blows are usually seen in road accidents or falls from a height. During sports activities, a person may suffer a fracture of the cervical vertebrae. For example, a gymnast falling from the hoop during a backstroke, or a rider falling from a horse, or hitting a swimmer's head while diving to the bottom of a shallow pool, can all cause a fracture of the cervical vertebra and subsequent damage to the spinal cord

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1-3: Emergency measures in the face of a patient with a broken neck: In any patient who has suffered a severe physical injury due to the blows mentioned above, the neck must be immobilized before moving the patient in any way. As soon as the emergency personnel encounter such a disease, they first tie a special necklace around the patient's neck and then transfer him to the ambulance. This necklace remains attached to the patient's neck until the patient takes a picture of the neck area in the hospital and the doctor is sure of the health of the cervical spine. To make sure that the vertebrae are broken, we gently push a sharp object into the palms of the hands. If the victim does not react and does not feel the movement of the object in any of his hands, it is due to damage to the neck nerves. Do not allow the victim to bend or turn his head. Place the victim's head and neck in a line so that his face is upwards. Use a splint that continues up to the waist and cover the neck of the victim with cotton or cloth. Then tie the splint with three bandages in such a way that one bandage is placed on the forehead and another bandage on the shoulders and one at the end of the splint (waist) and fill the empty space of the body with a pad or cloth.
Emergency measures in the face of neck fracture disease
1-4: Diagnosis of neck fracture: normal radiography and CT scan are used to diagnose these fractures, and MRI may be used to check possible damage to the spinal cord.
Diagnosis of neck fracture
1-5: Treatment of neck fractures: In most cases, the treatment of choice is surgical fixation. In rare cases, it may be controlled by wearing a cervical brace.
Treatment of neck fractures

2- Fracture of the thoracic and lumbar vertebrae: considering that the mechanism of injury of these two parts of the spine is similar and they have the same treatments, in this section we introduce these fractures together:
Fracture of the thoracic and lumbar vertebrae

2-1: Definition of thoracic and lumbar vertebrae fractures: The most common vertebral column fractures occur in the thoracic and lumbar vertebrae, which are four times more common in men than in women. Due to the fact that the patients who suffered these fractures have endured severe blows, many times along with these fractures, fractures in other organs or damage in other organs are also seen. The spinal cord passes through the vertebral column and is at risk in these fractures

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Fracture of the thoracic and lumbar vertebrae
2-2: Causes of thoracic and lumbar vertebrae fractures: These fractures often occur in road accidents and falls from a height. Of course, it can be seen in active sports and in armed conflicts. Sometimes a fracture can occur without causing a severe blow to the person, for example, in people suffering from osteoporosis or in some spinal tumors due to weakening of the bones.
Fracture of the thoracic and lumbar vertebrae

Another cause of these fractures is osteoporosis in the elderly. When the bone of the vertebra becomes weak, it also loses its resistance to pressure and light blows, and as a result, very small fractures are created in the vertebra due to every small impact that is inflicted on the vertebra. These blows and pressures may happen due to jumping, jumping, turning, going down the stairs, the car falling into a bump, lifting a heavy object or even coughing and sneezing. The person does not notice these fractures, except that at the same time, a person may experience some back pain, which will get better after a while. The fracture heals itself. Gradually, fracture after fracture occurs and gradually these fractures are added together. With each fracture, the shape of the vertebra changes slightly. The nut crumbles on itself. The height of the vertebra decreases and this decrease in height is more especially in front of the vertebra and the person gradually becomes hunched. He notices that his height is also decreasing. These fractures are called compression.
A vertebra that is suffering from osteoporosis can suffer a single and large fracture like any other bone. The probability of these fractures is higher in the cracked vertebra, and these vertebrae are fractured due to blows that are much weaker than usual.
2-3: Symptoms and diagnosis of fractures of the thoracic and lumbar vertebrae: the most important symptom of these fractures is severe pain that gets worse with movement. When a spinal cord injury occurs, symptoms such as numbness, tingling, weakness or impaired urination and defecation may also occur

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Fracture of the thoracic and lumbar vertebrae
2-4: Emergency measures in the face of a patient with thoracic and lumbar spine fracture: in any disease, to ensure the fracture of the vertebrae, we slowly pull a sharp object to the soles of the feet, if the victim does not show any reaction and the movement of the object in none of them He can't feel his legs, it's because of damage to the back nerves. If the spinal cord is severed following the fracture of the adjacent vertebra, the spinal cord will never recover and the victim will be paralyzed from the fracture level down for the rest of his life. Therefore, the method of dealing with the injured person first is very important. Place the victim in a lying and motionless position and keep him warm. To immobilize the spine, use a full-length splint. Put cotton or pads in the middle of the legs up to the top and wrap the legs tightly in different parts with bandages. wide, tighten the knees and thighs. Lift the injured person by at least 4 people about 20 cm from the ground and place him on a full-length splint. Fill the hollow points of the body with cotton or cloth and tie the body tightly to the splint with a bandage. Transfer the patient to medical centers by a rigid stretcher in a position where his breathing is open.
Actions in the face of disease with thoracic and lumbar spine fractures

2-5: Treatment of fractures of the thoracic and lumbar vertebrae: in cases where these fractures are very severe and the bone is crushed, or due to the crushing of the vertebra, its height is too low, or the vertebrae are too angular at the fracture site, or damage If an important nerve occurs due to pressure on the spinal nerves, surgery is the preferred procedure. During the surgery, the bone pieces that put pressure on the nerves are moved aside or removed, and then the fracture is stabilized by devices. In rare cases, such as the treatment of fractures of the transverse process of the vertebrae, surgery is not required

Treatment of thoracic and lumbar fractures
In cases of lumbar and thoracic vertebrae fractures due to osteoporosis, most of these fractures heal spontaneously after 6-8 weeks. A few days of rest and medication may be the only treatment these patients need. Sometimes the doctor prescribes special braces in the form of a medical belt for the patient to limit the movements of the spine. This restriction may help the fracture heal. Also, the treating doctor takes help from drugs to control the severity of osteoporosis. If the pain does not respond to the usual treatments, surgery may help the patient. The two types of surgery that are performed for these patients are kyphoplasty and vertebroplasty. The best candidates for these surgeries are patients who have experienced severe pain due to a new compression fracture. In kyphoplasty surgery, a small balloon is sent into the broken vertebra and inflated. This will make the shape of the bead return to its previous state. Then the balloon is removed and bone cement is injected instead of the empty area.
Treatment of thoracic and lumbar fractures

Vertebroplasty surgery is similar to kyphoplasty, with the difference that a balloon is not sent into the vertebra, but bone cement is injected directly into the vertebra. In this method, no attempt is made to correct the deformity created in the vertebra, and the purpose of the surgery is only to strengthen the broken vertebra.