FRACTURE

DEFINITION:-

A break in continuity of bones is called fracture, it may be due to excessive pressure on bone and bone is unable to absorb this pressure.

TYPES OF FRACTURES:-

Complete fracture:It involves the entire section of the bone.

Incomplete fracture: Also called greenstick fracture, break occurs only through part of the cross section of the bone.

Comminuted fracture: A break with several bone fragments.

Closed fracture: It is also called "simple fracture" it does not produce a break in skin.

Open fracture: It is also called compound or complex fracture. A break in which the skin or mucous membrane wound extends to fractured bone.

Impacted fracture: When one bone impact to another bone.

Pathologic fracture: Fracture occurs due to bone disease or without any other pressure, e.g., osteoporosis bone, osteomyelitis.


PATTERNS OF FRACTURE:-

Greenstick fracture: One side of the bone is broken and the other side is bent.

Oblique fracture: At an angle across the bone.

Transverse fracture: Straight across the bone.

Spiral fracture: Twists around the shaft of bone.

Compression fracture: Bone collapse on itself.


CLINICAL MANIFESTATIONS:-

Acute pain

Loss of function

Deformity

Shortening of the extremity.

Crepitus (abnormal mobility)

Swelling

Tenderness

Localized edema

Ecchymosis (bruise mark on skin due to impaired muscles)

Numbness (paresthesia)

Injured muscles, blood vessels, nerves

If open fracture, there may be chance of haemorrhage that leads to shock.


DIAGNOSTIC EVALUATION:-

X-ray

Anterior

Posterior

Lateral view.


COMPLICATIONS:-

Muscle atrophy

Loss of muscle strength

Pressure sores

Venous stasis and thromboembolism

Infection

Shock

Pulmonary embolembolism

Fat embolism

Bone union problem.


Management:-


Emergency Management

1)Check ABC of patient and also maintain it.

2)Check vital signs.

3)Immediately after injury, immobilize the body part while the patient have to move.

4)Splint the fracture.

5)To support the fracture site.

6)In an upper extremity injury, the arm may be bandaged to the chest, or an injured forearm may be placed in a sling.

7)Cover the wound of an open fracture with a sterile dressing to prevent contamination of deeper tissues.



Reductionn of Fractures

It is of three types:

Closed Reduction: It is method of fracture alignment. It is performed manually (by hands) apply a traction force to bone till end of the bone together.

Open Reduction: Surgical placement of internal fixation devices (e.g., metallic pins, wires, screws, plates, nails, or rods.

Traction Reduction: The application of a pulling force, especially as a means of counteracting the nature of tension in the tissues, surrounding a broken bone.


Two Directions:

Pull of traction

Pull of counter of traction.


NURSING MANAGEMENT:-

Assessmentment

Assess ABC of patient.

Assess types, location and severity of fractured part.

Observe condition of shock and haemorrhage.

Assess patients requirements according to fracture.



NURSING DIAGNOSIS

Risk for haemorrhage and shock related to Open Fracture.

Nursing Intervention

Check B.P. (blood pressure) of patient.

Observe any bleeding.

Provide ice pack and sponging application for vasoconstriction.

Administer IV fluids

Maintain I/O chart.



Pain swelling related to Fracture

Nursing Intervention

Immobilize injured part.

Provide comfortable position to patient.

Provide prescribed analgesics, e.g., Diclofenac sodium.



Risk for infection related to open wound

Nursing Intervention

To clean and irrigate the open wound.

Use aseptic technique during dressing.



Rehabilitating Programme

Nursing Intervention

Provide rehabilitation training to patient.

Introduce to physiotherapist and promote for exercise to patient.

To provide special care for the patient in plaster case.

To provide special care for a patient on traction.

Provide psychological support to patient.

Give education to patient and make discharge planning.


PREVIOUS YEAR QUESTIONS

Complications of fracture

 Types of fractures




Comments

Post a Comment

Popular posts from this blog

PNEUMONIA

Image
PNEUMONIA DEFINITION: - It is an inflammation of lung parenchyma which is associated with marked increase interstitial and alveolar fluid. CAUSES/AETIOLOGY:- Bacterial infection: Gram +ve: Strep. Pneumonia Strep. aurious. Gram -ve: H. influenza Pseudomonas Anaerobic bacteria Viral infection: Influenza virus Para influenza virus Adenovirus Fungus infection: Candidiasis Histoplasmosis Mycoplasma and protozoa in AIDS. CLASSIFICATION:- Community Acquired Pneumonia It occurs in normal healthy persons Bacterial infection Viral infection Hospital Acquired Pneumonia It occurs either when immunity is week or in lung disorders or anatomical abnormal lungs. TYPES:- Segmental Pneumonia:  Only in one small segmental lobes of lung. Bilateral Pneumonia:  Both side segmental lobes of lungs are affected. Lobar Pneumonia:  Complete lobe affected. Broncho Pneumonia:  Patchy like formation in the lungs. RISK FACTORS:- Air pollution/Aspiration Bed rest/prolonged immobility Ch...
Read more

COPD

Image
DEFINITION:-  COPD is the progressive and partially reversible disease of the airway  Comprises primarily of two related disease- chronic bronchitis and Emphysema  Chronic obstruction of the flow of air through the airway and out of the lungs permanent and progressive obstruction over time. Chronic bronchitis is defined clinically as a daily cough with production of sputum at least 3 month per year for 2 or more consecutive year.  It involves inflammation and swelling of the lining of the air way that leads to narrowing and obstruction of the air way.  The inflammation also stimulate production of mucus which can cause further obstruction of the airway.  EMPHYSEMA  It is permanent enlargement of the alveoli due to destruction of the wall between alveoli which leads to reduce the elasticity of the lungs over all.  Loss of elasticity leads to collapse of the bronchioles, obstructing air flow out of the alveoli. Air become trapped to the alveoli and reduce the ab...
Read more

OSTEOMYELITIS

Image
OSTEOMYELITIS DEFINITION:- It is an inflammation of bone due to infection, it may affect any bone. CAUSES:- Bacterial infection: - Staphylococcus Aureus - Streptococcus Viral infection Fungal infection PATHOPHYSIOLOGY:- Due to infection in medullary part of bone ↓ Infection spreads to periosteum ↓ Oedema or abscess formation ↓ Narcotic bone (sequestra) ↓ Peritonsillar abscess (Pus formation) SIGNS AND SYMPTOMS:- Fever Inability in weight bearing Signs of sepsis Erythema Chills Nausea Malaise Restlessness Spontaneous fracture. Night sweats Swelling, tenderness, and warmth at infection site.DIAGNOSTIC FINDING:- DIAGNOSTIC FINDING:- C.B.C - WBC es - ESR es X-ray C.T. scan/MRI Radionuclide bone scan COMPLICATIONS:- Non-healing wound Sepsis Immobility Amputation. MEDICAL MANAGEMENT:- Antibiotics, - Penicillin - Tetracycline - Cephalosporin, e.g., cefalexin Analgesics and antipyretics as prescribed Application of plaster cast and traction FNAC (Fine needle aspiration cytology) fo...
Read more