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A fracture is a break in the continuity of bone and is defined

according to its type and extent.


Fracture is a break in any bone in the body. Complete fracture : a
break across the entire cross-section of the bone.

CAUSES

TYPES OF FRACTURES
Complete fracture: a break across the entire cross-section of
the bone.
Incomplete fracture: the break occurs through only part of the
cross-section of the bone.
Closed fracture (simple fracture): one that does not cause a
break in the skin.
Open fracture (compound, or complex, fracture): one in
which the skin or mucous membrane wound extends to the
fractured bone.
Open fractures are graded according to the following criteria:
o Grade I is a clean wound less than 1 cm long.
o Grade II is a larger wound without extensive soft tissue
damage.

CLINICAL MANIFESTATIONS

Pain, aggravated by motion, tenderness; Loss of


Motion
Edema and Ecchymosis (after 24 hours); Crepitus
Shortening of the limb due to muscle spasms.
Obvious deformity (e.g. adduction, external rotation
of hip)

TYPICAL BONE FRACTURES

PATHOPHYSIOLOGY

Greenstick. One side of the bone is impaired,

COLLABORATIVE MANAGEMENT

Traction
Reduction
the other is bent. It affects cartilaginous bones;
o Closed Reduction with External Fixation
Common in children.
(CREF), done through manual manipulation
followed by application of cast.
Spiral. The line of break goes around the bone. Edema of Compartment
1. Encourage not to mobilize affected part. ROM
Contents
exercises for unaffected muscles and using of
Comminuted. Bone ends are splintered into 2 or
assistive devices.
more small pieces.
o Open Reduction with Internal Fixation (ORIF),
done through surgery involves pins, wires, screws
Increased
pressure within closed compartment
Transverse. The line of break is across
the bone.
and plates application.
1. Check dressings for bleeding and infection.
2. Empty hemovac. Serosanguinous drainage is
Compound. A fracture in which the bone is
normal.
5 Ps
sticking through the skin. Also called an open
3.
Assess LOC.
Pain
fracture.
4.
Turn every 2 hours.
Pallor
5.
Turn to unoperative side only.
Pulselessness
Compression.
A
fracture
caused
by
6.
Place 2 pillows between legs.
Paresthesia
7. Implement measure to prevent thrombus
compression, the act of pressing together.
Paralysis
formation.
8. Monitor bowl and bladder function.
OTHER FRACTURES:
9. Assist patient in getting in and out of bed.
Contractures (e.g. Volkmanns contracture) 10.Avoid weight bearing on the affected leg until
Avulsion: fracture which occurs when a fragment
allowed.
of bone tears away from the main mass of bone.
Cast Application
Function Disability Monitor for disorientation and confusion in elderly. May
Depressed: A fracture in which fragments are
result from stress of fracture, unfamiliar surroundings,
driven inward (seen frequently in fractures of skull
systemic diseases, cerebral ischemia, etc.

and facial bones)

Epiphyseal: A fracture through the epiphysis


Pathologic:

it occurs through an area of


diseased bone (eg, osteoporosis, bone cyst, bony
metastasis, tumor); can occur without trauma or a
fall.

Fracture
Tight Dressing
Tight Cast

COMPLICATIONS OF FRACTURES
Hypovolemic Shock, due to massive bleeding.
Fat embolism, usually follows fracture of the long bones may lead to
Acute Respiratory Distress Syndrome.
Compartment Syndrome, results from fractures of arms and legs where
closed compartments are present. A compartment contains blood vessels,
nerves and muscles that are enclosed by fascia.

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