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Fractures 1661703244837 - Coggle Diagram
Fractures
Definition
According to Mogotlane et al(2015) it is a break of the continuity of the bone because of trauma, disease or pressure.
Causes
Trauma
From a blow or crash (MVA)
Unintended violence (falls)
From sports and occupation injuries.
Degenerative disorders
Osteoporosis in elderly women
Metastasis in malignances
Pathophysiology
It's when the continuity of a bone breaks, this result into periosteum being stripped off I the bone and ts blood vessels
The bone edges may damage the tissues around it.
Blood vessels may also be damaged, that results in severe bleeding. A hematoma may form causing the area to be swollen.
Types of fractures
complete fracture
-it's a clear break of a bone, broken parts are usually displaced.
closed or simple fracture
-the bone is broken into two parts, there's no break on skin.
open fracture
-the bone is broken completely and there's a wound that opens exterior.
comminuted fracture
-there are many fragments at the point of the break, resulting from a crash.
compression fracture
-it's when the vertebral column has been compressed as a result from a fall from a height in an upright position.
Depressed fracture
-applies to the skull where a blunt blow causes a dent that presses on the brain substance.
impacted fracture
-it's when the bone fragment slips over the other fragment.
greenstick/incomplete fracture
-happens in children where the one side breaks while the other side is bent.
pathologic fracture
-related to a disease and can occur without trauma.
Surgical management
Closed reduction or manipulation.
Open reduction internal fixation.
Gradual reduction.
Nursing management
Assessment and common findings
Oedema and swelling resulting from injured tissues and blood vessels
Pain and tenderness resulting from muscle spasms.
Loss of function resulting from disturbed normal structure.
Deformity resulting from unnatural position of the bone.
Discoloration resulting from bleeding.
Crepitation resulting from palpable and audiable crunching sounds as a result of the crunching of bone fragments.
Nursing diagnosis
Altered comfort and activity tolerance related to the fracture evidence by a patient verbalising an experience of pain.
Potential for fat embolism related to the fracture.
Risk of infection related to injury and immobility.
Nursing intervention
Assess and determine the extent of pain in a pain scale of 1-10
Immobalise the fractured bone and maintain alignment to reduce pain and prevent further damage.
Administration of analgesia, anti inflammatory drugs and antibiotics.
Monitor vital signs and not any deviation from normal.
Apply aseptic techniques when giving pain and wound care.
Apply traction to provide support and reduce swelling.
Do careful neuro Vascular assessment using 5 P's.
Diagnostic tests
Bone scan or X-ray
History taking and physical examination
FBC, coagulation studies
Rehabilitation
It commences after injury and continues until healing has taken place.
Measures like mobilization are done to ensure the bone retains its normal anatomical position.
Muscles and joints should be exercised to restore and maintain full function.
A prosthesis may be used if the extremity had to be amputated.
Complications of fractures
Fat embolism
Non-union
Infection
Delayed union
Malunion
AVascular necrosis
Painful post-traumatic osteoporosis
Compartment syndrome
Gas gangrene
Reference
Mogotlane,S., Chauke, M., Matlakala, M., Mokena, J.&Young,A.(2015). Management of specific disorders of masculo-skeletal systems. Bone fracture . Jutas complete textbook of medical surgical nursing, page:915-919. Capetown.
