Fractures - MedG

 

• Definition: Fractures are broken bones involving bones, muscles, tendons, ligaments, and soft tissues.

• Symptoms: Include pain (continuous), numbness, muscle spasms, deformities, limb shortening, crepitus (grating sound), edema, and ecchymosis (bruising).

• Types:

  • Closed (simple): No break in skin; requires monitoring for edema, pain, and manual alignment.

  • Open (compound): Skin broken; risks include infection, bleeding, and tetanus. May require surgical fixation.

    • Type I: Clean wound <1 cm.

    • Type II: Minimal soft tissue damage.

    • Type III: Highly contaminated wound with soft tissue damage or vascular injury.

• Complications:

  • Acute (24–72 hrs):

    • Shock (especially pelvic or long bone fractures).

    • Fat embolism — bone marrow fat enters bloodstream causing respiratory and cardiac symptoms.

    • Compartment syndrome — pressure builds in muscle compartments, reducing circulation and causing emergency; may need fasciotomy.

  • Delayed: Malunion — bone heals in incorrect position.

• Nursing Interventions:

  • Splint and immobilize the limb, manage pain, monitor for infection, cover open wounds with sterile saline gauze, and perform frequent neuro checks (6 P’s: pain, pulse, pallor, paresthesia, paralysis, pressure).

• Traction: Uses pulling force to maintain bone alignment (skin or skeletal). Never remove weights; keep skin integrity intact.

• Key Note: Immobility increases the risk of DVT (deep vein thrombosis), so limb elevation and circulation checks are crucial.

• Definition: Fractures are broken bones involving bones, muscles, tendons, ligaments, and soft tissues.

• Symptoms: Include pain (continuous), numbness, muscle spasms, deformities, limb shortening, crepitus (grating sound), edema, and ecchymosis (bruising).

• Types:

  • Closed (simple): No break in skin; requires monitoring for edema, pain, and manual alignment.

  • Open (compound): Skin broken; risks include infection, bleeding, and tetanus. May require surgical fixation.

    • Type I: Clean wound <1 cm.

    • Type II: Minimal soft tissue damage.

    • Type III: Highly contaminated wound with soft tissue damage or vascular injury.

• Complications:

  • Acute (24–72 hrs):

    • Shock (especially pelvic or long bone fractures).

    • Fat embolism — bone marrow fat enters bloodstream causing respiratory and cardiac symptoms.

    • Compartment syndrome — pressure builds in muscle compartments, reducing circulation and causing emergency; may need fasciotomy.

  • Delayed: Malunion — bone heals in incorrect position.

• Nursing Interventions:

  • Splint and immobilize the limb, manage pain, monitor for infection, cover open wounds with sterile saline gauze, and perform frequent neuro checks (6 P’s: pain, pulse, pallor, paresthesia, paralysis, pressure).

• Traction: Uses pulling force to maintain bone alignment (skin or skeletal). Never remove weights; keep skin integrity intact.

• Key Note: Immobility increases the risk of DVT (deep vein thrombosis), so limb elevation and circulation checks are crucial.