Fracture and Dislocation Management

Question 1

Etiology - Fractures

Answer 1

A fracture is a condition in which there is a break in the continuity of a bone.

It may be caused by direct force or indirect impact. The aging process causes significant changes to the skeletal system; bones become more brittle and more susceptible to fractures

As well, pathological conditions such as tumours of the bone, periosteum or cartilage or other diseases can also increase likelihood of fractures.

Question 2

Types of Fractures

Answer 2

Fractures are charaterized by deformity, swelling, pain, bruising, crepitus and instability. Fractures are categorized as:

• Closed; surrounding skin remains intact
• Open/Compound; disruption in the surrounding skin w/ or w/p protruding bone ends

Question 3

Etiology - Dislocations

Answer 3

A dislocation is a separation of two bones where they meet a joint

In a complete displacement of a bone end from its normal joint position, the bone sits in an abnormal position

Risks associated w/ dislocations include trapping, compressing or tearing of the blood vessels and nerves.

Dislocations are usually characterized by obvs deformity, pain, swelling and immobility of the joint

Question 4

Interventions - Stabilization

Answer 4

1. If distal neurovascular status is intact, immobilize the limb in the position found
2. Assess neurovascular status prior to and after splinting
3. Consider cold packs and elevating the limb
4. Consider pain management as per the Pain Management Protocol

Question 5

Interventions - Limb Realignment

Answer 5

1. If a gross deformity that could compromise transport exists, apply in-line traction and realign the limb towards anatomical position
2. Attempt in-line traction and realignment once, if distal neurovascular status is compromised
3. For mid-third fractures consider Sager Traction Splint (https://handbook.bcehs.ca/treatment-guidelines/procedures/core-skills-injury-management/sager-traction-splint/)