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Nursing 201 Pathophys > Fractures > Flashcards

Fractures Flashcards

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1
Q

What is a fracture?

A

A disruption or break in the continuity of bone structure, mainly from traumatic injury, sometimes secondary to disease processes (e.g. Cancer, Osteoporosis)

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2
Q

What are the signs and symptoms of a fracture?

A

Localised pain and tenderness
Possible swelling and/or bruising
Decreased function
Inability to bear weight or use the limb
Guarding against movement
+/- deformity

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3
Q

What is a transverse fracture?

A

A fracture straight across the bone

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4
Q

What is a spiral fracture?

A

A fracture that spirals around the bone

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5
Q

What is an oblique fracture?

A

A fracture that is at an angle to the length of the bone

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6
Q

What is a comminuted fracture?

What is a segmental fracture?

A

Comminuted fracture: A fracture with three or more bone fragments

Segmental fracture: One bone fractured in two places, leaving a “floating” segment of bone

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7
Q

What is a buckle fracture?

A

A compression fracture which is characterised by the bulging of the bone cortex

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8
Q

What is a greenstick fracture?

A

A fracture on one side of the bone causing a bend in the other side of the bone (More common in small children due to their more flexible bones)

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9
Q

What is a stress/hairline fracture?

What is an avulsion fracture?

A

Stress/hairline fracture: A fracture resulting from overuse/overworking the bone over time

Avulsion fracture: A fracture resulting from a tendon pulling on the bone

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10
Q

What is the difference between a complete and incomplete fracture?

A

A complete fracture has the break going all the way through the bone, whereas an incomplete fracture only has the break going part way through the bone

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11
Q

What is the difference between a displaced and non-displaced fracture?

A

A displaced fracture has the bone fragments out of alignment with each other whereas a non-displaced fracture has them still aligned

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12
Q

What is the difference between an open and closed fracture?

A

An open fracture breaks the skin whereas a closed fracture doesn’t break the skin

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13
Q

What are the six stages of bone healing?

A
  1. Fracture hematoma
  2. Granulation tissue formation
  3. Callus formation
  4. Callus ossification
  5. Consolidation
  6. Remodelling
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14
Q

What happens during a fracture hematoma?

How long after a fracture does this occur?

A

Inflammatory processes occur and bone bleeding creates a hematoma

This occurs within the first 72 hours of a fracture

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15
Q

What happens during the granulation tissue formation stage?

How long after a fracture does this occur?

A

Phagocytosis occurs, and the hematoma is organised into a fibrous network of granulation tissue by fibroblasts and osteoblasts (osteoid)

This occurs within 3-14 days after the fracture

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16
Q

What happens during the callus formation stage?

How long after a fracture does this occur?

A

Chondroblasts and osteoblasts form a collagen-rich soft fibrocartilaginous callus

This occurs within 10-14 days after the fracture

17
Q

What happens during the callus ossification stage?

How long after a fracture does this occur?

A

New bone is built up by osteoblasts, and the callus begins to calcify and turn into a hard callus (Weight bearing is introduced)

This occurs within 3 weeks to 6 months after the fracture

18
Q

What happens during the consolidation and remodelling stages?

A

The distance between bone fragments closes, excess bone tissue is resorbed by osteoclasts, and the union is complete

This occurs at least 17 weeks after the fracture

19
Q

What complications can occur during bone healing?

A

Mal-union: Fracture healing in the expected time but in an unsatisfactory position resulting in deformity and/or dysfunction

Non-union: Fracture failing to heal despite treatment and no x-ray evidence of callus formation

Delayed union: Fracture healing progresses more slowly than expected but eventually heals

Venous thromboembolism due to muscle inactivity

Infection

Fat embolism

Compartment syndrome

20
Q

What factors can influence bone healing?

A

Age
Obesity
Endocrine conditions
- Diabetes
- Parathyroid disease
Menopause
Steroids
Malnutrition
Smoking

21
Q

What can infection lead to in relation to bone healing?

A

Osteomyelitis

22
Q

What is compartment syndrome?

What can happen as a result of compartment syndrome?

A

Swelling and increased pressure within a confined fascia compartment happening initially or within several days

Compartment syndrome can lead to impaired arterial flow, leading to ischaemia within 4-8 hours, tissue and cell death and the possible need for amputation

23
Q

What are the signs and symptoms of compartment syndrome?

A

Pain
- Disproportional to the injury
- Worse with passive stretch
- Doesn’t resolve with pain relief

Pressure (early sign)

Paresthesia (early sign)
- Numbness and tingling

Pallor (late sign)

Paralysis (late sign)

Pulselessness (late sign)

24
Q

How is compartment syndrome relieved?

A

With a fasciotomy

25
Q

What are some nursing assessments to perform for a fracture patient?

A

Neurovascular assessment (especially distal to the fracture)
- Colour
- Warmth
- Movement
- Sensation
- Capillary refill
- Pulses
- Deformities
- Oedema
- Pain assessment

Vitals

Did they hit their head?

26
Q

What can be used to immobilise fractures?

A

Casts: Plaster and fibreglass

Buddy strapping (e.g. fingers)

Moon boots/square-toed shoes

Splinting

27
Q

What is fracture reduction?

A

Realignment of displaced bones

28
Q

What is a closed reduction?

A

Nonsurgical, manual realignment of bone fragments under local or general anaesthesia, followed by immobilisation

29
Q

What is an open reduction?

A

A surgical procedure that includes the insertion of metal plates, pins, rods, wires and/or screws to internally fixate the bones in place

30
Q

What is external fixation?

A

A surgical treatment where rods are screwed into bone and exit the body to be attached to a stabilising structure on the outside of the body

31
Q

What is traction?

A

Use of weights, pulleys and ropes to gently realign broken bones back into position prior to or while waiting for corrective surgery

Nursing 201 Pathophys (29 decks)

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