Fractures- EXAM 3 Flashcards
What is a fracture
A break in continuity of bone
Most common in patients who have experienced trauma or older adults
Two main factors that contribute to a fracture
Strength of the force acting against the bone & strength of the bone
Force includes: direct blow, twisting, trauma, repetitive force
Fracture healing phases
Inflammatory, Reparative, and Remodeling phase
Inflammatory phase
The reactive phase
Damage to bone, blood vessels and surrounding tissue causes bleeding, hematoma and inflammation
Reparative phase
Fibroblasts, osteoblasts secrete collagen–fibrocartilage–soft callus–woven bone–hard callus
Remodeling phase
Woven bone replaced by lamellar bone
Stronger, more compact, better blood circulation
What is normal healing
Union, bone heals properly
Delayed union
Healing process takes significantly longer than expected
Nonunion
Fracture shows no sign of healing for at least 3 months
Malunion
Bone fragments join in position that is not automatically correct
Risk factors
Age; younger from sport injuries
Older from falls and disease
Presence of bone disease
Poor nutrition
Bone cancer
Low intake of Vitamin D, calcium
Anorexia or bulimia
Manifestations of a fracture
Pain
Visible fracture on xray
Visible deformaty
Swelling
Numbness
Loss of blood
Crepitus
What is compartment syndrome
When cast is placed too tight
Swelling is caused and decreased blood flow
If it continuous for too long, muscles and nerves can die and limb may need to be amputated
Symptoms of Compartment syndrome
Severe pain and tenderness
Swelling
Absent pulse
Most common in lower legs and forearm
DVT and symptoms
Blood clot forms in a deep vein, usually in legs
Redness and warmth, Leg pain, Cramping, Swelling
Cured with anticoagulants or compression stockings
Complications of DVT
Blood clot can dislodge and travel elsewhere in the body
In brain, can cause stroke
In lungs, can cause pulmonary embolism
In coronary arteries, can cause myocardial infraction
When is surgery needed
Open fractures and commented fractures
Pharmacological therapy
Tylenol is given BUT IF SEVERE, opioids are given
Want to start slow and low and then move up from it if not working
NSAID’s for pain and inflammation
Antibiotics to prevent or treat infection
anticoagulants to prevent or treat DVT
NonPharmacological therapy
CAST- palpate for hot spots:infection
Report any drainage
Assess for compartment syndrome
SPLINT
TRACTIONS- provides proper alignment
skin or skeletal tractions
RICE therapy
REST
ICE
COMPRESSION- enough to provide support fro injured area
ELEVATION
Infants with fractures
Difficult to detect because they can’t communicate location
Inconsolable crying, limited movement to extremity, Swelling of extremity, Deformity of area
Long bone fractures higher in C-sections or breech birth
Adults with fractures
Lengthened recovery time, especially women after menopause
Older adults with osteoporosis
Increased risk for hip fractures
More likely to develop DVT, infection
Alterations in mental status increase risk
