Management of fracture

Question 1

How do fractures present?

Answer 1

• The area will be very swollen; it may appeared deformed in appearance
• A lot of pain
• Reduced range of movement about the joint
• Nerves may be compressed so there would be complaints of an altered sensation (Closed fracture)
• If there is an open fracture, there will be obvious skin loss and possibly a protruding bones. In other situations, it may be only a puncture wound.

Question 2

How do you investigate a fracture

Answer 2

-First take an AMPLE history:
=Allergies
=Medication
=Past medical history
=Last meal
=Events leading up to the injury
-Then you should assess the surrounding nerves and investigate the vascular status
-You should also do the Look, Feel, move assessment

Question 3

How do you manage a fracture? (part 1)

Answer 3

-Ensure the patients general condition is stable. This includes checking airways, breathing, circulation, fluid management and oxygenation. Then you can continue with the below:
=Give the appropriate analgesia
=Control any external bleeding by direct pressure and cover any open wounds with a dressing. Take clinical photograph to avoid unnecessary expose which could increase risk of infection
=Immobilise the fractured bone. You can do this by using a plaster, splint, brace or sling.

Question 4

How do you manage a fracture? (part 2)

Answer 4

=Talk to the patients about ways they could reduce the fracture or dislocation
=You should do a nerve assessment before and after the reduction.
=Perform the reduction- this will usually take two people. It can include displacements, angulation or rotation.
=Reduction means to put the bone back in their original place

Question 5

Complications of fractures

Answer 5

• You should do a never assessment before and after because it is possible to catch a nerve in the process of reduction. If you do catch a nerve it will usually requires an operation to release it again.
• Ischaemia can occur
• Haemorrhage can occur, especially in the pelvis
• Compartment syndrome
• Infection
• DVT
• Stiffness
• Growth disruptions
• Osteoarthritis