Musculoskeletal Dysfunction Flashcards
Frctures
the resistance between bone yielding to applied stress
- break in the bone
What is the most common site of childhood fractures?
distal forearm (radius, ulna, or both)
Children are at high risk for fractures due to
high activity levels
immature bones
- brace themselves
Children have a faster
remodeling/healing
Younger the child the shorter amount of remodeling time
Fractures in infancy are rare and warrant
further investgation
If you wait to go to ER after a break, then what will happen?
the bone will remodel itself and not heal correctly
What fracture can stop the bone from growing and create a more complex treatment?
growth plate fracture
Factors affecting remodeling
age (younger = faster healing)
location (growth plate = complex/stop growing)
degree of deformity (complex to simple crack)
Dx of Fractures
X-ray
If still showing s/s = CT/MRI
What are the different types of fractures?
Plastic Deformation (bend)
Buckle (torus)
Greenstick
Complete
Spiral
Growth Plate
Plastic Deformation
bend
- not a break
- MALLEABLE BONES
Children have malleable bones. To what degree does the bone been but not break?
45 degrees
Buckle fracture
- torus
- pulled/raised in the fx site
Greenstick fracture
broke but not all the way through
Spiral fracture
twisting force
- sports with a plant and twist
- child abuse
Growth plate fracture
Epiphysis - end of the long bone
Assessment of Fx
general swelling
pain/tenderness/numb
deformity
low functional use guarding
Ecchymosis
Rigid muscles/spasms
Crepitus
Why is it important to make a splint for the affected fractured bone?
Muscular rigidity is a s/s of a fracture and will affect/move the bone out of place
Crepitation
bones scraping together with bubbling under the skin
- careful not to cause damage
What is the initial priority nursing actions of a child extremity fracture in order?
- calm/reassure
- Assess the extent (mech of injury)
-
Peripheral neurovascular assessment (6Ps)
~ only move distal (as little as possible) - If compound, then cover with sterile dressing
- Immobilize (sling/immobilizer)
- RICE
~ Elevate/Isolate
~ Apply cold - Cont. monitor neovascular status
- Apply traction if circulatory compromise is present
- Transport to ER
Neurovascular Assessment
Pallor
Pulse
Pain
Poikilothermia - temperature
Parenthesis - numbness (only move phalanges)
Paralysis - no mvmt
If the circulatory compromise is present with the fracture, then apply
traction
T/F: Do not try to reduce or press on the fracture.
True
What are the different types of casting materials?
plaster
synthetic (fiberglass)