Musculoskeletal Injuries/ Trauma and Congenital Disorders Flashcards
Fracture
break in continuity of bone
Cartilage
provide support, shape, and protection
Differences of Fracture in Children vs in Adults
- bones in childhood = extremely porous = bend > break
- periosteum = thick = not break all the way through
- epiphyseal lines = cushion blow = bones may not break
- healing = rapid due to overall increased bone growth
- damage to area = undergrowth/ uneven growth = angulation
Common Fracture Sites
- clavicle
- humerus (supracondylar fracture: fall backward on hands with straight elbow = neurovascular complication: rel of brachial artery and nerves to fracture site)
- radius and ulna
- femur (associated w child abuse)
- epiphyseal plates (potential for growth deformity)
Closed or Simple Fracture
bone broken but skin not lacerated
Open or Compound Fracture
- skin may be pierced by bone or by blow that breaks skin
- bone may or may not be visible
Transverse Fracture
fracture at right angle in long axis
Greenstick Fracture
fracture on one side of the bone = bend on other side of the bone
Comminuted Fracture
fracture that results in 3 or more bone fragments
Oblique Fracture
fracture is diagonal to long axis
Spiral Fracture
atleast one part of bone has been twisted
Complication of Fractures
- problems associated with immobility (muscle atrophy, joint contracture, pressure sores)
- growth problems
- infection
- shock (due to blood loss)
- venous stasis and thromboembolism
- pulmonary emboli and fat emboli
- bone union problems
Etiology
- trauma from motor vehicle accidents, falls, or child abuse
- resilience of soft tissue of children
- predisposing factors: age, underlying factors
- precipitating factors: diet
Assessment (5P’s)
- pallor
- paresthesia (tingling and numbness)
- pain (pain scale)
- pulse
- paralysis (sensation)
Manifestations
- deformity
- swelling
- bruising
- muscle spasm
- tenderness
- pain
Radiographic Examinations
reveals initial injury and subsequent healing progress
Blood Studies: Bleeding
elevated aspartate transaminase
Blood Studies: Muscle Damage
- decrease hemoglobin and hematocrit
- decrease lactic dehydrogenase
Prevent Circulatory Impairment
- assess pulse, color, temperature
- report changes
Prevent nerve compression syndromes
- test sensation and motor function
- induce subjective symptoms of pain, muscle weakness, burning sensation, limited ROM, and altered sensation
Prevent Compartment Syndrome
- assess muscle weakness and pain out of proportion to injury
- early detection = prevent tissue damage
Prevent Infection
- including osteomyelitis
- use infection control measures
Prevent Renal Calculi
- encourage fluids
- monitor I&O
- mobilize as much as possible
Prevent Pulmonary Emboli
- monitor child and adolescent with multiple fractures
- emboli generally occurs within first 24 hours
