Orthopedic Nursing Flashcards
what is the main consideration for orthopaedic surgery? how do we combat this?
they have a high risk of SSI occurring which can lead to wound breakdown and surgical failure
to avoid this:
- do first so not contaminated by other surgeries
- closed gloving, mask, hat etc
- disposable drapes - water proof and extra security
- give pre, peri and post antibiotics
what are the different categories of fractures?
- cause
- direction of fracture line
- the extent of fracture damage
- the extent of tissue damage
- the number of fracture lines
- position of bone fragments
what are the different causes of fractures?
direct = impact on bone
indirect = pressure on bone
disease = eg oesteoparosis
what are the different directions of fracture lines?
transverse = short way
longitudinal = long ways
spiral = around
oblique = diagonally
what are the different extents of fracture damage?
complete = through both cortex
incomplete = through one cortex
fissure = small crack
what are the different extents of tissue damage with fractures?
open = with wound
closed = no wound
complicated = other tissue injury (eg ligament or tendon damage)
what are the terms for different numbers of fracture lines?
simple = one
comminuted = one fracture line but many fragments
multiple = multiple fracture lines and several fragments
segmental = multiple fractures on shaft of long bone
what are the different positions of bone fragments?
non-displaced = still inline
overriding = fragments have moved position
what are the stages of fracture healing?
haematoma formation
- swelling and bruising to stabilise bone
fibrocartilage callus formation
- new blood vessels through haematoma
bony callus formation
- spongy bone
- some stability back
bone remodelling
- now healed
- need to mobilise to remodel and remove bone lumps
what factors effects bone healing?
immobilisation/weight-bearing
insufficient support
poor nutrition
poor perfusion
infection
pain
what is an ASIF kit? what does it include?
Association for the Study of Internal Fixation
Contains;
- drill bit
- drill sleeve
- countersink
- depth gauge
- tap
- screwdriver
what is the function of drill bits?
cutting tools used in a drill to create holes
glide hole
- with a drill bit with the same external diameter as the screw being placed
pilot hole
- created with a drill bit that has the same diameter as the core of the screw
what is the function of a drill sleeve?
prevents the drill bit from collecting debris from the surrounding tissues
what is the function of a countersink?
cuts an indent in the bone surface that allows the head of the screw to be flush
what is the function of a depth gauge?
used to measure the depth of a drilled hole
helps determine the length of screw to place
what is the function of a tap?
used to tap a thread in a drilled hole before a screw is placed
what is the function of a screwdriver?
used to place and tighten screws
what are the different types of screws?
cortical
- used on tough bone
- thread is smaller and close togther
cancellous
- used on spongey bone
- thread is wider and further apart
self-tapping
- flat sections by tip cut own thread when being placed
non-self-tapping
- rounded ends which require a ta to cut thread beforehand
partial threaded
- thread only covers part of screw
- used to bring fragments together
fully threaded
- thread covers full length
what are the different types of plates?
sherman
Venables
- both provide stability
dynamic compression
- provide stability and compression
what is the main type of pin used during ortho surgery?
Steinmann - inside/through bone
what are the key principle of surgical fracture repair?
reduce the fracture
align the fragments
- give muscle relaxant as soft tissue may act against
immobilise the fragments
- screws and plates
restore soft tissue function
what is the function of bone holding foreceps?
to align and hold bone fragments together
what is the function of ferris smith rongeurs?
used in arthroscopy
- removing tissue or fragments from joint
what is the function of a jacobs chuck and key?
grasps drill bit
