Trauma 2: Fractures Flashcards
what is a fx
disruption or break in continuity of structure of bone
what is an open fx
skin broken; bone exposed
what is a closed fx
skin intact
what is a linear fx
a break along the bone’s long axis
fx classification: what is a displaced fx
two ends separated from one another
what 2 fx are often classified as displaced
comminuted
oblique
fx classification: what is a nondisplaced fx
periosteum is intact & bone is aligned
what 3 types of fx are usually classified as nondisplaced
transverse
spiral
greenstick
a broken bone can cause damage to (3)
surrounding tissue
peri-osteum
blood vessels in the cortex/marrow
what s/s of fx will we see (8)
edema/swelling
pain & tenderness
muscle spasm
deformity
contusion
loss of function
crepitation
guarding
what objective data can we see upon assessment of pt with fx (22)
apprehension
guarding
skin lacs, color changes
hematoma, edema
decreased or absent pulse, decreased skin temperature
delayed cap refill
paresthesia
absent, decreased, or increased sensation
restricted or lost function
deformities; abnormal angulation
shortening, rotation, or crepitation
muscle weakness
imaging findings
what are the 6 stages of bone healing
- hematoma
- granulation tissue
- callus formation
- ossification
- consolidation
- remodeling
a hematoma forms from
bleeding @ fractured ends of the bone
a hematoma gets organized into fibrous network which converts to
granulation tissue
callus forms when
new bone is built up as osteoclasts destroy dead bone
ossification of callus occurs
3 wks to 6 mnths after fx
consolidation is when the
callus continues to develop, closing the distance b/w bone fragments (up to 1 yr after fx)
remodeling is accomplished as excess callus is
reabsorbed & trabecular bone is laid down
osteoblasts form ___ ____ and osteoclasts ____ ______ bone
new bone
reabsorbs existing
what is the purpose of traction (4)
prevent or decrease pain & muscle spasm
immobilize joint or part of body
reduce fx or dislocation
treat a patho joint condition
Buck’s traction is a type of ____ traction used for pt w/ what 3 fx
traction
hip, knee, or femur fx
how long can Buck’s traction be used to relieve painful muscle spasms
24-48 hrs
What is skeletal traction
long-term pull to maintain alignment
a ___ or ___ is inserted into the bone for skeletal traction
pin or wire
skeletal traction utilizes wts to keep alignment; how much do the wts weigh
5-45 lbs
what do we need to maintain with skeletal traction (2)
maintain counteraction (elevate end of bed)
maintain continuous traction
we need to keep wts ____ the floor
off
a cast typically incorporates joints ____ & ____ fx
above & below
for lower extremity immobilization elevate extrem above the ___
hrt
observe for s/s of ____ ____ & ____ ____ for lower extrem
compartment syndrome
increased pressure
External fixation compresses _____ ____
fx fragments
external fixation immobilizes & is usually used for ____ _____
long bones
we should assess external fixation devices for (2)
assess for pin loosening & infection
internal fixation are surgically inserted to maintain ____ & _______ ______
alignment & position of bony fragments
what dietary requirments should we teach our fx pts about (6)
adequate protein
Vits B, C, D
Calcium
Mag
Fluid intake 2,000 to 3,000 mL/day
High fiber diet w/ fruits & veggies
What assessment do we do for fx pts
Peripheral Neurovascular (6 Ps!)
what complications of being immobile post op should we be preventing (4)
Constipation
Renal calculi
Cardiopulm deconditioning
DVT/pulm emboli
what are the degrees of wt bearing
non
touch down/toe touch
partial
wt bearing as tolerated
full wt bearing
