Trauma 2: Fractures

Question 1

what is a fx

Answer 1

disruption or break in continuity of structure of bone

Question 2

what is an open fx

Answer 2

skin broken; bone exposed

Question 3

what is a closed fx

Answer 3

skin intact

Question 4

what is a linear fx

Answer 4

a break along the bone’s long axis

Question 5

fx classification: what is a displaced fx

Answer 5

two ends separated from one another

Question 6

what 2 fx are often classified as displaced

Answer 6

comminuted
oblique

Question 7

fx classification: what is a nondisplaced fx

Answer 7

periosteum is intact & bone is aligned

Question 8

what 3 types of fx are usually classified as nondisplaced

Answer 8

transverse
spiral
greenstick

Question 9

a broken bone can cause damage to (3)

Answer 9

surrounding tissue
peri-osteum
blood vessels in the cortex/marrow

Question 10

what s/s of fx will we see (8)

Answer 10

edema/swelling
pain & tenderness
muscle spasm
deformity
contusion
loss of function
crepitation
guarding

Question 11

what objective data can we see upon assessment of pt with fx (22)

Answer 11

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

Question 12

what are the 6 stages of bone healing

Answer 12

1. hematoma
2. granulation tissue
3. callus formation
4. ossification
5. consolidation
6. remodeling

Question 13

a hematoma forms from

Answer 13

bleeding @ fractured ends of the bone

Question 14

a hematoma gets organized into fibrous network which converts to

Answer 14

granulation tissue

Question 15

callus forms when

Answer 15

new bone is built up as osteoclasts destroy dead bone

Question 16

ossification of callus occurs

Answer 16

3 wks to 6 mnths after fx

Question 17

consolidation is when the

Answer 17

callus continues to develop, closing the distance b/w bone fragments (up to 1 yr after fx)

Question 18

remodeling is accomplished as excess callus is

Answer 18

reabsorbed & trabecular bone is laid down

Question 19

osteoblasts form ___ ____ and osteoclasts ____ ______ bone

Answer 19

new bone
reabsorbs existing

Question 20

what is the purpose of traction (4)

Answer 20

prevent or decrease pain & muscle spasm
immobilize joint or part of body
reduce fx or dislocation
treat a patho joint condition

Question 21

Buck’s traction is a type of ____ traction used for pt w/ what 3 fx

Answer 21

traction
hip, knee, or femur fx

Question 22

how long can Buck’s traction be used to relieve painful muscle spasms

Answer 22

24-48 hrs

Question 23

What is skeletal traction

Answer 23

long-term pull to maintain alignment

Question 24

a ___ or ___ is inserted into the bone for skeletal traction

Answer 24

pin or wire

Question 25

skeletal traction utilizes wts to keep alignment; how much do the wts weigh

Answer 25

5-45 lbs

Question 26

what do we need to maintain with skeletal traction (2)

Answer 26

maintain counteraction (elevate end of bed) maintain continuous traction

Question 27

we need to keep wts ____ the floor

Answer 27

off

Question 28

a cast typically incorporates joints ____ & ____ fx

Answer 28

above & below

Question 29

for lower extremity immobilization elevate extrem above the ___

Answer 29

hrt

Question 30

observe for s/s of ____ ____ & ____ ____ for lower extrem

Answer 30

compartment syndrome increased pressure

Question 31

External fixation compresses _____ ____

Answer 31

fx fragments

Question 32

external fixation immobilizes & is usually used for ____ _____

Answer 32

long bones

Question 33

we should assess external fixation devices for (2)

Answer 33

assess for pin loosening & infection

Question 34

internal fixation are surgically inserted to maintain ____ & _______ ______

Answer 34

alignment & position of bony fragments

Question 35

what dietary requirments should we teach our fx pts about (6)

Answer 35

adequate protein Vits B, C, D Calcium Mag Fluid intake 2,000 to 3,000 mL/day High fiber diet w/ fruits & veggies

Question 36

What assessment do we do for fx pts

Answer 36

Peripheral Neurovascular (6 Ps!)

Question 37

what complications of being immobile post op should we be preventing (4)

Answer 37

Constipation Renal calculi Cardiopulm deconditioning DVT/pulm emboli

Question 38

what are the degrees of wt bearing

Answer 38

non touch down/toe touch partial wt bearing as tolerated full wt bearing