fracture
Post on 07-Jan-2016
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TRAUMATIC INJURIES AFFECTING THE MUSCULOSKELETAL SYSTEMFracture a break in the continuity of the bone
Signs and Symptoms* pain aggravated by motion* loss of motion* shortening of the extremity* crepitus* swelling/discoloration (ecchymosis)* affected extremity colder than contralateral part
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Types of fractureA. Open/Compound bone protudes through a break in the skinB. Closed/Simple skin remains intactC. Complete bone completely separated into two partsD. Incomplete only a part of the bone is brokenE. Communited - bone broken into several fragments.F. Depressed - bone fragments are in-driven.G. Compression - collapsed of a bone fragment.H. Greenstick - splintering on one side.I. Pathologic - results from other primary disease. J. Impacted- a bone fragment is driven into another bone fragmentK. Avulsion- pulling of a bone fragment by ligaments or tendon attachment
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TYPES OF FRACTURES
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CAUSES OF PATHOLOGIC FRACTUREOsteoporosisBone CystBone TumorPagets DiseaseMultiple Myeloma
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FIRST AID FOR FRACTUREI- ImmobilizationC- Control bleeding/ Cover open packsE- Elevate affected extremity
T- TransportE- Emotional or Psychological careA- Assess overall conditions
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Complications of FracturesA. HemorrhageB. ShockC. Avascular NecrosisD. Fat emboli (long bones)E. OsteomyelitisF. Gasgangrene
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COMPLICATIONS OF FRACTUREA. AVASCULAR NECROSIS - any interference of the blood supply to a particular bone; most often affects head and neck of the femur.
SIGNS AND SYMPTOMS:Asymptomatic during early stagesIntermitttent or constant pain on weight bearingLimitation of joint motionX-ray shows calcium loss and structural collapse
TREATMENT:1. Surgery: Bone graft, prosthetic fitting/replacement Arthrodesis (joint fusion)
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B. GAS GANGRENE -it is caused by the anaerobic-Gram positive saprophytic bacterium, Clostridium welchii or Chlostridium perfringens.
SIGNS AND SYMPTOMS:EdemaProfuse drainage of gas bubbles with characteristic fruity odorVesicles filled with red, watery fluid, crepitus produced by gas; necrotic tissue
Treatment:Wound irrigation with antiseptics and antibioticsHyperbaric oxygen therapy
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C. OSTEOMYELITIS-it is an infection of osseous tissue involving the cortex of the bone and or marrowTYPES:Exogenous-an infection that enters from outside the bodyHematogenous-an infection that results from sites of infection elsewhere in the body
SIGNS AND SYMPTOMS:Low grade feverMalaisePain, tenderness, increased swelling and warmth of the area and purulent drainage from the sinus tract
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TREATMENTAntibioticsDebridement of open fractures to remove necrotic tissue
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D. FAT EMBOLISM SYNDROME- It results when the fracture occurs and fat globules are freed from the bone marrow and from the tissue that has sustained damage.
SIGNS AND SYMPTOMS:Changes in mentation: confusion, apprehension,agitation, restlessness, lethargy, deliriumRespiratory manifestations: tachypnea over 30, dyspnea, wheezes, rales and scattered infiltrates seen on x-rayPetechiae on neck, axillae, and upper chestHypoxemia, hypocapnea, elevated blood PH
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TREATMENT:Oxygen therapy by nasal cannula or Venturi maskMechanical ventilation with PEEPIV Glucose and alcoholHeparinLow molecular weight dextranSteroidsImmediate immobilization and adequate support during turning and positioningABG analysisMorphine
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Management of Fracture A. Close reduction - realignment of bones without surgery.B. Open reduction - surgical realignment of bone fragments. * Internal Fixation - application of screws, pins, plates, nails, to hold fragments in alignment. * External Fixation - sturdy external frame with multiple pins through bone; used with extensive open fractures with soft tissue damage, if infected fractures do not heal properly, with multiple trauma.
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