Easy to learn

1. GOOD MORNING

2. FRACTURES

3. FRACTURES
A fracture is a break or disruption
in the continuity of the
bone.Fractures in children differ
from those in adults

4. FRACTURES
ETIOLOGY
• Most fractures in children are
as a result of low velocity
trauma such as a fall
• Upto age 2,most fractures are
sustained as a result of child
abuse. Abuse should be
suspected in this age group
• Fractures in newborns and
often the result of child abuse

5. FRACTURES
PATHOPHYSIOLOGY A bone
fractures when the force applied
to it exceeds the amount the
bone can absorb.
• Children’s long bone are almost
resilent then those of adults.they
are able to withstand greater
deflection without fracturing
• Children’s long bone also have
thick periosteum

6. FRACTURES
• Unique to fractures in children is
the involvement of growth
plates.The plate is weaker than the
surrounding ligaments and tendons
and joint capsules and is disrupted
before these tissues are injured.
• Epiphyseal or physeal injuries
• The weakest point of long bones is
the cartilage growth or epiphyseal
plate.

7. FRACTURES
• Types of fracture
• Complete( Bone fragments are separated)
• Incomplete( fragments remain attached
•

8. FRACTURES
The fracture line can be any of
the following
• Transverse- cross wise at right
angle to the long axis of the
bone
• Oblique- slanting but straight
between a horizontal and a
perpendicular direction
• Spiral- slanting or circular,
twisting around the bone shaft

11. FRACTURES
• Simple or closed fracture
• Open or compound fracture
• Complicated fracture
• Communited fracture

13. FRACTURES
TYPES OF FRACTURE IN
CHILDREN
• Bend (bent 45 degrees n more.mostly ulna
and fibula)
• Buckle or torus (compression of
porus bone raised or bulging projection)
• Green stick fracture (occurs when a
bon eis angulated beyond the limits of bending)

15. FRACTURES
• BONE HEALING AND
REMODELLING
• Neonatal period 2 to 3 weeks
• Early childhood- 4 weeks
• Later childhood- 6 to 8 weeks
• Adolescence- 8 to 12 weeks

16. FRACTURES
• Clinical manifestations
Generalized swelling,pain or
tenderness,deformity,diminishe
d functional use of affected part
• Diagnostic evaluation-
history and radiographic
examination

17. FRACTURES
Therapeutic management
Goal
• To regain allignment and
length of the body fragments
• To retain allignment and length
• To restore function to the
injured parts to prevent further
injury

18. FRACTURES
• Therapeutic management
• Realignment by traction
• Closed manipulation
• Casting
• Weight bearing on lower extremities

19. FRACTURES
• Nursing considerations
• Initial assessment
• Reassuring the parent and
the child
• Reduction of pain
• Care of child in a cast
• Care of child in a traction

20. FRACTURES
Nursing alerts
• Pain
• Pallor
• Pulselessness
• Paresthesia
• paralysis

21. The child in a cast
Four major categories
• Upper extremeties
• to immobilise wrist or elbow
• Lower extremity
• to immobilise ankle or knee
• Spinal or cervical
• immobilisation of the spine
• Spica casts
to immobilise the hip and knee

22. Upper extremity cast

24. Lower extremity cast

26. Spinal or cervical cast

27. Spica casts

34. Sunthetic cats

35. Water resistant casts

39. The child in traction
Purposes
• To provide rest for an extremity
• To help prevent or improve
contracture deformity
• To correct a deformity
• To treat a dislocation
• To provide poistioning and
allignment
• To reduce muscle spasm

40. Types of traction
Upper extremity traction
Overhead suspension traction
Dunlop traction
Lower extremity traction
Bryant traction
Buck traction
Russel traction
Balance suspension traction
Cervical traction

41. Over head suspension
• The arm bent at the elbow is suspended
vertically by skin or skeletal attachment
and traction is applied to the distal end of
the humerus

43. DUNLOP TRACTION
The arm is suspended
horizontally using skin or
skeletal attachment

45. BRYANT TRACTION
It is a type of running traction in which the
pull is in only one direction.legs are flexed
at 90 degree of the hips

46. Bryant traction

47. Bucks traction
• Type of traction in which the legs are in
extended position
• Used for short term immobilisation

49. Buck’s traction

50. Rusell traction
• Uses skin traction on the lower leg and a
padded sling under the knee.two lines of
pull one along the longitudinal line and the
other perpensdicular to the leg

52. Balanced suspension traction

54. Balance suspension traction
• A thomas splint from the groin to above
the foot
• Pearson attachment to support the lower
leg

56. Cervical traction

57. Thank you