6. Pathologic fracture
• Occurs in a bone that is made weak bye some
disease
• Causes
- inflammation eg osteomyelitis
- neoplastic- Ewing's sarcoma
- hereditary – osteogenesis imperfecta
- acquired- rickets ,osteomalacia
8. • Closed fracture - fracture hematoma does not
communicate with the outside surface(skin)
• Open fracture/compound/complex - fracture
hematoma communicate with the outside
surface(skin)
9. Anatomical classification
1) Impacted # - vertical force drives the distal
fragment of the # into the proximal fragment
2) Depressed # - type of skull fracture, segment
of the bone get depressed into the cranium
10. # type based upon “path of fracture line”
1) Transverse #
2) Oblique #
3) Longitudinal #
4) Spiral /torsion #
11.
12.
13. CLINICAL MANIFESTATION
• Pain
• Local swelling/tenderness/painful movement
• Discoloration of limb
• Deformity/shortening
• Loss of function of limb
14. Diagnosis of fracture
• History
• Physical examination- General and local
• X-ray- two view imaging
• CT scan- vertebral /joint /hairline #
• MRI scan- vertebral fracture compressing SC
16. STAGES OF FRACTURE HEALING
1) Inflammatory stage (A & B) –
A – stage of hematoma formation
B - Stage of granulation tissue (more fibrin to
hematoma & increased blood flow)
2) Reparative phase (A & B) –
A- stage of fibrocartilaginous callus
B- stage of bony callus (woven bone become calcified)
3) Remodeling Phase –excess material inside bone shaft
get replaced by more compact bone
17.
18. Immediate
Damage to Vessel Hemorrhage/shock
Damage to Organ Brain/Liver/spleen etc
Damage to Nerve Power/sensation loss
Damage to Muscle compartment syndrome
Fat embolism
21. SAVE THE LIFE
• Check for the Vitals and Injury to vital organs
act accordingly
A-airway
B-breathing
C-circulation
22. SAVE THE LIMB
• Early splinting
• Assess the fracture site and involved limb
• Look for the color and perfusion of limb
• Look for the injury to blood vessels and
Nerves
• Wound contamination
23. Splinting
• It is the most common procedure for
immobilizing an injury
• It stabilizes the limb and reduces the area
• Any material available can be used like towel,
paper etc
25. Guideline for splinting
• Support the injured area
• Splint injury in the position that you find it
• Don’t try to realign the bones
• Check color, warmth and sensation
• Immobilize above and below the injury
26. SAVE THE LIMB FUNCTION
• Fracture reduction
• Wound/limb care
• Immobilization
• Early physiotherapy and rehabilitation
• Help to hasten recovery
• Look for complications
27. Reduction of fracture
(correction of displacement of fragments)
- Closed or Open reduction
CLOSED REDUCTION
Non-surgical procedure
plaster applied
28. OPEN REDUCTION
• Surgical correction of fractured bone alignment
• Internal Fixator used for stabilization
29. NURSING MANAGMENT
Closed Fracture
• Encourage patient to not to mobilize fracture
site
• Exercise to maintain the health of the
unaffected muscle for using assisted devices
like crutches /walker
• Patient education about – self care,
medication information, monitoring for
potential complication and need for
continuous supervision
30. Open fracture
• Injection TT
• Wound irrigation and debridement
• Heavily contaminated wounds – left
unsutured and dressed with sterile gauze to
permit swelling & wound drainage
• Administering IV antibiotics/painkiller
31. Nursing diagnosis
• Acute pain related breakdown of continuity of
the bone as evidenced by facial expression
and verbalization of patient
• Goal- patient should be pain free
• Interventions-
- asses the onset,duration,location,severity & intensity
of pain
- administer the analgesic as per prescription
- provide the comfort devices like sand bag for
immobilization of affected parts
