THIS PPT IS USEFULL FOR PARAMEDICAL STUDENTS.

1. TOPIC
FRACTURE
PRESENTED BY:
BHUMIKA.G.THAKOR

3. The structure of a
long bone allows
for the best
visualization of all
of the parts of a
bone . A long bone
has two parts:
the diaphysis and
the epiphysis.

4. DEFINITION:
 A fracture is a complete or incomplete disruption in
the continuity of bone structure and is defined
according to its type and extent.

5. CAUSES:

15. DIAGNOSIS
 HISTORY TAKING
 PHYSICAL EXAMINATION
 X – RAY
 CT SCAN
 MRI SCAN

16. 1. MEDICAL/SURGICAL MANAGEMENT OF
FRACTURES:
1. REDUCTION:
Reduction of fracture (“setting” the bone) refers to
restoration of the fracture fragments to anatomic
alignment and rotation.
A. Open reduction
B. Closed reduction

17. A. Open reducation

18. B. Closed reduction
Closed reduction is accomplished by bringing the bone
fragments into apposition (ie, placing the ends in contact)
through manipulation and manual traction.
 Extremity is held in the desired position while the
physician applies a cast, splint, or other device.
 X - rays are obtained to verify that the bone fragments are
correctly aligned.

19. (2) Immobilization
• Immobilization may be accomplished by external or
internal fixation
• Methods of external fixation include bandages, casts,
splints, continuous traction, and external fixators.
• Metal implants used for internal fixation serve as internal
splints to immobilize the fracture.

20. TRACTION
 Tractionis the use of weights, ropes and pulleys to
apply force to tissues surrounding a broken bone.

21. SPLINTING
 Possible items for Splinting
 Soft materials :Towels, blankets, or pillows, tied with
bandaging materials or soft cloths.
 Rigid materials. A board, metal strip, folded magazine
or newspaper, or other rigid item.

22. Guidelines for Splinting
1. Support the injured area.
2. Splint injury in the position that you find it.
3. Don’t try to realign bones.
4. Check for color, warmth, and sensation.
5. Immobilize above and below the injury.
The splint should go beyond the joints above and below
the fractured or dislocated bone to prevent these from
moving

24. (3) . Maintaining and restoring
function
 Restlessness, anxiety, and discomfort are controlled
with a variety of approaches, such as reassurance,
position changes, and pain relief strategies, including
use of analgesics.
 exercises are encouraged to minimize disuse atrophy
and to promote circulation.

25. Complication
 Early complications
• Shock
• fat embolism
• compartment syndrome
• deep vein thrombosis
• disseminated intravascular coagulopathy
 Delayed complications
• delayed union and nonunion
• avascular necrosis of bone
• reaction to internal fixation devices

26. NURSINGMANAGEMENT:
Patients with closed fractures:
 Encourage patient not to mobilize fracture site.
 Exercises to maintain the health of unaffected muscles for
using assistive devices (eg,crutches, walker).
 Teach patients how to use assistive devices safely.
Patients with open fractures:
 Administers tetanus prophylaxis if indicated.
 Wound irrigation and debridement in the operating room are
necessary.
 Intravenous antibiotics are prescribed to prevent or treat
infection.

27. Care of client with cast:
 Windowing or bivalving a cast :
Cutting a cast along both sides then splitting it to decrease
pressure on underlying tissue. Window may also be cut
into cast to allow the physician or nurse to visualize
wounds under the cast or removes drains.

28.  Assessment of the cast:
The skin around the cast edges should be observed for
damage or swelling.
“Hot spots” areas of the cast that feel warmer than other
section may indicate tissue necrosis or infection under the
cast.
“Wet spots” may indicate drainage under the cast.

29. Care of external fixation
 Assessment- pain, nerve supply,infection,pin site etc.
 Small bleeding from pin site is normal
 Critical, If extend more than 24 hours
 Administer antibiotics, analgesic medicines.

30. Care of traction
 Assessment – skin breakdown, pain, neurovascular
,constipation
 Stool softner
 Plenty of fluids
 Provide bedpan and urinals for elimination •
 Encourage clients activity.

32. ASSIGNMENT
 Write down the five nursing diagnosis of patient with
fracture?