Fracture is a break in the bone caused by trauma or disease. The document discusses the different types of fractures such as closed versus open, displaced versus nondisplaced, and classifications based on the direction of the break. Symptoms include pain, deformity, loss of function. Diagnosis involves history, physical exam, and imaging tests like x-rays. Treatment involves reducing and immobilizing the fracture through methods like casting, bracing, traction, or surgery. Nursing care focuses on pain management, preventing complications like immobilization, and ensuring proper healing through diet, exercise, and patient education.

1. TOPIC- FRACTURE
BY- SHREYA YADAV
MEDICAL SURGICAL NURSING
REGENCY INSTITUTE OF NURSING

2. FRACTURE
Fracture is a disruption or break in the
continuity of the structure of bone.
Although traumatic injuries account for the
majority of fractures, some fractures are
secondary to a disease process such as caner
or osteoporosis.

3. TYPES OF FRACTURE
Open Fracture
Closed Fracture
Incomplete fracture
Complete fracture
Displaced Fracture
Nondisplaced Fracture
According to the direction of the fracture line:
Linear Fracture
Oblique Fracture
Transverse Fracture
Longitudinal Fracture
Spiral Fracture

4.  Open Fracture:- In an open fracture ,the skin
is broken and bone exposed, causing soft
tissue injury.
 Closed Fracture: The skin remains intact and
bone is not exposed.

5. • Complete fracture: A fracture is termed as
complete if the break goes complete.
• Incomplete Fracture: It occurs partly across
a bone shaft but the bone is still intact.

6.  Non displaced fracture- The periosteum is
intact across the fracture and the bone
fragments are still in alignment.
 Displaced Fracture- The two end of the broken
bone are separated from one another and out of
their normal positions.

8. Transverse Fracture – In which the
line of the fracture extend across the
bone sharp at right angle to the
longitudinal axis.
Linear Fracture- A straight clean
break along the bone that is typically
the result of a direct fall.
Oblique Fracture- It is a type of
fracture in which the line of fracture
extends in an oblique direction.

9.  Spiral Fracture- It is a type of fracture
in which the line of fracture extends in
an Spiral direction along the shaft of
the bone.
 Greenstick fracture- The fracture is
an incomplete fracture with one side
splinted and other side bent.
 Comminuted fracture- In which bone
is broken, splintered or crushed into a
number of pieces.

10. PATHOPHYSIOLOGY
Due to etiological factor
More force on bone than it bears
Pull the fracture fragment out of the
position
Proximal portion remain in place & distal
portion displaced

12. Damage to the soft tissue and blood vessels
Bleeding occur from soft tissue and
hematoma formation will occur
Swelling, Infection, pain ,inflammation
Fracture

13. CLINICAL MANIFESTATION
Pain: The pain is continuous and
increases in severity until the bone
fragments are immobilized. The
muscle spasm that accompany a
fracture begin within 20 min after the
injury and result in more intense pain
that the patient reports at the time of
injury.

14. Loss of Function- After a fracture, the
extremity can not function properly
because normal function of the muscles
depends on the integrity of the bone to
which they are attached. Pain
contributes to the loss of function.
Deformity- Rotation of the fragments
in a fracture of the arm or leg causes a
deformity
Shortening- In fracture of long bones,
there is actual shortening of the
extremity

15. Crepitus-It is caused by rubbing of the
bone fragment against each other.
Swelling and Discoloration-
Localized edema and discoloration of
skin occur after fracture as a result of
trauma and bleeding into the tissues.
These skin sign may not develop for
several hours after the injury.

16. DIAGNOSTIC EVALUATION
History collection
Physical examination
X-ray
CT- scan(assess bone, soft tissues and
joints damage)
Magnetic resonance imaging(MRI)

17. MANAGEMENT
MEDICAL MANAGEMENT:
 Muscle relaxant and to reduce
pain(Carisoprodol, Cyclobenzaprine or
Mehocarbmol).
 Tetanus Toxoid to prevent tetanus
 Antibiotics (Cephalosporin)
 Anti-inflammatory (corticosteroids)

18. FRACTURE REDUCTION-
OPEN REDUCTION: Open reduction is the
correction of bone alignment through a
surgical incision. It includes wires, screws,
Pins, Plates, Internal fixation.

19. CLOSED REDUCTION- It is nonsurgical ,
manual realignment of bone fragments to
their previous anatomic position.

20. TRACTION- It is the application of pulling
force to an injured or diseased body part or
extremity. It is used to prevent pain , muscle
spasm, immobilized a joint or part of the
body and to promote active and passive
exercise.

21. Fracture immobilization: Fracture
immobilization can be done using cast,
braces, splints, immobilizers and external
and internal fixation devices.
CAST

22. Braces & splints:-

23. INTERNAL & EXTERNAL FIXATION

24. NURSING MANAGEMENT
 Advice patient to drive in a standard speed.
 Stretching and warm up muscles priopr to exercise.
 Provide protien, vitamin B,C &D, Calcium
,phosphorus and magnesium rich diet.
 Advice to don’t drink and drive.
 Adequate foot wear and lightening are maintain.
 Administer medicine as prescribed by doctor.

25. NURSING DIAGNOSIS
 Acute pain related to bone displacement, muscle
spasm as evidence by patient verbalization.
 Impaired physical mobility related to loss of
integrity of bone structure as evidenced by
unwilling to move or limited range of motion.
 Risk of constipation related to immobility and
change in eating pattern.
 Knowledge deficit related to fracture as evidenced
by patient is not following instructions properly.