A fracture is a break in the bone. It can be caused by trauma, osteoporosis, overuse, or aging. There are several types including open, closed, greenstick, transverse, oblique, and comminuted fractures. Fracture healing involves inflammation, callus formation, bone remodeling, and takes several weeks to years. Treatment depends on the fracture type and severity, and may include splinting, casting, surgery, or traction to immobilize the bone. The goals of treatment are to heal the bone in proper position and restore function.
Fracture regarding information and also useful in nursing in that types of fracture included and also include treatment regarding fracture , nursing care plan...commonly fracture is more so its very useful for study.....
Fracture regarding information and also useful in nursing in that types of fracture included and also include treatment regarding fracture , nursing care plan...commonly fracture is more so its very useful for study.....
It is not surprising if a bone breaks but what is surprising is the fact that bone does not break more often considering the amount of forces it is subjected to everyday by muscle action ,load transmission, etc. bone has devised its own mechanism to ward off the unnatural forces and keep itself intact. But only when the force is to large and occurs suddenly or the force is chronic and repetitive or when the natural resistance of bone is eroded by diseases process that a bone succumbs to the insult and break.
fracture is the breakdown in the continutity of the bone alignment this has many types as the fracure this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from fracture and for learning for their examination and knowledge purpose
It is not surprising if a bone breaks but what is surprising is the fact that bone does not break more often considering the amount of forces it is subjected to everyday by muscle action ,load transmission, etc. bone has devised its own mechanism to ward off the unnatural forces and keep itself intact. But only when the force is to large and occurs suddenly or the force is chronic and repetitive or when the natural resistance of bone is eroded by diseases process that a bone succumbs to the insult and break.
fracture is the breakdown in the continutity of the bone alignment this has many types as the fracure this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from fracture and for learning for their examination and knowledge purpose
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. Fracture
Break in the continuity of the bone
when force is applied that exceeds
the tensile strength or compressive
strength of the bone. The breaking of
a bone, cartilage, or the like, or the
resulting condition.
4. Fracture Types
• Open fracture (Also called compound fracture.)-
the bone exits and is visible through the skin, or
a deep wound that exposes the bone through
the skin.
• Closed fracture (Also called simple fracture.)-
the bone is broken, but the skin is intact.
Fractures have a variety of names. Below is a
listing of the common types that may occur:
5. • Simple (closed) - little or no bone displacement . The
broken bone hasn’t pierced the skin.
SIMPLE
6. • Compound- fracture ruptures the skin & bone protrudes.
or ‘open’ fracture. The broken bone penetrates through
the skin, or a wound leads to the fracture site. The risk of
infection is higher with this type of fracture.
7. • Green stick - occurs mostly in children whose bones have
not calcified or hardened . Fracture on one side of the
bone, causing a bend on the other side of the bone. The
broken bone is not completely separated.
GREENSTICK
8. • Transverse - crack perpendicular to long axis of the bone -
displacement may occur. The break is in a straight line
across the bone. The two ends tend to stay together i.e.
it's a stable fracture
TRANSVERSE
9. • Oblique - diagonal crack across the long axis of the bone
& chance of displacement
OBLIQUE
10. • Spiral - diagonal crack involving a "twisting" of the bone
about the longitudinal axis (occurs in skiing when bindings
are too tight).
SPIRAL
11. • Comminuted (blowout) - "crushing" fracture - more
common in elderly. It may cause permanent discrepancy in
leg length. This generally needs surgery using pins to hold
everything together until the bone heals.
COMMINUTED
12. • Impacted - one end of bone is driven up into the
other - may result in length discrepancy
13. • Depressed – broken bone is pressed inward
(skull fracture)
14. • Avulsion - fragment of bone is pulled away by
tendon (Hip flexors, adductors). This type of
fracture is more common in the knee and shoulder
joints.
15. • Displaced fracture- Meaning the bone ends are no
longer touching. This means they'll have to be
reduced back together before healing will occur.
16. • Hairline fracture- This is a small crack in the bone from a
repetitive action like running which is so tiny you may not
see it on X-ray, but it hurts! This has an excellent prognosis
if we give the bone a rest from repetitive injury as the
damage is mild.
17. • Stress fracture- A stress fracture is an overuse
injury, the bone fail’s to absorb the shock that is
being put upon it and become weakened. It is seen
in the lower leg, the shin bone (tibia), or foot.
18. • Pathological fracture– bones weakened by various
diseases (such as osteoporosis or cancer) tend to
break with very little force.
21. Bone impact
exceed tensile
strength
Break in the
continuity of
the bone
Swelling
Pain
Moderate to
severe energy
transmitted
Fat embolus
Myoglobinurea
Compartment
syndrome
Deformity
Loss of function
Impaired
sensation
Decrease
mobility
Bleeding
24. Clinical Manifestations
• Local Swelling, Oedema
• Severe pain/ local tenderness
• Loss of function or abnormal movement of affected part
• Deformities such as shortening, rotation
• Crepitation
• Muscle spasm
• Anaesthesia and flaccidity (few minute to hrs.)
- This is due to a temporary loss of nerve function at the
site associated vascular injury.
• Discoloration
• Paralysis
25. Complication
Osteomyelitis
The open area is a rich
culture medium for
infection. It retards
healing by destroying
newly formed bone
and interrupting it’s
blood supply.
S. aureus is the usual
cause.
26. Embolism
Fat & Pulmonary
Embolism.
Fractures of long bones
may release enough fat
to travel through the
veins, they attract
platelets which become
part of the
microembolus and
deplete circulating
platelets
Complications
28. Nerve Damage
- Bone fragments
may rupture and
compress nerves
that may also be
damaged by
dislocation or direct
trauma
Complications
29. Dislocation
temporary displacement of
one or more bones in a joint
in which the opposing bone
surface loss contact entirely.
Complications
Subluxation
if the contact bone
between the opposing bone
surface is partially lost.
30. Myoglobinuria
Severe muscle trauma.
An excess myoglobin
(intracellular muscle protein)
in the urine.
Muscles damage, with
disruption of sarcolemma,
releases myoglobin which
would lead to renal failure
Complication
31. COMPARTMENT SYNDROME
- Pressure build within the compartment due to
bleeding.
- swelling reaches the point at which the fascia
permits no outward enlargement
- increasing pressure is directed inward and
compresses components in the compartments.
Complication
33. RADIOLOGIC EXAM
Radiologic exam- to determine location extent of
fracture/trauma; may reveal preexisting undiagnosed
fracture.
Bone scan, tomograms, CT, MRI scan
- Visualized fractures, bleeding and soft tissue
damage. May be prepared for diagnostic tool
because of superior ability to image some types of
injuries.
Arteriogram
- May be done when occult vascular damage is
suspected.
34. Urine creatinine clearance
- Muscle trauma increases load of Creatinine for renal
clearance.
- Creatinine level and urea nitrogen level should be
analyzed when renal function is elevated.
- NORMAL VALUE
- 0.6-1.3 mg/dL
URINE ANALYSIS
35. Blood Urea Nitrogen
- Urea normally freely filtered through renal
glomeruli, small amount reabsorbed in the
tubule and the remainder excreted in the
urine.
-NORMAL VALUE
8-25 mg/dl
URINE ANALYSIS
36. BLOOD ANALYSIS
Hemoglobin
- main component of erythrocyte & serve
as the vehicle for transportation of O2 and CO2.
- NORMAL VALUES
Male: 14-16.5 g/dL Female: 12-15 g/dL
Hematocrit
- Determinations are important in identifying
anemia.
- Fasting is not required.
- NORMAL VALUES
- Male: 42%-52% Female: 35%-47%
37. BLOOD ANALYSIS
- Immune defense system of the body.
- Cell count assess each leukocytes distribution.
- increase WBC, normal response to trauma.
NORMAL VALUE
4,500 – 11, 000 cells/L
WBC
38. Coagulation profile
activated Partial Thromboplastin Time (aPTT)
- Test screens
deficiencies & inhibitors of all factors
except factor VII & XIII.
- Screen for coagulation disorders.
- NORMAL VALUE
20-36 seconds
39. Coagulation profile
Prothrombin Time (PT)
- Measures the amount of time it takes for clot
formation
- within 2 sec (+ or - ) of the control is considered
normal.
NORMAL VALUES
- Male: 9.6 -11.8 seconds Female: 9.5 -11.3
seconds
-
PT > 30 seconds at risk for
HEMORRHAGE
40. Steps in Fracture Healing
1.) Inflammatory Phase
Bleeding from bone, bone periosteum, &
tissues surrounding the bone
- formation of fracture hematoma & initiation of
inflammatory response
- Induction (stimulus for bone regeneration) -
caused by:
Without Oxygen bone necrosis starts (fractured
bone becomes hypoxic immediately)
41. Inflammatory response - lasts between days
2- 9 following injury:
phagocytes & lysosomes clear necrosed bone
and other debris.
A fibrin mesh forms and “walls off” the fracture
site which serves for fibroblasts and capillary
buds, capillaries grow into the hematoma in a
fracture, the new blood supply arises from
periosteum
normally 3/4 of blood flow in adult bone arises
from endosteum.
42.
43. 2.) Fibrocartilagenous callus Formation
Lasts an average of 3 weeks
Fibroblasts and osteoblasts arrive from periosteum &
endosteum
Within 2-3 days, fibroblasts produce collagen fibers that span
the break
This tissue is called Fibro - Cartilagenous Callus and
serves to “splint” the bone
FCC is formed both in and around the fracture site
Osteoblasts in outer layer of FCC begin to lay down
new hard bone
in a non-immobilized fracture, the FCC has poor
vascularization
Steps in Fracture Healing
44. 3.) Hard Boney Callus Formation & Ossification
Weeks to months
Fracture fragments are joined by collagen, cartilage, &
then immature bone
Osteoblasts form trabecular bone along fracture periphery
(external callus)
Trabecular bone is then laid down in the fracture interior
(internal callus)
Ossification (mineralization) starts by 2-3 weeks &
continues for 3-4 months
Alkaline phosphatase is secreted by osteoblasts
blood serum levels serve as an indicator of the rate of bone
formation
Steps in Fracture Healing
45. In non-Immobilized fractures, more
“cartilage” than bone is laid down
this must later be replaced by normal
cancellous bone
results in a longer healing time and fractured area
remains weak for a longer period
fibrocartilage callus is gradually replaced by one
made of spongy bone, known as the bony callus.
Fractures should be reduced (immobilized)
within 3-5 days
46. 4.) Bone Remodeling
Months to years (mechanically stable at 40 days)
Excess material inside bone shaft is replaced by more
compact bone
Final remodeled structure is influenced by optimal
bone stress
the bony callus is remodelled in response to
mechanical stresses placed on it, so that it forms
a strong permanent (bone) patch at the fracture
site.
Steps in Fracture Healing
1.
3. 4.
49. Factors Enhancing Bone Healing
Youth
Early Immobilization of fracture fragments
Maximum bone fragment contact
Adequate blood supply
Proper Nutrition
Vitamines A & D
Weight bearing exercise for long bones in the late
stages of healing
Adequate hormones:
growth hormone
thyroxine
calcitonin
50. Factors Inhibiting Bone Healing
Age
Fractured Femur Healing Time
infant: 4 weeks
teenager: 12 to 16 weeks
60 year old adult: 18 to 20 weeks
Extensive local soft tissue trauma
Bone loss due to the severity of the fracture
Inadequate immobilization (motion at the fracture
site)
Infection
Avascular Necrosis
51. Therapeutic Implications for
Treating Fractures
Active ROM exercises to joints above and below
immobilized region
Resistive ROM exercises to muscle groups that are not
immobilized
Once the cast or immobilization device has been
removed:
gentle but progressive resistance exercises of all immobilized joints
evaluate strength of joint(s) and compare to non-injured counterparts
return to vigorous activity only after strength discrepency <
15%
52. GOALS OF FRACTURE TREATMENT
• Restore the patient to optimal functional state
• Prevent fracture and soft-tissue complications
• Get the fracture to heal, and in a position which will
produce optimal functional recovery
• Rehabilitate the patient as early as possible
53. TREATMENT
Depending on the site of the fracture and the severity
of the injury, treatment options may include:
Splints – to discourage movement of the broken limb
Braces – to support the bone
Plaster cast – to provide support and immobilise the
bone
Traction – this option is less common
Surgically inserted metal rods or plates – to hold the
bone pieces together
& Pain relief.
54. MANAGEMENT OF THE INJURED
PATIENT
• Life saving measures
• Diagnose and treat life threatening injuries
• Emergency orthopaedic involvement
– Life saving
– Complication saving
– Emergency orthopaedic management (Day 1)
– Monitoring of fracture (Days to weeks)
– Rehabilitation + treatment of complications
(weeks to months)
55. LIFE SAVING MEASURES
–A Airway and cervical spine
immobilisation
–B Breathing
–C Circulation (treatment and diagnosis
of cause)
–D Disability (head injury)
–E Exposure (musculo-skeletal injury)
56. EMERGENCY ORTHOPAEDIC
MANAGEMENT
• Life saving measures
• Reducing a pelvic fracture in haemodynamically
unstable patient
• Applying pressure to reduce haemorrhage from open
fracture
– Complication saving
• Early and complete diagnosis of the extent of injuries
• Diagnosing and treating soft-tissue injuries
57. DIAGNOSING THE SOFT TISSUE
INJURY
• Skin
• Open fractures, degloving injuries and ischaemic
necrosis
– Muscles
• Crush and compartment syndromes
– Blood vessels
• Vasospasm and arterial laceration
– Nerves
• Neurapraxias, axonotmesis, neurotmesis
– Ligaments
• Joint instability and dislocation
58. TREATING THE SOFT TISSUE
INJURY
• All severe soft tissue injuries require urgent
treatment
• Open fractures , Vascular injuries, Nerve injuries,
Compartment syndromes, Fracture/dislocations
– After the treatment of the soft tissue injury the
fracture requires rigid fixation
– A severe soft-tissue injury will delay fracture
healing
59. DIAGNOSING THE BONE INJURY
– Clinical assessment
• History
• Co-morbidities
• Exposure/systematic examination
– “First-aid” reduction
– Splintage and analgesia
– Radiographs
• Two planes including joints above and below area of injury
60. INDICATIONS FOR OPERATIVE
TREATMENT
• General trend toward operative treatment last 30 yrs
• Improved implants and antibiotic prophylaxis, Use of closed and
minimally invasive methods
• Current absolute indications:-
• Polytrauma Displaced intra-articular fractures
• Open fractures with vascular injuries or compartment symptoms,
Pathological fracture, Non-unions
• Current relative indications:-
• Loss of position with closed method, Poor functional result with
non-anatomical reduction, Displaced fractures with poor blood supply,
Economic and medical indications
61. REHABILITATION
• Restoring the patient as close to pre-injury functional
level as possible
• May not be possible with:-
– Severe fractures or other injuries
– Frail, elderly patients
– Approach needs to be:-
• Pragmatic with realistic targets
• Multidisciplinary
– Physiotherapist, Occupational therapist, District nurse, Social
workers
62. Nursing Diagnosis
1. Acute pain r/t stimulation of free nerve
endings 2 to soft tissue injury.
2. Risks for peripheral neurovascular dysfunction
r/t reduction/interruption of blood flow.
3. Impaired Gas Exchange r/t altered blood
flow/fat emboli.
4. Impaired physical mobility r/t skeletal
instability 2 to physical trauma.
63. 5. Impaired Tissue integrity r/t insertion of
traction pins wires and screw/ physical
immobilization
6. Situational low Self –Esteem r/t loss of body
parts/ change in functional abilities.
7. Ineffective peripheral tissue perfusion r/t
reduced arterial venous blood flow; tissue
edema; hematoma formation.
Nursing Diagnosis
Editor's Notes
Osteomyelitis – The open area is a rich culture medium for infection. It retards healing by destroying newly formed bone and interrupting it’s blood supply.
Delayed union – Increased healing time; may result from a breakdown in the early stages of healing which may occur from Inadequate immobilization, breakdown in hematoma formation or poor alignment.
Nonunion – fragments fail to unite over a 5-month period. May be due to varying factors like: health, degree of trauma, underlying disease, infection and movement. Infection causes continuous bleeding and breakdown of osteoid matrix. Movement causes repeated bleeding and decalcification at the fragmented ends
Malunion – union of the fragments in an abnormal position that may modify function.
Internal Bleeding - (Usually from closed Fx) The bleeding may occur from the bone itself or from surrounding soft tissues.
Embolism
Fat Embolism -Fractures of long bones may release enough fat (and other substances in bone marrow) to travel through the veins, they attract platelets which become part of the microembolus and deplete circulating platelets.
Pulmonary Embolism
Osteoarthritis - Fractures that extend into joints usually damage cartilage (a smooth, tough, protective tissue that reduces friction as joints move). Damaged cartilage tends to scar, causing osteoarthritis and impairing motion in the joints.
Nerve Damage - Bone fragments may rupture and compress nerves that may also be damaged by dislocation or direct trauma
Alteration may occur because of blood loss, multiple injury.
Evaluates coagulation sequence is functioning by measuring the time it takes for re-calcified, citrated plasma to clot
Baseline PT should be drawn before anticoagulation therapy is started; note the time of collection on the laboratory form.