It is best for care of soft tissue injury patient

1. Care of the patient with Soft Tissue
Injury
Robina Yaqoob
INC

2. Objectives
 Review the normal anatomy & physiology of
Musculoskeletal system.
 Define the soft tissue injury.
 Discuss the different types of soft tissue
injuries.
 Identify etiology and clinical manifestations of
soft tissue injury.
 Discuss the management of different types of
soft tissue injury.
 Provide comprehensive discharge teaching to
patient with soft tissue injury.

3. Musculoskeletal disorders
 Musculoskeletal disorders commonly include:
1. Soft Tissue Injuries (strains and sprains,
Dislocations)
2. Fractures (open, closed, long bone, pelvic)

4. Classification of Open Fracture
Type I
 Fractures with a clean wound of less than 1 cm in size
 Little or no contamination
 Wound results from an inside-out perforation
 The fracture pattern is simple
Type II
 Skin laceration is longer than 1 cm
 The surrounding tissues have minor or no signs of
contusion
 No dead muscle present
 The fracture instability is moderate to severe.

5. Conti…
Type III
 Extensive soft-tissue damage
 Frequently with compromised vascularity with or without
severe wound contamination
 The fracture pattern is complex with marked fracture
instability.

6. Classification of Closed fracture
Closed fracture grade 0
 No or minor soft-tissue injury Simple fracture
 Indirect trauma
 Spiral fracture of the tibia in a skiing injury.
Closed fracture grade I
 Superficial abrasion or skin contusion
 Simple or medium severe fracture types
 The pronation-external rotation fracture dislocation of the ankle
joint

7. Conti…
Closed fracture grade II
 Deep contaminated abrasions and localized skin or muscle
contusions
 Direct trauma
 Imminent compartment syndrome also belongs to this group
Transverse or complex fracture patterns
 The segmental fracture of the tibia from a direct blow by a car
fender
Closed fracture grade III
 Extensive skin contusion, destruction of muscle or subcutaneous
tissue avulsion
 Compartment syndrome and vascular injuries The fracture types
are complex

9. Soft tissue injuries
 Soft tissue injuries are those injuries
(excluding fractures) affecting the joints and
muscles of the limbs.
 Sprains, strains and dislocations are
considered soft tissue injuries

10. Soft Tissue Injuries
Two classifications when considering soft
tissue injuries:
 – Closed wounds
 – Open wounds

11. Contusions
 Small blood vessels
rupturing and
bleeding into soft
tissues

12. Strains
 Overuse,
overstretching of
muscle
 Incomplete muscle
tear
 Sudden pain
 Local tenderness

13. Sprain
 Sprains involve the over-
extension of a joint, usually
with partial rupture of the
ligaments. There may also be
blood vessel, nerve and
tendon damage.
 Injury to ligament
surrounding joint that is
caused by twisting motion
 Fingers, ankles, knee

14. Sign and symptoms
 Sudden pain in the joint
 Loss of power and ability to bear weight
 Bruising
 Swelling
 Site becomes tender, painful to palpate

15. Treatment
 R – rest
 I – immobilization
 C – cold (24-48 hrs)
 E – elevate
 Elastic compression bandage
 Heat after acute inflammatory stage
 Progressive exercises 2-5 days
 Splinting
 Pain management
• NSAIDS, Narcotics

16. Subluxation and Dislocation

17. Subluxation
• An incomplete
or partial
dislocation of
a joint
• Examples
• Vertebrae

18. Dislocation
• Bones completely disarticulated; no parts of
articular surfaces are in contact.

19. Dislocation
• Congenital,
or present at
birth
• Trauma
• spontaneous
or pathologic
Causes

20. Signs and symptoms
• Visibly deformed or out of place
• Swollen or discolored
• Painful
• May have some temporary paralysis of the
injured limb
• Change in length of extremity

21. SPORTS RELATED INJURIES
 Tendinitis
 Prevention
 Inflammation of tendon
 Runners, basketball players
 To help prevent a dislocation
 Take precautions to avoid falls.
 Wear protective gear when you
play contact sports.

23. Management
The effective treatment of fractures depends upon good
soft tissue management.
Fractures with a soft-tissue injury must be considered as
surgical emergencies.
Evaluation of the fracture must determine the extent of
the soft tissue injury, which will be a key factor in
management
 Type of insult and area of contact (blunt, penetrating,
crushed, etc)
 Force applied-Direction of force
 Areas of body affected
 Wound contamination
 General physical condition of the patient

24. Nursing Diagnosis
Class Activity

26. References
 Brunner, L. S., & Suddarth, D. S. (2004).
Text book of Medical-Surgical nursing
(10th e.d). Phi;ladephia: Lippincott.