fractu re.pptx

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1. ANATOMY AND PHYSIOLOGIC OVERVIEW The musculoskeletal system provides protection for vital organs , including the brain , heart , and lungs ; provides a study framework to support body structures and makes mobility possible. Muscles and tendon hold the bones together and joints allow the body to move.

2. FUNCTION OF BONES:

3. TYPES OF BONES:

4. DEFINATION OF FRECTURE A fracture is a complete or incomplete disruption in the continuity of bone structure and is defined according to its type and extent. Fracture may be caused by direct blows, crushing forces , sudden twisting motions , and extreme muscle contractions.

5. TYPES OF FRACTURE The simplest classification method based on whether the fracture is closed or open. Tissue damage can be extensive with open fracture , which are graded according to their severity: Grade I. the wound is smaller than 1 cm;contamination is minimal Grade II. The wound is larger than 2 cm;contamination is moderate. Grade III. The wound exceeds 6 to 8 cm; there is extensive damage to soft tissue , nerve and tendon; there is high degree of contamination.

6. Open fracture : A fracture in which damage also involves the skin or mucous membranes , also called a compound fracture

7. Closed Facture: A fracture that remains contained , with no disruption of the skin integrity. And it is also called simple fracture.

8. Green stick Fracture : A fracture in which one side of a bone is broken and the other side is bent.

9. Transverse Fracture : A fracture that is straight line across the bone shaft.

10. Oblique Fracture : A fracture occurring at an angle across the bone ( less stable than a transverse fracture )

11. Spiral fracture : A fracture that twists around the shaft of the bone. Common in a twisting injury.

12. Impacted Fracture : A fracture in which a bone fragment is driven into another bone fragment.

13. Burst Fracture : Characterized by multiple pieces of bone, often occurs at bone ends or in vertebrae.

14. Linear Fracture : Fracture line is intact ; fracture is caused by minor to moderate force applied directly to bone.

15. Displaced Fracture : Fragment out of normal position at fracture site. Non – Displaced Fracture : Fragment aligned at fracture site.

16. Displacement, Angulations Angulation Varus Apex lateral Valgus Apex medial Parallel No angulation

17. CAUSES

18. PATHOPHYSIOLOGY:

19. CLINICAL MANIFESTATION

20. DIAGNOSTIC EVALUATION:

21. Principles of Treatment Methods of holding reduction: Sustained traction Cast splintage Functional bracing Internal fixation External fixation

22. Definitive Fracture Fixation Options Casts and Splints Appropriate for many fractures especially hand and foot fractures Adults typically will get plaster splints initially transitioned to fiberglass casts as swelling decreases Kids typically will get fiberglass casts

23. CONSERVATIVE TREATMENT

24. FUNCTIONAL BRACING Braces are used to provide support ,control movement , and prevent additional injury.

25. TRCTION: Traction by gravity E.g.. Fractures of the humerus Balanced Traction Skin traction: Adhesive strapping kept in place by bandages. Skeletal traction: It is applied directly to the bone by use of metal pin or wire.

26. INTERNAL FIXATION Types of Internal Fixation Pin & wire fixation. Screw fixation. Plate & screws fixation. Intra-medullary fixation.

27. PLATE & SCREWS FIXATION. Open Reduction and Internal fixation with Plates and screws Used for many fractures especially those involving joints

28. Intramedullary Fixation: Treatment of choice for most tibia and femur fractures Used in selected humerus and forearm fractures

29. INDICATIONS FOR INTERNAL FIXATION Fractures that cannot be reduced except by operation Fractures that are inherently unstable and prone to re-displacement after reduction Fractures that unite poorly and slowly Pathological fractures Multiple fractures

30. External Fixation Used primarily in the treatment of open fractures and pelvis fractures Also useful as temporary stabilization prior to definitive fixation

31. INDICATIONS FOR EXTERNAL FIXATION Fractures of the pelvis. Fractures associated with severe soft-tissue damage where the wound can be left open for inspection, dressing, or definitive coverage. Severely comminuted and unstable fractures, Fractures associated with nerve or vessel damage. Infected fractures, for which internal fixation might not be suitable.

32. COMPLICATIONS IN DETAIL Heals in the wrong position  - this is known as a mal union; either the fracture heals in the wrong position or it shifts (the fracture itself shifts). Disruption of bone growth  - if a childhood bone fracture affects the growth plate, there is a risk that the normal development of that bone may be affected, raising the risk of a subsequent deformity.

33. Persistent bone or bone marrow infection  - if there is a break in the skin, as may happen with a compound fracture, bacteria can get in and infect the bone or  bone marrow , which can become a persistent infection ( chronic osteomyelitis ). Patients may need to be hospitalized and treated with  antibiotics . Sometimes, surgical drainage and curettage is required. Bone death (avascular necrosis)  - if the bone loses its essential supply of blood it may die.

34. PREVENTION

35. PREVENTION IN DETAIL Nutrition and sunlight  - the human body needs adequate supplies of  calcium  for healthy bones. Milk, cheese, yoghurt, and dark green leafy vegetables are good sources of calcium. Our body needs  vitamin D  to absorb calcium - exposure to sunlight, as well as eating eggs and oily fish are good ways of getting  vitamin  D.

36. Physical activity  - the more weight-bearing exercises you do, the stronger and denser your bones will be. Examples include skipping, walking, running, and dancing - any exercise where the body pulls on the skeleton. Older age not only results in weaker bones, but often in less physical activity, which further increases the risk of even weaker bones. It is important for people of all ages to stay physically active.

37. Menopause  -  estrogen , which regulates a woman's calcium, drops during  menopause , making calcium regulation much more difficult. Consequently, women need to be especially careful about the density and strength of their bones during and after the menopause. The following steps may help reduce post-menopausal osteoporosis risk: Do several short weight-bearing exercise sessions each week. Do not smoke. Consume only moderate quantities of alcohol, or don't drink it. Get adequate exposure to daylight. Make sure your diet has plenty of calcium-rich foods. For those who find this difficult, a doctor may recommend calcium supplements.

38. NURSING DIAGNOSIS: pain related to fracture due to pressure on nerve endings. Impaired physical mobility related to body weakness and disease condition (fracture). Activity intolerance related to post operative condition Deficient knowledge related to new condition and treatment. Self care deficit related to musculoskeletal impairment secondary to fracture femur. Constipation related to decrease physical activity. Risk for infection related to wound secondary to fracture. Risk for pressure ulcer related to immobility.

39. THANK YOU

40. BIBLIOGRAPHY https://www.medicalnewstoday.com/articles/173312.php https://www.scribd.com./document ROSS AND WILSON TEXT BOOK OF “ ANATOMY AND PHYSIOLOGY”11THE EDITION PAGE NO : 380 - 419 JOYCE M.BLACK “ MEDICAL SURGICAL NURSING “ 8 TH EDITION PAGE NO : 507- 525 BRUNNER AND SUDDARTH’S TEXT BOOK OF “ MEDICAL SURGICAL NURSING “12 TH EDITION PAGE NO : 2084 - 2106