Fracture Fixation.Cast. Musculoskeletal and Orthopedic Nursing Assessment

Cast. Musculoskeletal and Orthopedic Nursing Assessment

1. Fractured Fixation إعداد طالب الدكتوراه حيدر مزهر فنجان قسم تمريض البالغين

2. Fixation : surgical procedures indicated for a fracture that requires direct visualization and repair, a fracture with common long term complications, or a fracture that is severely comminuted and threatens vascular supply

3. The Patient with an External Fixator - Ilizarov Definition: The simplest type of surgical procedure consists of a frame connected to pins that are inserted perpendicular to the long axis of the bone

4. External Fixator - Ilizarov Uses Manage fractures with associated soft tissue damage (humerus, forearm, femur, tibia, pelvis). Correcting defects , treating nonunion, and limb lengthening. Provide skeletal stability for severe comminuted fractures.

5. Nursing Management Psychological Preparation • Risk of altered body image due to bulky device. • Provide information , reassurance about minimal discomfort, and explain early mobility benefits.

6. Nursing Management Post-application Care • Elevate limb to heart level to reduce swelling. • Cover sharp pin ends to prevent injury. • Monitor for pressure injuries, nerve/vessel compromise, and compartment syndrome.

7. Nursing Management Mobility & Safety • If restricted → encourage isometric exercises to prevent complications (e.g., thrombosis ( • Progress mobility within prescribed weight-bearing limits.

8. Internal Fixation Internal fixation is accomplished through a surgical procedure called an open reduction and internal fixation (ORIF). In this procedure, the fracture is reduced (placed in correct anatomic alignment) and nails, screws, plates, or pins are inserted to hold the bones in place.

9. Nursing intervention for patients with internal fixation Frequently assess type, location, and severity of pain Perform neurovascular assessments frequently, promptly reporting any change in pulses, color, temperature, capillary refill, movement, or sensation of the affected extremity. Assess the following: a. Amount, color, odor of drainage on dressing and in wound drain device (e.g., Hemovac, Jackson-Pratt ( b. Bowel sounds c. Lung sounds

10. Nursing intervention for patients with internal fixation Administer medications , such as analgesics and antibiotics as prescribed In hip fractures, place an abductor pillow between patient’s legs to prevent dislocation of the hip joint. Assist with weight-bearing program. Encourage early mobilization, coughing, and deep breathing, as appropriate to help prevent complications.

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