FRACTURE PPT.pptx

FRACTURE

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.

7. 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.

8. 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.

9. 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

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

11. 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.

12. 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

13. 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.

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

15. MANAGEMENT MEDICAL MANAGEMENT: Muscle relaxant and to reduce pain ( C arisoprodol , Cyclobenzaprine or M ehocarbmol ). Tetanus Toxoid to prevent tetanus Antibiotics (Cephalosporin) Anti-inflammatory (corticosteroids )

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

17. CLOSED REDUCTION- It is nonsurgical , manual realignment of bone fragments t o their previous anatomic position.

18. 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.

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

20. Braces & splints:-

21. INTERNAL & EXTERNAL FIXATION

22. 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.

23. 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.