FRACTURE Report Smallin

8/10/2019 FRACTURE Report Smallin

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FRACTURE

BY: Ma. Elizabeth C. Jardiolin


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Defnition:

A racture is a dissolution o a bonycontinuity with or without displaceento the ra!ents.

a brea" in the continuity o hard tissuesli"e bones# cartila!es# etc.


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Etiolo!y:

$%&'$%($C CA)(E(Muscular Contraction

*atholo!ical +racture

E,&'$%($C CA)(E(Direct -iolence

$ndirect -iolence


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Muscular Contraction *atholo!ical +racture shortening of the muscle - The occurrence of a

fracture a bone that causes the fracture of the bodycaused by a disease state.


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Classifcation:

+racture is Broadly Classifed into &wo /01&ypes:

2. (iple +racture

0. Copound +racture


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$ncoplete +ractures:

2. 4reenstic"+racture

racture in which a

bone is partly bro"enli"e a bent !reenstic".

0. +issured +racture crac"s or fssure lines

will occur when directtraua is applied to

any lon! or 5at bone.


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6. Deerred+racture

depression ractures

represent areas inwhich ultiple fssureracture linesintersect.


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Coplete +racture

2. &rans3erse +racture- +racture line runs

trans3erse to the lon!

a7is o the bone.

0. 8bli9ue +racture

racture line runs

obli9ue to the lon!a7is o the bone.


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6. (piral +racture

racture line spirals

alon! the lon! a7is othe bone.

. Coinuted+racture

two or ore racture

lines interconnect eachother at one point


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;. Copression+racture

ractures wherecancellous bonecollapses andcopresses upon

itsel.


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>. $pacted+racture

a bony ra!ent isorced or ipactedinto cancellous bone.

?. A3ulsion +racture when a part o bone

is torn away.


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Classifcation o +racture by @ocation:


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2. Diaphyseal+racture

occurs in thediaphysis o a lon!bone.

urther be describedas pro7ial third#

iddle third# or distalthird.

0. Metaphyseal

racture within the etaphysis

o a lon! bone

described as distal orpro7ial etaphyseal

racture.


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6. Epiphyseal+racture

racture on the epiphyses

. +racture on theepiphyseal plate

racture occurs in

iature anials durin!

the tie the epiphysealplate reains open andcartila!inous.


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>. *eriarticular+racture a ter used to describe

the ractures close tooints.

owe3er# such racture isnot in3ol3e in the oint.

?. +ractureDislocation

oint ractures that

produce oint instabilitysucient to result insiultaneous sublu7ationor lu7ation o the aectedoint.


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(i!ns and (yptos o lib racture :

(wellin! in o3erlyin! tissues ("in discoloration Distortion $paired or coplete in loss o unction

4rindin! sensation in the lib durin!o3eent se3ere pain and diculty in o3eent deority or abnoral twist o lib

&he inured person should not be o3edunless the lib has been iobilized withsplints.


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Coplications:

(oe ractures can lead to serious coplicationsincludin! a condition "nown ascopartent syndroe. $ not treated# copartentsyndroe can result in aputationo the aected

lib. 8ther coplications ay include nonunion#

where the ractured bone ails to heal or alunion#where the ractured bone heals in a deored anner.

Coplications o ractures can be classifed into three

broad !roups dependin! upon their tie ooccurrence. &hese are as ollows : Immediatecoplications occurs at the tie o the racture.

Earlycoplications occurrin! in the initial ew days ater theracture.

Latecoplications occurrin! a lon! tie ater the racture.
http://en.wikipedia.org/wiki/Compartment_syndromehttp://en.wikipedia.org/wiki/Amputationhttp://en.wikipedia.org/wiki/Amputationhttp://en.wikipedia.org/wiki/Compartment_syndrome


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(erious and liethreatenin!coplications can occur in otherparts o the body ro aterial

released into the bloodstrea at thetie o racture.

&hese include inury to the lun!s

/eboli o at# blood clot1# blood3essels /3ein throbosis#copartent syndroe1# andinection.
http://www.mdguidelines.com/deep-vein-thrombosishttp://www.mdguidelines.com/deep-vein-thrombosis


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A fat embolism# an occasional coplication o lon!

bone ractures# can occur as a result o bone arrow

releasin! at into the 3eins ollowin! a racture.

&his at can lod!e in the lun!s where it obstructs blood5ow or pass into the arteries where it can cause centralner3ous syste chan!es.

+at eboli occur 20 to ? hours ollowin! racture andare capable o producin! a wide ran!e o syptosincludin! e3er# increased heart and breathin! rate# bloodtin!ed sputu# rash# cyanosis# an7iety# restlessness#altered le3el o consciousness# con3ulsions# and coa.

+at eboli are rare but ay occur with tibialoreoral shat ractures.
http://www.mdguidelines.com/anxiety-disorder-generalizedhttp://www.mdguidelines.com/fracture-tibia-or-fibulahttp://www.mdguidelines.com/fracture-femoral-neckhttp://www.mdguidelines.com/fracture-femoral-neckhttp://www.mdguidelines.com/fracture-tibia-or-fibulahttp://www.mdguidelines.com/anxiety-disorder-generalized


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Daa!e to structures near the racture# suchas blood 3essels# ner3es# or li!aentscoplicate treatent and ad3ersely aect theoutcoe. Cople7 re!ional pain syndroe

/re5e7 sypathetic dystrophy1 is an e7aple osuch probles.


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$nection:

in either the bone /osteoyelitis1# oint# orsot tissues re9uires treatent and can delayhealin!. +ractures that ha3e been successullyreduced ay later shit out o position. &his is

especially true o ractures around the wrist.(tienin! o oints /contracture1 or daa!e

resultin! in looseness o the oint /la7ity1prolon!s treatent. Coe7istin! traua that

would delay treatent o the racture cancoplicate healin!.
http://www.mdguidelines.com/fracture-carpal-boneshttp://www.mdguidelines.com/fracture-carpal-bones


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Ci!arette so"in! delays bone healin!# asdoes any proble with blood circulation oro7y!en deli3ery. %oncopliance with treatent /reo3in! protecti3e de3ices1 can result in

otion across the racture# which pre3ents ordelays healin! /delayed union or nonunion1.De!enerati3e arthritis oten occurs in oints thatha3e been inured.


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%onsteroidal antiin5aatory dru! /%(A$D1

and corticosteroid use ay delayracturehealin!.

A healthy patient usually can copensate orthe eects o a sin!le# lowdose antiin5aatory dru!. *atients ta"in! ultiple#siultaneous antiin5aatory dru!s are at

increased ris" o delayed racture union.


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&reatent:

&reatent o bone ractures are broadlyclassifed as surgical or conservative# thelatter basically reerrin! to any nonsur!icalprocedure# such as pain ana!eent#

immobilization or other nonsur!icalstabilization.

+ractures are treated by ali!nin! the ends o

bro"en bones and holdin! in place or se3eralwee"s or onths in plaster casts or splintsGetal wires or screws ay be needed or specialtissue called CA@@)(.


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Immobilization

(ince bone healin!is a natural process which will ostoten occur# racture treatent ais to ensure the bestpossible functiono the inured part ater healin!. Boneractures are typically treated by restorin! the racturedpieces o bone to their natural positions /i necessary1# andaintainin! those positions while the bone heals. 8ten#ali!nin! the bone# called reduction# in !ood position and3eriyin! the ipro3ed ali!nent with an ,ray is all that isneeded. &his process is e7treely painul withoutanesthesia# about as painul as brea"in! the bone itsel. &o

this end# a ractured lib is usually iobilized with aplasteror fber!lasscastor splint which holds the bones inposition and iobilizes the oints abo3e and below theracture.
http://en.wikipedia.org/wiki/Bone_healinghttp://en.wikipedia.org/wiki/Reduction_(orthopedic_surgery)http://en.wikipedia.org/wiki/Anesthesiahttp://en.wikipedia.org/wiki/Plasterhttp://en.wikipedia.org/wiki/Glass-reinforced_plastichttp://en.wikipedia.org/wiki/Cast_(orthopedic)http://en.wikipedia.org/wiki/Cast_(orthopedic)http://en.wikipedia.org/wiki/Glass-reinforced_plastichttp://en.wikipedia.org/wiki/Plasterhttp://en.wikipedia.org/wiki/Anesthesiahttp://en.wikipedia.org/wiki/Reduction_(orthopedic_surgery)http://en.wikipedia.org/wiki/Bone_healing


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8ccasionally saller bones# such as phalan!es o

the toesand fn!ers# ay be treated without thecast# by buddy wrappin!the# which ser3es asiilar unction to a"in! a cast. By allowin!only liited o3eent# f7ation helps preser3eanatoical ali!nent while enablin! callusoration# towards the tar!et o achie3in!union.

(plintin! results in the sae outcoe as castin!in children who ha3e a distal radius racture with

little shitin!.
http://en.wikipedia.org/wiki/Toeshttp://en.wikipedia.org/wiki/Fingerhttp://en.wikipedia.org/wiki/Buddy_wrappinghttp://en.wikipedia.org/wiki/Fibrocartilage_callushttp://en.wikipedia.org/wiki/Fibrocartilage_callushttp://en.wikipedia.org/wiki/Buddy_wrappinghttp://en.wikipedia.org/wiki/Fingerhttp://en.wikipedia.org/wiki/Toes


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urgery

(ur!ical ethods o treatin! ractures ha3e their ownris"s and benefts# but usually sur!ery is done only iconser3ati3e treatent has ailed# is 3ery li"ely to ail#or li"ely to result in a poor unctional outcoe. Hithsoe ractures such as hip ractures/usually caused by

osteoporosis1# sur!ery is oered routinely because nonoperati3e treatent results in prolon!ediobilization# which coonly results incoplications includin! chest inections# pressuresores# deconditionin!# deep 3ein throbosis/D-&1

and pulonary ebolis# which are ore dan!erousthan sur!ery. Hhen a oint surace is daa!ed by aracture# sur!ery is also coonly recoended toa"e an accurate anatoical reduction and restore thesoothness o the oint.
http://en.wikipedia.org/wiki/Hip_fracturehttp://en.wikipedia.org/wiki/Osteoporosishttp://en.wikipedia.org/wiki/Deep_vein_thrombosishttp://en.wikipedia.org/wiki/Pulmonary_embolismhttp://en.wikipedia.org/wiki/Fracturehttp://en.wikipedia.org/wiki/Fracturehttp://en.wikipedia.org/wiki/Pulmonary_embolismhttp://en.wikipedia.org/wiki/Deep_vein_thrombosishttp://en.wikipedia.org/wiki/Osteoporosishttp://en.wikipedia.org/wiki/Hip_fracture


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$nection is especially dan!erous in bones# due tothe recrudescent nature o bone inections. Bonetissue is predoinantly e7tracellular atri7# ratherthan li3in! cells# and the ew blood 3esselsneededto support this low etabolis are only able to

brin! a liited nuber o iune cellsto an inuryto f!ht inection. +or this reason# open racturesand osteotoitescall or 3ery careul antisepticprocedures and prophylacticantibiotics.

8ccasionally bone !ratin!is used to treat aracture.
http://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Extracellular_matrixhttp://en.wikipedia.org/wiki/Blood_vesselshttp://en.wikipedia.org/wiki/Immune_cellhttp://en.wikipedia.org/wiki/Open_fracturehttp://en.wikipedia.org/wiki/Osteotomyhttp://en.wikipedia.org/wiki/Antiseptichttp://en.wikipedia.org/wiki/Prophylactichttp://en.wikipedia.org/wiki/Bone_graftinghttp://en.wikipedia.org/wiki/Bone_graftinghttp://en.wikipedia.org/wiki/Prophylactichttp://en.wikipedia.org/wiki/Antiseptichttp://en.wikipedia.org/wiki/Osteotomyhttp://en.wikipedia.org/wiki/Open_fracturehttp://en.wikipedia.org/wiki/Immune_cellhttp://en.wikipedia.org/wiki/Blood_vesselshttp://en.wikipedia.org/wiki/Extracellular_matrixhttp://en.wikipedia.org/wiki/Infection


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(oeties bones are reinorced with etal. &heseiplantsust be desi!ned and installed with care.

Stress shieldingoccurs when plates or screws carrytoo lar!e o a portion o the boneIs load# causin!atrophy. &his proble is reduced# but noteliinated# by the use o lowodulusaterials#includin! titaniuand its alloys. &he heat!enerated by the riction o installin! hardware caneasily accuulate and daa!e bone tissue#reducin! the stren!th o the connections. $dissiilar etals are installed in contact with one

another /i.e.# a titaniu plate with cobaltchroiualloy or stainless steelscrews1# !al3anic corrosion will result. &he etal ions produced can daa!ethe bonelocally and ay cause systeic eects aswell.
http://en.wikipedia.org/wiki/Implant_(medicine)http://en.wikipedia.org/wiki/Stress_shieldinghttp://en.wikipedia.org/wiki/Atrophyhttp://en.wikipedia.org/wiki/Young's_modulushttp://en.wikipedia.org/wiki/Titaniumhttp://en.wikipedia.org/wiki/Bone_tissuehttp://en.wikipedia.org/wiki/Cobalthttp://en.wikipedia.org/wiki/Chromiumhttp://en.wikipedia.org/wiki/Stainless_steelhttp://en.wikipedia.org/wiki/Corrosionhttp://en.wikipedia.org/wiki/Ionhttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Ionhttp://en.wikipedia.org/wiki/Corrosionhttp://en.wikipedia.org/wiki/Stainless_steelhttp://en.wikipedia.org/wiki/Chromiumhttp://en.wikipedia.org/wiki/Cobalthttp://en.wikipedia.org/wiki/Bone_tissuehttp://en.wikipedia.org/wiki/Titaniumhttp://en.wikipedia.org/wiki/Young's_modulushttp://en.wikipedia.org/wiki/Atrophyhttp://en.wikipedia.org/wiki/Stress_shieldinghttp://en.wikipedia.org/wiki/Implant_(medicine)


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4eneral Mana!eent:

Maintain airway Breathin!

Circulation

Disability

(pecifc Mana!eent:

'eduction oldin! a racture

'ehabilitation


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Fi!ation


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+i7ation stabilizin! ractured bone# toenable ast healin! o the inured bone.

0types:2. $nternal +i7ation iplants ftted

directly on to the bone and are thenco3ered with sot tissue s"in.

screws plates

nails wires


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(crews *lates%ails


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0. E7ternal +i7ation Those where the

mechanical strength of the construct is outsidethe skin are defined as external fixation

QUESTION: Which fracture heals faster

!"I#$%EN or &$U#T '%&!TU%E


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Facts about Fracture"

Children=s racture is ore dicult todia!nose than adult=s because their boneslac" enou!h calciu /to be seen on ,ray1

and because !rowth plates in the bones aydis!uise a hidden racture.


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FIRT AI#

TI$


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First Aid for %&enFracture"

control bleedin! beore treatent.

'inse and Dress the wound.


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First Aid for Close 'ound"

chec" the breathin!

cal the person

e7aine or other inuries

iobilize the bro"en woundApple ice to reduce painK swellin!

consult edical help


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#o(s and #on(ts "

D8 %8&:

assa!e the aected area strai!hten the bro"en racture

o3e without support to bro"en bone o3e oints abo3eK below the racture

!i3e oral li9uidsK oods


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8ther tips:

i the person is unresponsi3e# isn=tbreathin! or isn=t o3in!# be!in C*'/cardiopulonary resuscitation1 i there is norespiration or heartbeat.

e3en !entle pressure or o3eent willcause pain ractured are has hea3y bleedin! lib or oint appears deored

bone has pierced the s"in e7treity or the inured ar or le!# suchas a toe or fn!er# is nub or bluish at the tip.


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T)A*+ ,%U

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FRACTURE Report Smallin