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INTRODUCTION

Fracture A traumatic injury to a bone in which the continuity of the bone tissue is broken. a fracture is classified by the bone involved, the part of that bone, and that nature of the break, such as a comminuted fracture of the head of the tibia.
Common Types and Locations of Fractures

There are a variety of types and locations that bone fractures that can occur. Common types and locations of fractures include:

greenstick fracture, spiral fracture, comminuted fracture, transverse fracture, compound fracture, vertebral compression fracture, stress fracture, compression fracture, rib fracture, and skull fracture,wrist fracture (scaphoid fracture)

Signs and Symptoms Acute pain Loss of function Deformity Shortening of the extremity Crepitus Localized edema Ecchymosis Shock Tenderness Neurovascular changes

Types of Fractures Complete fracture: a break across the entire cross section of the bone the bone, which is frequently displaced. Incomplete fracture, also called greenstick fracture: Break occurs only through part of the cross section of the bone. Comminuted fractures: A break with several bone fragments. Closed fracture, or simple fracture: does not produce a break in the skin. Open fracture, or compound, or complex fracture: A break in the skin or mucous membrane wound extends to the fracture bone. open fractures are graded as follows: grade I: a clean wound less than 1 cm long, grade II: a larger wound without extensive soft tissue damage, grade III: wound is highly contaminated and has extensive soft tissue damage(most severe type).

Fractures may also be described according to anatomic placement of fragments, particularly if they are displaced or nondisplaced. An intra-articular fracture extends into the joint surface of a bone. Complications Early complications includenshock, fat embolism, compartment syndrome, and venous thromboemboli(deep vein thrombosis[DVT], pulmonary embolism[PE]), delayed complications include delayed union, malunion, nonunion, avascular necrosis of bone, reaction to internal fixation devices, complex regional pain syndrome, enheterotopic ossification.

Diagnostic Procedure 1. X-ray 2. CT scan 3. Tomogram

Management

Medical Management The goal of treatment is to control the pain, promote bone healing, prevent complications, and restore normal use of the fractured area. An open fracture(one in which the bone exits and is visible through the skin, or where a deep wound exposes the bone through the skin) is considered an emergency. Surgical Management Arthroscopy Joint replacement surgery microfracture ORIF External Fixation Pharmacologic Management Acetaminophen Ibuprofen

Non Surgical Management Closed reduction Bandage and splint Cast Traction

Nursing Interventions Enhance comfort Ensure adequate oxygenation of the tissue

Tape measures toward restring the function of the fractured bone Maintain body mobility while keeping the injured part at rest Protect against infection in the absence of an intact first line of defense against infection Provide adequate nutrition for healing Prevent constipation Promote urinary elimination Prevent additional trauma to soft tissues Assist in allaying anxiety Assist patient to attain optimal level of independence Help prevent boredom Provide care for patients in cast, traction, external fixation, brace and ambulatory devices Provide care for patients for surgery.