Fracture

 a break in the rigid structure and continuity of bone

 

·        several types of fracture lines; e.g., complete vs incomplete

 

 

 

 

Local complications:

l      muscle spasms

l      infection (tetanus, osteomyelitis) with open fractures & surgery

l      nonunion or malunion

l      ischemia (edema in first 48 hours)

l      nerve injury

l      compartment syndrome

¡     common with crush injuries

¡     swelling á pressure inside the non-elastic fascial compartment

¡     nerves & blood vessels compressed

l      fat emboli

¡     fatty marrow escapes the medullary canal

¡     occurs with fractures of pelvis, femur

¡     ­ risk if fracture has not been mobilized initially

l      long-term effects

¡     osteoarthritis

¡     stunted growth if the epiphyseal plate is damaged in a child

 

Factors that affect healing:

¡     amount of damage to bone & soft tissue

¡     approximation of bone

¡     foreign material or infection

¡     systemic factors

¡     circulatory problems e.g., diabetes

¡     nutritional deficits e.g.,  anemia

¡     medications e.g., glucocorticoids

 

 

Treatment:

l      sterile / clean dressing

l      immediate immobilization (splinting), including joints above and below

l      elevate limb

l      check pulse and sensory function distal to fracture

l      reduction (closed vs open)

l      traction may be necessary to maintain alignment

l      exercise to prevent atrophy, stiffness, poor circulation