Fracture regarding information and also useful in nursing in that types of fracture included and also include treatment regarding fracture , nursing care plan...commonly fracture is more so its very useful for study.....

1. PREPARED BY :
PATEL VEDANTI S.
F.Y.M.SC NURSING
23/10/2018
FRACTURE

2. ANATOMY AND PHYSIOLOGIC
OVERVIEW
 The musculoskeletal system provides protection
for vital organs , including the brain , heart , and
lungs ; provides a study framework to support
body structures and makes mobility possible.
Muscles and tendon hold the bones together and
joints allow the body to move.

3. Provision Of The Frame Work Of The Body
Giving attachment to muscle and tendons.
Allowing movement of the body as a whole and parts of the
body , by forming joints that are moved by muscles.
Forming the boundaries of the cranial ,thoracic and pelvic
cavities , protecting the organs they contain.
Haemopoiesis , the production of blood cells in red bone
marrow.
Mineral storage , especially calcium phosphate- the mineral
reservoir within bone is essential for maintenance of blood calcium
levels, which must be tightly controlled.
FUNCTION OF BONES:

4. TYPES OF BONES:
Short bones: carpals
Irregular bones : vertebrae
and some skull bone
Flat bones : sternum , ribs
and most skull bones
Sesamoid bones : patella
( knee cap)

5. DEFINATION OF FRECTURE
 A fracture is a complete or incomplete disruption
in the continuity of bone structure and is defined
according to its type and extent. Fracture may be
caused by direct blows, crushing forces , sudden
twisting motions , and extreme muscle
contractions.

6. TYPES OF FRACTURE
 The simplest classification method based on
whether the fracture is closed or open. Tissue
damage can be extensive with open fracture ,
which are graded according to their severity:
 Grade I. the wound is smaller than 1
cm;contamination is minimal
 Grade II. The wound is larger than 2
cm;contamination is moderate.
 Grade III. The wound exceeds 6 to 8 cm; there is
extensive damage to soft tissue , nerve and
tendon; there is high degree of contamination.

7.  Open fracture :
A fracture in which
damage also involves
the skin or mucous
membranes , also
called a compound
fracture

8.  Closed Facture:
A fracture that
remains contained ,
with no disruption of
the skin integrity. And
it is also called simple
fracture.

10.  Green stick Fracture :
A fracture in which
one side of a bone is
broken and the other
side is bent.

11.  Transverse
Fracture :
A fracture that is
straight line across
the bone shaft.

12.  Oblique Fracture :
A fracture
occurring at an angle
across the bone
( less stable than a
transverse fracture )

13.  Spiral fracture :
A fracture that
twists around the
shaft of the bone.
Common in a twisting
injury.

14.  Impacted Fracture :
A fracture in which
a bone fragment is
driven into another
bone fragment.

15.  Burst Fracture :
Characterized
by multiple pieces of
bone, often occurs at
bone ends or in
vertebrae.

16.  Linear Fracture :
Fracture line is
intact ; fracture is
caused by minor to
moderate force
applied directly to
bone.

17.  Displaced Fracture :
Fragment out of
normal position at
fracture site.
 Non – Displaced
Fracture :
Fragment aligned
at fracture site.

18. Displacement, Angulations
Angulation
Varus
Apex lateral
Valgus
Apex medial
Parallel
No angulation

20. Road
Traffic
Accident
Injuries
From
Sports
Falls
Down
Directly
strikes to
your
body
CAUSES

22. PATHOPHYSIOLOGY:
Soft tissue damage
Disruption of muscle and blood vessels
attached to the ends of the bone
Disruption in the continuity of bone
Injury in the bone
Vehicular accident

23. Inflammatory Response
Bone tissue surround the fractured site dies
Hematoma forms in medullary canal
Bleeding

24. CLINICAL MANIFESTATION
Pain
Abnormal Mobility and Crepitus
Deformity - the limb looks out of place ( Displacement)
Numbness and tingling
swelling, redness, and Muscle spasm in the injured area
Problems moving a limb
Bruising ( Ecchymosis)

25. DIAGNOSTIC EVALUATION:
physical
examination
X-RAY MRI CT SCAN

27. Principles of Treatment
Methods of holding reduction:
Sustained traction
Cast splintage
Functional bracing
Internal fixation
External fixation

28. Definitive Fracture Fixation
Options
 Casts and Splints
 Appropriate for many
fractures especially
hand and foot
fractures
 Adults typically will
get plaster splints
initially transitioned to
fiberglass casts as
swelling decreases
 Kids typically will get
fiberglass casts

29. CONSERVATIVE TREATMENT

30. FUNCTIONAL BRACING
 Braces are used to provide support ,control
movement , and prevent additional injury.

31. TRCTION:
 Traction by gravity
 E.g.. Fractures of the humerus
 Balanced Traction
 Skin traction: Adhesive strapping kept in place by
bandages.
 Skeletal traction: It is applied directly to the bone by
use of metal pin or wire.

32. INTERNAL FIXATION
Types of Internal Fixation
 Pin & wire fixation.
 Screw fixation.
 Plate & screws fixation.
 Intra-medullary fixation.

33. PLATE & SCREWS FIXATION.
 Open Reduction
and Internal
fixation with Plates
and screws
 Used for many
fractures especially
those involving
joints

36. Intramedullary
Fixation:
Treatment of
choice for most
tibia and femur
fractures
Used in selected
humerus and
forearm fractures

38. INDICATIONS FOR INTERNAL
FIXATION
1. Fractures that cannot be reduced
except by operation
2. Fractures that are inherently
unstable and prone to re-
displacement after reduction
3. Fractures that unite poorly and
slowly
4. Pathological fractures
5. Multiple fractures

39. External Fixation
 Used primarily in
the treatment of
open fractures and
pelvis fractures
 Also useful as
temporary
stabilization prior
to definitive
fixation

40. INDICATIONS FOR EXTERNAL
FIXATION
1) Fractures of the pelvis.
2) Fractures associated with severe soft-
tissue damage where the wound can be
left open for inspection, dressing, or
definitive coverage.
3) Severely comminuted and unstable
fractures,
4) Fractures associated with nerve or vessel
damage.
5) Infected fractures, for which internal
fixation might not be suitable.

41. COMPLIC
-ATION
Persistent
bone or bone
marrow
infection
Disruption
of bone
growth
Bone death
(avascular
necrosis)
Heals in
the wrong
position

42. COMPLICATIONS IN DETAIL
 Heals in the wrong position - this is known as a
mal union; either the fracture heals in the wrong
position or it shifts (the fracture itself shifts).
 Disruption of bone growth - if a childhood bone
fracture affects the growth plate, there is a risk
that the normal development of that bone may be
affected, raising the risk of a subsequent
deformity.

43.  Persistent bone or bone marrow infection - if
there is a break in the skin, as may happen with a
compound fracture, bacteria can get in and infect
the bone or bone marrow, which can become a
persistent infection (chronic osteomyelitis).
 Patients may need to be hospitalized and treated
with antibiotics. Sometimes, surgical drainage
and curettage is required.
 Bone death (avascular necrosis) - if the bone
loses its essential supply of blood it may die.

44. PREVENTION
Nutrition and
sunlight
Menopause
Physical
activity

45. PREVENTION IN DETAIL
 Nutrition and sunlight - the human body needs
adequate supplies of calcium for healthy bones.
Milk, cheese, yoghurt, and dark green leafy
vegetables are good sources of calcium.
 Our body needs vitamin D to absorb calcium -
exposure to sunlight, as well as eating eggs and
oily fish are good ways of getting vitamin D.

46.  Physical activity - the more weight-bearing
exercises you do, the stronger and denser your
bones will be.
 Examples include skipping, walking, running, and
dancing - any exercise where the body pulls on
the skeleton.
 Older age not only results in weaker bones, but
often in less physical activity, which further
increases the risk of even weaker bones. It is
important for people of all ages to stay physically
active.

47.  Menopause - estrogen, which regulates a woman's calcium,
drops during menopause, making calcium regulation much more
difficult. Consequently, women need to be especially careful
about the density and strength of their bones during and after the
menopause.
 The following steps may help reduce post-menopausal
osteoporosis risk:
 Do several short weight-bearing exercise sessions each week.
 Do not smoke.
 Consume only moderate quantities of alcohol, or don't drink it.
 Get adequate exposure to daylight.
 Make sure your diet has plenty of calcium-rich foods. For those
who find this difficult, a doctor may recommend calcium
supplements.

48. NURSING DIAGNOSIS:
 pain related to fracture due to pressure on nerve
endings.
 Impaired physical mobility related to body weakness
and disease condition (fracture).
 Activity intolerance related to post operative condition
 Deficient knowledge related to new condition and
treatment.
 Self care deficit related to musculoskeletal impairment
secondary to fracture femur.
 Constipation related to decrease physical activity.
 Risk for infection related to wound secondary to
fracture.
 Risk for pressure ulcer related to immobility.

49. THANK YOU

50. BIBLIOGRAPHY
 https://www.medicalnewstoday.com/articles/1733
12.php
 https://www.scribd.com./document
 ROSS AND WILSON TEXT BOOK OF “ ANATOMY AND
PHYSIOLOGY”11THE EDITION PAGE NO : 380 - 419
 JOYCE M.BLACK “ MEDICAL SURGICAL NURSING “ 8TH EDITION
PAGE NO : 507- 525
 BRUNNER AND SUDDARTH’S TEXT BOOK OF “ MEDICAL
SURGICAL NURSING “12TH EDITION PAGE NO : 2084 - 2106