Medical-Surgical Management of Fractures

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17 Questions

What is the primary reason for performing fracture reduction as soon as possible?

To prevent loss of elasticity through infiltration by edema and hemorrhage

What is the purpose of internal fixation devices in Open Reduction Internal Fixation (ORIF)?

To ensure firm approximation and fixation of bony fragments

What should be checked in patients with Open Reduction Internal Fixation?

Dressings for bleeding and infection

What is the purpose of taking X-rays after reduction?

To confirm correct alignment of bone fragments

What type of internal fixation device is used for a segmental fracture?

Medullary nail

What should be emptied in post-reduction care?

Hemovac drain

What is a joint subluxation?

A partial dislocation of the joint

What is the primary goal of medical management in joint dislocation?

To stabilize the joint and prevent further injury

What is the purpose of gentle, progressive, active and passive movements in post-reduction care?

To preserve ROM and restore strength

What is the definition of a fracture?

A complete or incomplete disruption in the continuity of bone structure

What is the first step in medical management at the scene of a joint dislocation?

Immoblize the affected joint

What is the primary goal when managing an open fracture?

Covering the wound with a sterile dressing to prevent contamination

What is the primary purpose of reduction in fracture management?

To restore the fractured bone to its anatomic alignment and positioning

What is the purpose of immobilization after fracture reduction?

To maintain the reduced position of the fracture and promote healing

What is a common diagnostic tool used to confirm the presence of a fracture?


What should be done upon arriving at the emergency department with a patient who has a fracture?

Gently remove clothing from the uninjured side first

What is the purpose of internal fixation devices in fracture management?

To promote bone growth and healing

Study Notes

Fractures and Dislocations

  • Fractures are complete or incomplete disruptions in the continuity of bone structure, occurring when the bone is subjected to stress greater than it can absorb.
  • Causes of fractures: direct blows, crushing forces, sudden twisting motions, and extreme muscle contractions.

Types of Fractures

  • ' Closed Fractures (simple fractures): do not cause a break in skin.
  • Open Fractures (compound/complex fractures): skin or mucous membrane wound extends to the fractured bone.

Specific Types of Fractures

  • Transverse fractures
  • Short oblique fractures
  • Long oblique fractures
  • Spiral fractures
  • Segmental fractures

Clinical Manifestations of Fractures

  • Pain: continuous and increases in severity until fragments are immobilized.
  • Loss of function: fractured extremity cannot function properly.
  • Deformity: detectable when compared to non-injured extremity.
  • Shortening: commonly seen in long bone fractures.
  • Crepitus: crumbling sensation/sound produced by a fractured extremity upon gentle palpation.
  • Localized edema and ecchymosis: occurs as a result of trauma and bleeding into the tissues.

Diagnosis of Fractures

  • X-ray: confirms the presence of a fracture.

Emergency Management of Fractures

  • Immobilize injured extremity before moving patient.
  • Splinting the injured part.
  • If open fracture: cover wound with sterile dressing to prevent contamination of deeper tissues.
  • Apply splint for immobilization.

Medical-Surgical Management of Fractures

  • Reduction: restoration of the fracture fragments to anatomic alignment and positioning.
  • Immobilization: holding the bone fragments in position until solid bone healing occurs.
  • Maintaining and restoring function: through exercises and rehabilitation.

Joint Dislocation

  • Subluxation: a partial dislocation that does not cause as much deformity as a complete dislocation.
  • Clinical manifestations: acute pain, change in or awkward positioning of joint, and decreased ROM.
  • Medical management: immobilize affected joint, closed reduction, and gentle, progressive exercises to preserve ROM and restore strength.

Open Reduction Internal Fixation (ORIF)

  • Through a surgical approach, the fracture fragments are anatomically aligned.
  • Internal fixation devices (metallic pins, wires, screws, plates, nails, or rods) are used to hold the bone fragments in position until solid bone healing occurs.

This quiz covers the medical-surgical management of fractures, including closed reduction and stabilization techniques. It discusses the importance of prompt intervention to prevent complications and promote healing.

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