Fracture & Dislocation 11th Lecture PDF

Fracture & dislocation  Fracture is “a break of bone continuity”. This can be caused by car accident, falls from stairs especially without rails, roofs without defense, and windows without protective bars. Types of fractures: There are several types of bone fracture, including: 1. Closed (Unc...

Fracture & dislocation  Fracture is “a break of bone continuity”. This can be caused by car accident, falls from stairs especially without rails, roofs without defense, and windows without protective bars. Types of fractures: There are several types of bone fracture, including: 1. Closed (Uncomplicated) fracture: If the bone doesn't break the skin. 2. Open (Complicated/Compound) fracture: involve trauma to surrounding tissue and a break in the skin Open Closed 1. Incomplete fracture: a fracture in which the bone fragments are still partially joined. The bone is only cracked and partially broken. a. Hairline fracture (Capillary fracture): an incomplete fracture in which the fragments do not separate because the line of break is so fine. b. Greenstick fracture: an incomplete fracture in which one side of the fracture has broken and one side is bent. 1.Complete fracture: a fracture in which bone fragments separate completely. a.Linear fracture: a fracture that is parallel to the bone's long axis. b.Transverse fracture: a fracture that goes across the bone's axis c. Oblique fracture: a fracture that is diagonal to a bone's long axis. d. Spiral fracture: a fracture where at least one part of the bone has been twisted (runs around the axis of the bone). e. Impacted fracture: a fracture caused when bone fragments are driven into each other. f. Comminuted fracture: a fracture in which the bone has broken into a number of fragments (pieces 1. Simple fracture: Uncomplicated (closed) non-fragmented fracture. Depressed fractures: a fracture is when part of the bone is pushed out of line with the rest of the bone. This is usually in the skull. - Clinical manifestations  Pain and tenderness to touch  Swelling/ Edema  Abnormal movement and crepitus  Loss of function  Visible deformity  Paresthesia and other sensory abnormalities  Discoloration Signs and symptoms of fracture are different from one situation to another. Be aware of the possibilities of fracture. Whenever in doubt, assume that there is fracture.  Potential complications of fracture: A) Early complications 1-Arterial bleeding, possibly leading to shock. 2-Increase pressure and constriction of nerves and vessels. 3-Arterial damage during treatment. 4-Fat embolism , a life-threatening complication which most commonly develops within 24 to 72 hours after fracture. 5-Infection and possibly sepsis. B) Late complication: 1-Delayed union of the fracture side. 2-Mal union. 3-Non union. Care and first aid management: 1. ABC and activate EMS. 2. Reassurance and comforting the casualty 3. Ask the casualty not to move. 4. Immobilize the fractured bone at the place where the casualty lying; this will help to: a) Reduce additional injury. b) Reduces pain.  5- In open fractures: a) The first task is to control bleeding. Apply the pressure points method on the artery which supplies blood to the injured part. b) Prevent contamination of the wound that could cause infection of the bone. c) Cover the wound with a sterile dressing and bandage. 1. Immobilize the joints above and below the fracture by applying splints on both sides of a limb. 2. Make sure that splints or bandages do not interfere with blood circulation. 3. Pad and fix the splints with bandages. 4. Prevent shock.  Dislocation: is "a disruption in the normal relationship of two bones at the joint". Dislocations most commonly occur in free-moving joints, such as the jaw, shoulder, elbow, fingers, hip, knee, and ankle. A dislocation may be causes by a direct blow, hyperextension, a fall, sports injury or other accident. Other complications may present with dislocation:  Torn ligaments  Damaged blood vessels or nerves. Fractured bone  Signs & Symptoms: 1.Pain. 2.Deformity in the appearance. 3.Swelling. 4.Decreased function. First aid and Treatment: 1. Check for signs of other injuries or shock and treat accordingly. 2. Reassurance and comforting the casualty 3. Treats as if it was fractured: a) Ask the casualty not to move. b) Splint the joint in the position in which it was found. c) Apply a sling if an arm is involved. 4. Do not attempt to correct the dislocation or force the bone back into its proper position. This may cause further injury. 5. The person should be taken to an emergency room immediately for x-rays and treatment.  Thank you