Management of Fractures
Analgesics (i.e. NSAIDs) and muscle relaxants
This is done by applying direct pressure or sterile pressure dressings and elevation of extremities
Control external bleeding
Skin broken, bone and soft tissue exposed
Open fracture
The most essential of the letters
ABC - Airway, breathing, circulation
In this stage of bone healing, bleeding creates a [...] around fracture ends, forming a semisolid clot within 72 hours.
Fracture hematoma (first stage)
This management option allows the patient to perform many normal activities of daily living. Its application incorporates joints above and below fractures
Casts
This assessments includes colour, temperature, cap refill, peripheral pulses, edema, sensation and pain
Peripheral vascular assessment
Bone may be cracked or bent and is usually non-displaced (e.g. greenstick fracture)
Incomplete fracture
The last letter in a primary survey; may include removing the patients clothes to inspect their body
E - Expose/environmental controls
During the second stage of bone healing, phagocytosis absorbs necrosis, converting the hematoma to this
Granulation tissue
This management option is non-surgical and involves manual realignment of bone fragments to their previous anatomical position
Closed reduction
A nurse caring for a patient with an open fracture knows to administer these to prevent infection down the line
Prophylaxis tetanus and antibiotics
In an x-ray of this type of fracture, the bone would appear aligned and the periosteum intact
Nondisplaced fracture
May include cardiac monitoring, urinary catheter and gastric tubes, just to name a few.
F - Full set of vitals, Focused adjuncts
This stage of bone healing is the second last stage. The gap between bone fragments close and can take up to a year.
Consolidation (stage 5)
This management strategy involves correcting the bone alignment through surgery. It includes internal (and/or external0 fixations with use of pins, rods, ect.
Open reduction
It is important to do this, as unnecessary movement increases soft tissue damage, which may convert a closed fracture to an open one
Immobilize/split the fracture site above and below
This type of fracture appears as tiny cracks in the bone and are caused by repetitive force, often from overuse
Stress fracture
This part of a the secondary survey includes verbal, touch, pharmacologic and non-pharmacologic management of pain
G - Give comfort measures
During this stage, Minerals and new bone matrix form an unorganized network of bone around the fracture and appears by the end of the second week
Callus formation (third stage)
The purpose of this management option is to prevent or reduce muscle spasm, immobilize joint or part of the body and reduce a fracture. The two most common types are skin and skeletal
Traction
Check neurovascular status [...] before and after splinting
Distal to the injury
This type of fracture is usually caused by landing on the bone at an angle after a fall or when the bone is suddenly hit from an angle
Oblique fracture
These last two letters of the secondary survey can uncover important information that may have been overlooked in the primary survey
H - History and head-to-toe assessment
I - Inspect posterior surfaces
This stage of bone healing is the name of the process that occurs from 3 weeks to 6 months and stabilizes the fracture site. During this stage limited mobility may be allowed.
Ossification (stage 4)