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Fractures
Medical-Surgical Nursing
| Question | Answer |
|---|---|
| What is a disruption or break in the continuity of bone? | A fracture |
| What is a pathologic fracture? | A fracture occurring secondary to a disease process (e.g., osteoporosis) |
| Type of Fracture: Skin is broken and bone exposed, causing soft tissue injury. | Open fracture |
| Type of Fracture: Skin remains intact. | Closed fracture. |
| What is a fracture termed if the break goes all the way through the bone? | Complete |
| What is a fracture termed if the break occurs partly across a bone shaft but the bone is still intact? | Incomplete |
| What are the 5 directional terms to describe a fracture line? | Linear, oblique, transverse, longitudinal, and spiral fractures |
| What is fracture termed if the two ends of the broken bone are separated from one another and out of their normal positions? | Displaced |
| What type of fracture does the periosteum remain intact across the fracture and the bone fragments are in alignment? | Nondisplaced |
| What are two classifications of displaced fractures? | Oblique and comminuted (more than 2 fragments) |
| What are 3 classifications of nondisplaced fractures? | Transverse, spiral, or greenstick |
| What is a greenstick fracture? | An incomplete fracture with one side splintered and the other side bent. |
| Which type of fracture line extends across the bone shaft at a right angle to the longitudinal axis? | Transverse fracture |
| What are the 6 stages of bone healing? | Fracture hematoma, granulation tissue, callus formation, ossification, consolidation, and remodeling. |
| What are manifestations of fracture? | Edema and swelling, pain, tenderness, muscle spasm, deformity, contusion, loss of function, and crepitation. |
| When does a fracture hematoma form? | Usually in the first 72 hours after injury |
| What is the healing process of bone called? | Union |
| In which stage of bone healing does active phagocytosis occur? | Granulation tissue |
| What is new bone substance? | Osteoid |
| When does granulation tissue form in bone healing? | During days 3-14 after injury |
| What minerals are associated with callus formation? | Calcium, phosphorus, and magnesium |
| What is callus primarily composed of? | Cartilage, osteoblasts, calcium, and phosphorus. |
| When does a callus usually appear after injury? | By the end of the second week |
| When does the callus ossify? | 3 weeks to 6 months after injury |
| Is a fracture still evident on x-ray during the ossification stage? | Yes |
| When can a patient be allowed limited mobility or maybe have the cast removed? | During the ossification stage |
| What phase of bone healing is equated with radiologic union? | Consolidation |
| How long does it take consolidation to occur? | Up to 1 year after injury |
| What occurs in the remodeling stage? | Excess bone tissue is resorbed and union is complete |
| What is Wolff's law? | Bone remodels in response to physical loading stress |
| Does healing time for fractures increase with age? | Yes |
| How long does it take an uncomplicated midshaf femur fracture to heal in a newborn? An adult? | 3 weeks for a newborn; 20 weeks for an adult |
| What are complications of fracture healing? | Delayed union; nonunion; malunion; angulation; pseduoarthritis; refracture; myositis ossificans. See page 1470 in Lewis Med-Surg |
| What is the nonsurgical, manual realignment of bone fragments? | Closed reduction |
| Is closed reduction performed with anesthesia? | Yes; general or local |
| Do you immobilize the injured body part with closed reduction until healing occurs? | Yes |
| What is the correction of bone alignment through a surgical incision? | Open reduction |
| What form of open reduction facilitates early ambulation? | Open reduction internal fixation (ORIF) |
| What is the application of a pulling force to an injured or diseased body part or extremity? | Traction |
| What form of treatment is generally used for short term treatment (48-72 hours)? | Skin traction |
| What are weight limits limited to for skin traction? | 5-10 lbs. |
| What is Buck's traction used for? | Preoperatively for the patient with a hip fracture to reduce muscle spasms |
| How often should you assess pressure points in skin traction? | Every 2-4 hours |
| What is skeletal traction used for? | To align injured bones and joints or to treat joint contractures and congenital hip dysplasia. |
| What are the weight ranges for skeletal traction? | 5-45 lbs. |
| What can using too much weight in skeletal traction result in? | Nonunion or delayed union |
| What are the major complications of skeletal traction? | Infection at pin insertion site and complications from prolonged immobility |
| What commonly supplies countertraction? | Patient's body weight or by weights pulling in the opposite direction |
| True or False: Weights can be allowed to lay on the floor. | False; they must be off the floor and hanging freely |
| Should a casted extremity be kept below or above heart level? Why? | Above heart level to help decrease edema |
Created by:
shrewsburysd
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