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Fractures

Medical-Surgical Nursing

QuestionAnswer
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