closed fracture
skin remains intact
compound fracture
bone breaks through the skin
displaced fracture
bones are out of alignment
nondisplaced fracture
bones are in alighnment
transverse fracture
occurs straight across the bone
linear fracture
straight up and down bone
oblique fracture
diagonal fracture
spiral fracture
- abuse suspicion
greenstick fracture
doesn't go all the way through the bone- most common in children
comminuted fracture
multiple fractures and bone fragments- smashed or crushed
assessment for fractures
5 P's- pain- pulse- pallor- paresthesia- paralysis
treatment for fractures
- pain management- RICE: rest, ice, compression, elevation- immobilization: cast, splint, brace, monitor the casted extremity closely for perfusion!!!- traction: no hip flexion
traction
T: temperature - monitor the tempR: ropes - should be hanging freelyA: alignment: ensure proper alignment of the extremityC: circulationT: tension - high risk for skin breakdownI: intake - monitor I/O'sO: overhead trapeze - bar overhead to help w/ ROMN: no weights on floor**
compartment syndrome
- increased pressure within a confined space: CAST- compromises circulation- w/o circulation the distal tissue becomes ischemic- tissue and nerve damage occurs
compartment syndrome assessment
- extremely painful- limbs feel tight- swelling- numbness- tingling- paralysis- pallor- diminished or absent pulses- decreased sensation
compartment syndrome treatment
- FASCIOTOMY- cut open the compartment
rhabdomyolysis
- injury to skeletal muscle: burns, trauma, compartment syndrome- muscles release their intracellular contents in blood: MYOGLOBIN, creatinine kinase, potassium increase, phosphorus increase- can become toxic- major kidney damage as nephrons try to filter the toxins out
rhabdomyolysis s/s
- vomiting- muscle weakness- DARK COLORED URINE (Coca Cola)- bruising- fatigue
rhabdomyolysis treatment
- fluids to help w kidneys- diuretics: decreased swelling, increased UOP, flush out toxins - dialysis if potassium is too high- BEDREST- monitor electrolytes and creatinine: telemetry - Foley catheter
walker
step forward w/ affected side and bring unaffected leg up to walker
crutches
- don't rest on armpit- use shoulders and arms for strength- slight bend in elbows
3 point gait
- partial weight bearing- crutches are advanced w/ affected leg- unaffected leg brought forward
swing through gait
- non weight bearing- stand on unaffected leg - balance on unaffected leg
crutches up stairs
- crutch on affected side- GOOD leg first
crutches down stairs
- crutch on unaffected side- BAD leg first
cane
- goes on unaffected side - slight bend at elbow- affected leg moves forward w/ cane