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


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


- 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


step forward w/ affected side and bring unaffected leg up to walker


- 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


- goes on unaffected side - slight bend at elbow- affected leg moves forward w/ cane