Chapter 1

INTRIDUCTION

This chapter contains the Introduction of the study in which it is composed of

Background of the Study, Purpose of the Study, Theoretical Lens, Definition of terms

used, and Limitation and Delimitation of Study.

Background of the study

Tibia and fibula are the two long bones located in the lower leg. The tibia is a

larger bone on the inside, and the fibula is a smaller bone on the outside. The fibula

supports the tibia and helps stabilize the ankle and lower leg muscles. Tibia and fibula

fractures are characterized as either low-energy or high-energy. Low-energy,

nondisplaced (aligned) fractures, sometimes called toddler’s fractures, occur from minor

falls and twisting injuries. High-energy fractures, such as those caused by serious car

accidents or major falls, are more common in older children. An open fracture occurs

when the bone or parts of the bone break through the skin. This type of fracture usually

results from high-energy trauma or penetrating wounds. Open fractures of the tibia are

common among children and adults.

Around the world, these fractures often result from direct, high-energy traumas,

such as road, work, or sports injuries. They frequently affect young adults with an

average age of 37 years. The frequency of tibial fracture is approximately 11–26

fractures per 100,000 per year, with open fracture being 1.9% of all tibial fractures

(Pizzolo et al. 2018). In Tanzania, Africa, tibia/fibula fractures are one of the commonest

admissions to the orthopedic department at a resource-limited Northern Tanzanian

hospital. These fractures are associated with poor prognosis and pose a huge

socioeconomic burden on developing countries. However, to date there is a paucity of

epidemiological data on lower-limb fractures in Tanzania (Clelland et al.2016).

In the Philippines, Open fractures were mostly due to road traffic accidents and

affected the tibia and fibula most frequently. Management was challenging with late

presentations, scarcity of resources and consequent high rate of infections, prolonged

morbidity and hospital stay. These problems were worsened by delay in antibiotic

commencement and initial debridement, sub-optimal treatment at peripherial hospitals

and mis-management by traditional bone setters (Gustilo et al. 2018).

Purpose of the study

General Objective:

The general purpose of this study is to investigate and enhance the researcher’s

knowledge about Open Fracture Distal 3rd Tibia and Fibula.

Specifically, this study aims to;

 Study the possible complications or effects of the disease to the clients,

 Trace the pathophysiology of the condition and the course of disease

mentioned on the case. Connect the signs and symptoms and diagnostic

procedures as well as the priority nursing diagnosis.

 Study the drugs as indicated,

 Provide nursing care plan,

 Enumerate health teachings for the patient based on his/her condition.

THEORETICAL LENS

This study is anchored to Patient-Centered Approaches to Nursing Model

proposed by theorist Faye Glenn Abdellah. According to this theory, nursing is an art

and science that develops an individual, nurses attitudes, intellectual competences, and

practical expertise into a desire and capacity to serve people, sick or well, cope with

their care needs. This concept is classified as a theory of human needs. This one was

established as a tool for nursing practice, thus it is most appropriate and beneficial

within this field. This theory is considered to be engaged with the requirements of

patients and the responsibility of nurses in identifying problems using a problem-solving

method.

In addition, this study is also associated with Nola Pander’s Health Promotion

Model. It is intended to serve as a complementing alternative to models of health

protection. It expands to include health-improving practices and is applicable throughout

the entire lifecycle. Its goal is to assist nurses learn about and understand the primary

factors of health behaviors so that they may implement behavioral counselling services

to improve well-being and healthy lifestyles. Health-promoting habits should result in

better wellbeing, increased functional capacity, and an improved quality of life at all

phases of development. The immediate competing need and preferences also impact

the ultimate behavioral demand, which might hinder planned health-promoting acts.

Furthermore, this study was also anchored “Need Theory” by Virginia Henderson

that emphasizes on the importance of increasing the patient’s independence and focus

on the basic human needs so that progress can be meet. Nurses or other health care
provider is not present 24/7 so they must learn to manage their health at home without

being too independent on others.

These theories support the study, demonstrating how nurses take a proactive

approach to improving the patient's health while yet allowing the patient to work. The

nurse should only provide the patient what he or she requires, and the treatment should

be centered on the individual who requires it. Nurses may use the health promotion

model to educate people how to avoid injuries, how to deal with the condition properly,

and how to improve the client's psychological well-being. The need theory emphasizes

collaboration with patients in order to become self-sufficient and cope with one's own

capabilities.

Definition of terms

 Tibia- tibia is the shinbone, the larger of the two bones in the lower leg. The top

of the tibia connects to the knee joint and the bottom connects to the ankle joint.

Although this bone carries the majority of the body’s weight, it still needs the

support of the fibula (children hospital.org).

 Fibula- The fibula, sometimes called the calf bone, is smaller than the tibia and

runs beside it. The top end of the fibula is located below the knee joint but is not

part of the joint itself. The lower end of the fibula forms the outer part of the ankle

joint (children hospital.org).

 Open fracture- An open fracture, also called a compound fracture, is a fracture in

which there is an open wound or break in the skin near the site of the broken

bone. Most often, this wound is caused by a fragment of bone breaking through

the skin at the moment of the injury (Dunbar et al).

  Fracture- A fracture is a break, usually in a bone. If the broken bone punctures

the skin, it is called an open or compound fracture. Fractures commonly happen

because of car accidents, falls, or sports injuries (Medline plus).

LIMITATIONS AND DELIMITATIONS

This study is delimited only about Open Fracture Distal 3rd Tibia and Fibula, its

complications and effect, as well as the indications of the issue. Moreover, this study

was conducted on the second semester of school year 2021-2022 under the Nursing

Program in St. Mary’s College of Tagum, Inc.

REFERENCE

Cleland , S. (2020, January 1). The epidemiology and management of tibia and fibula fractures at

Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. The Epidemiology and Management

of Tibia and Fibula Fractures at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania;

www.panafrican-med-journal.com.

https://www.panafrican-med-journal.com/content/article/25/51/full/

Tibia and Fibula Fractures | Johns Hopkins Medicine. (2022, January 1). Tibia and Fibula Fractures |

Johns Hopkins Medicine; www.hopkinsmedicine.org.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/tibia-and-fibula-fractures

https://www.ncbi.nlm.nih.gov/books/NBK448083/

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