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Muskuoloskeletal System CS
Muskuoloskeletal System CS
With Musculoskeletal
Disorders
Lecturer: Isaac Amankwaa
Outline
Fractures: Types
Management & complications
Traction (Skin and Skeletal)
Casts (Compartment Syndrome,
Infection, Cast Syndrome)
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Class Objectives:
Fracture
Definition
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Fracture ctd
Causes of fracture
Direct blow
Crushing force
Sudden twisting motion
Extreme muscle contraction
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Types of Fracture
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Table 6.1
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Table 6.1
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Table 6.1
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Table 6.1
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PHYSIOLOGICAL
RESPONSES
Local Response
PHYSIOLOGICAL
RESPONSES
Systemic Response
The client suffers some degree of shock
which is influenced by the severity of the
injury, the amount of soft tissue damage,
associated disorders or multiple injuries
and the patients age and general
condition at the time of injury.
In addition there is also the psychological
dimension to consider as different people
respond to different ways to same injury.
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Clinical Manifestations
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Diagnostic Investigations
HEALING OF FRACTURE
Bone is different from many of the
specialized
tissues because of its ability to
regenerate and hence restore the
continuity
Haematoma formation
Granulation tissue formation
Callous formation
Ossification
Remodeling and Consolidation
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Stages of Healing a
Fracture
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Figure 6.14
2.
3.
4.
5.
6.
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Complications of
fracture
Shock
Infection
Cast syndrome
Compartmental Syndrome
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Long-term Complications
Joint stiffness or post-traumatic
arthritis
Avascular necrosis
Nonfunctional union after a
fracture
Complex regional pain syndrome
Reaction to internal fixation
device
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Avascular Necrosis
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Emergency mgt of
fractures
Emergency mgt of
fractures
Emergency mgt of
fractures
Fracture Reduction
Fracture fragments brought into their
pre-injury position.
It consists of pulling the broken bone
ends to correct alignment and regain
continuity.(Bone setting)
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FRACTURE REDUCTION
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Methods of fracture
reduction
Includes;
1.
Closed manipulative
reduction
2.
Open (Internal )reduction
3.
Traction
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Methods of fracture
Reduction
Closed Reduction
Methods of reduction
Open reduction
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Open
Reduction
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Traction
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Immobilization or fixation
Immobilization or fixation
External Fixation
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Immobilization or fixation
Splint
Brace
Cast
External Fixator
Traction
Bandage
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Nail
Plates
Screws
Wires
Rods
Metal implants used
for internal fixation
serve as internal
splints to immobilize
the fracture.
Alignment &
Immobilization
2.
3.
4.
External fixation
The method is
used mainly in the
management of
open fractures
with severe softtissue damage.
Common sites
include face &
jaw, pelvis,
fingers.
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Immobilization or
fixation
Casts
Purpose of cast
Immobilization
prevention or correction of deformity
to realign bone
promotion of healing
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CASTING MATERIALS
Non-plaster
Plaster (P.O.P)
polyester-cotton
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Types of cast
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Types of cast
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Types of cast
Extends from
below the knee to
the base of the
toes. The foot is
flexed at a right
angle in a neutral
position.
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Types of cast
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POLYESTER/FIBERGLASS
The nurse:
The nurse:
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The nurse:
Monitor for the presence of a foul
odor, which may indicate infection
Monitor drainage and circle the area
of drainage on the cast
Monitor for warmth on the cast.
Monitor for wet spots, which may
indicate a need for drying, or the
presence of drainage under the cast
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The Nurse
If an open draining area exists on the
affected extremity, a cut-out portion of
the cast or a window will be made by
the physician
Instruct the client not to stick objects
inside the cast
Teach the client to keep the cast clean
and dry
Instruct the client on isometric
exercises to prevent muscle atrophy
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Bivalving a cast
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Bivalving a Cast
Cast
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Window
Potential complications of
cast
Hidden bleeding
Neurovascular compromise
Hidden infection from wound
Skin breakdown
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Traction
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Purposes of traction
Terminologies
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To reduce fractures
Immobilization of an area
before surgery
Control and relieve of painful
muscle spasm
stretching adhesions
correct deformities
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Contraindications
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Types of traction
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Types of traction
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Methods of applying
traction
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Skin Traction
2.
3.
Bryants traction
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Bryant's Traction
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Skeletal Traction:
Is accomplished by surgically
inserting metal wires or pins thru
distal bones to the # site or by
anchoring metal tongs in the skull.
A traction bow is attached to wire or
pin and traction force is applied .
Used to reduce unstable fractures of
long bones
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Skeletal traction
Skeletal traction
Advantage:
Relative ease of use and
ability to maintain comfort
Disadvantage:
Wt required to maintain
Normal body alignment or
fracture alignment can not
exceed 6 lbs per extremity.
Advantage:
Increases mobility without
threatening joint continuity.
Easier to change linen,
backcare
Disadvantage:
Need to use multiple wts
makes client slide in bed
more.
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Bucks
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Bone inflammation.
Infection can occur at the pin sites.
Both types of traction have complications
associated with long periods of immobility:
bed sores
reduced respiratory function
urinary & and circulatory problems
occasionally, fractures fail to heal
emotional toll of prolonged bedrest
Kidney/gallstones
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Relieving Pain