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TRAUMA Fractures, Dislocations & other injuries. By Barbara Peacock Cumberland County College 2009. Definition of trauma:. Injuries which are caused by external force or violence. They may range from minor to major, obvious to not apparent, single injury to multiple.

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Trauma fractures dislocations other injuries

TRAUMAFractures, Dislocations & other injuries

By Barbara Peacock

Cumberland County College

2009


Definition of trauma
Definition of trauma:

  • Injuries which are caused by external force or violence. They may range from minor to major, obvious to not apparent, single injury to multiple.


When a bone fractures there is usually damage to the surrounding area which may include
When a bone fractures, there is usually damage to the surrounding area which may include:

  • Damage to muscles

  • Tearing of blood & lymph vessels

  • Severing of nerves

  • Damage to nearby organs

  • Laceration of the skin


Signs of fracture
Signs of fracture: surrounding area which may include:

  • limited or no movement of a limb

  • swelling at the site of injury

  • pain at, or distal to, the injury

  • bruising at injury site

  • deformity of a limb

  • no pulse distal to the injury

  • loss of feeling at, and distal to, the injury


Deformity of a limb surrounding area which may include:

Clinical indication of dislocation


Fracture healing
Fracture Healing surrounding area which may include:

  • Healing begins when swelling occurs.

  • Blood, lymph, & tissue fluids form a fibrin clot around the fracture.

  • Soon fibroblasts appear & begin granulation.

  • Granulation process helps stabilize the fracture…….. (continued)


Healing continued
Healing (continued) surrounding area which may include:

  • Calcium is deposited around the fracture forming a callus.

  • *The callus is the first phase of healing which can be demonstrated radiographically.

  • Calcified area may be large at first, but will reduce with use.

  • Fracture site may be stronger than before!


Factors affecting healing
Factors affecting healing: surrounding area which may include:

  • Patient age

  • general health

  • nutrition

  • circulation at site of injury


Terminology

A/A or MVA surrounding area which may include:

abrasion

amputation

concussion

crepitus

dislocation

Fracture

hematoma

sprain

luxation

subluxation

Terminology


Examples of dislocation
Examples of dislocation surrounding area which may include:


Example of subluxation
Example of subluxation surrounding area which may include:


General types of fractures
General types of fractures surrounding area which may include:

  • Complete vs. Incomplete

  • Entire cross section of the bone fractures vs. not broken into separate pieces.


General fracture types cont
General fracture types (cont.) surrounding area which may include:

  • Closed (simple) vs. compound

  • Bone does not pierce through the skin

  • vs. bone is through the skin


Closed vs compound fractures surrounding area which may include:


General types of fractures cont
General types of fractures (cont.) surrounding area which may include:

  • Direct vs Indirect

  • fractureoccurs at the site of trauma vs away from the impact point


Fracture alignment
Fracture Alignment surrounding area which may include:

  • Displacement or apposition = misalignment of a fracture

  • Other terms denoting misalignment:

    • Varus

    • Valgus

    • Bayonet

(see note)


OUCH! surrounding area which may include:


Varus or valgus
Varus or Valgus? surrounding area which may include:


ANOTHER OUCH ! surrounding area which may include:


Overlapping fx
Overlapping fx. surrounding area which may include:


Specific types of fractures
Specific types of fractures surrounding area which may include:

  • LINEAR - straight lines


Transverse fx
Transverse fx surrounding area which may include:


Transverse fx1
Transverse fx. surrounding area which may include:


Longitudinal cleft
Longitudinal (cleft) surrounding area which may include:


Oblique fx
Oblique fx surrounding area which may include:

(also an oblique fx because of the direction of the fracture line)


Spiral fx
Spiral fx surrounding area which may include:

Fracture line rotates around the bone, usually from a twisting force


Spiral fx1
Spiral fx. surrounding area which may include:


Comminuted fx
Comminuted fx surrounding area which may include:

2 or more fracture lines = 3 or more fragments


Crush fx
Crush fx surrounding area which may include:

Severe communited !


Impacted fx
Impacted fx surrounding area which may include:

Typical of a front seat

passenger in a car

crash !

Fractured ends get pushed into one another


Impacted fx1
Impacted fx. surrounding area which may include:


Splinter fx
Splinter fx surrounding area which may include:

Fracture ends are thin shards or splinters like wood.

(gunshot wounds)


Stellate fx
Stellate fx surrounding area which may include:

Specific to the patella-

fracture lines radiate out from a center point in a star-like pattern.


Compression fx
Compression fx surrounding area which may include:

Specific to the vertebrae - vertebral body collapses, anterior aspect is reduced in height.

From trauma or demineralization of bone (old age).


Burst fx
Burst fx surrounding area which may include:

C1 ring is broken, fragments move outward.

Football injuries, heavy object dropped on head.

C - 1 (atlas)


Blowout fx
Blowout fx surrounding area which may include:

Orbital floor collapses from direct blow to eyeball

(fist, baseball)


Depressed fx
Depressed fx surrounding area which may include:

Section of bone pushed into center of an area

(skull, sternum)


Complicated fx
Complicated fx surrounding area which may include:

Fractured bone causes damage to an internal organ. Ex. - rib pierces lung


Avulsion fx chip fx
Avulsion fx (chip fx) surrounding area which may include:

Caused by stress to a joint, ligament, or tendon. Small piece of bone is torn away. Often seen with dislocations.(see note)


Non trauma fractures
NON-TRAUMA FRACTURES surrounding area which may include:

1. Pathologic - bone is weakened by disease, spontaneous fx’s

(cancer, osteomalacia, osteomyelitis, Pagets)

2. Stress - caused by prolonged running or marching - metatarsals fracture. Difficult to visualize.


Pediatric fractures
Pediatric fractures surrounding area which may include:

1. Greenstick (torus) - incomplete fx, bones more flexible, bends & fractures only outer edge.

2. Epiphyseal - fractures located at the site of an epiphysis. Sometimes with associated dislocation (slipped epiphysis)


Don’t forget to review the specific fracture types listed on the last pages of your handout! (eg: Colles, nursemaid, Potts)


The end

THE END !! on the last pages of your handout! (eg: Colles, nursemaid, Potts)


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