Trauma fractures dislocations other injuries
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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:

  • 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


Trauma fractures dislocations other injuries

Deformity of a limb

Clinical indication of dislocation


Fracture healing

Fracture Healing

  • 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)

  • 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:

  • Patient age

  • general health

  • nutrition

  • circulation at site of injury


Terminology

A/A or MVA

abrasion

amputation

concussion

crepitus

dislocation

Fracture

hematoma

sprain

luxation

subluxation

Terminology


Examples of dislocation

Examples of dislocation


Example of subluxation

Example of subluxation


General types of fractures

General types of fractures

  • Complete vs. Incomplete

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


General fracture types cont

General fracture types (cont.)

  • Closed (simple) vs. compound

  • Bone does not pierce through the skin

  • vs. bone is through the skin


Trauma fractures dislocations other injuries

Closed vs compound fractures


General types of fractures cont

General types of fractures (cont.)

  • Direct vs Indirect

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


Fracture alignment

Fracture Alignment

  • Displacement or apposition = misalignment of a fracture

  • Other terms denoting misalignment:

    • Varus

    • Valgus

    • Bayonet

(see note)


Trauma fractures dislocations other injuries

OUCH!


Varus or valgus

Varus or Valgus?


Trauma fractures dislocations other injuries

ANOTHER OUCH !


Overlapping fx

Overlapping fx.


Specific types of fractures

Specific types of fractures

  • LINEAR - straight lines


Transverse fx

Transverse fx


Transverse fx1

Transverse fx.


Longitudinal cleft

Longitudinal (cleft)


Oblique fx

Oblique fx

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


Spiral fx

Spiral fx

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


Spiral fx1

Spiral fx.


Comminuted fx

Comminuted fx

2 or more fracture lines = 3 or more fragments


Crush fx

Crush fx

Severe communited !


Impacted fx

Impacted fx

Typical of a front seat

passenger in a car

crash !

Fractured ends get pushed into one another


Impacted fx1

Impacted fx.


Splinter fx

Splinter fx

Fracture ends are thin shards or splinters like wood.

(gunshot wounds)


Stellate fx

Stellate fx

Specific to the patella-

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


Compression fx

Compression fx

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

C1 ring is broken, fragments move outward.

Football injuries, heavy object dropped on head.

C - 1 (atlas)


Blowout fx

Blowout fx

Orbital floor collapses from direct blow to eyeball

(fist, baseball)


Depressed fx

Depressed fx

Section of bone pushed into center of an area

(skull, sternum)


Complicated fx

Complicated fx

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


Avulsion fx chip fx

Avulsion fx (chip fx)

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

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

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)


Trauma fractures dislocations other injuries

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 !!


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