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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
slide5

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
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
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)

specific types of fractures
Specific types of fractures
  • LINEAR - straight lines
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

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

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)

slide42

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

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