Transcript TRAUMA Fractures, Dislocations & other injuries

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.
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:
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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
Clinical
indication
of
dislocation
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)
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:
• 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
Examples of dislocation
Example of subluxation
General types of fractures
• Complete vs. Incomplete
Entire cross section of the
bone fractures vs. not
broken into separate
pieces.
General fracture types (cont.)
• Closed (simple) vs.
compound
Bone does not pierce
through the skin
vs. bone is through the skin
Closed vs compound fractures
General types of fractures
(cont.)
• Direct vs Indirect
fracture occurs at the site of
trauma vs away from the impact
point
Fracture Alignment
Displacement or apposition =
misalignment of a fracture
(see
note)
Other terms denoting misalignment:
• Varus
• Valgus
• Bayonet
OUCH!
Varus or Valgus?
ANOTHER OUCH !
Overlapping fx.
Specific types of fractures
LINEAR - straight lines
Transverse fx
Transverse fx.
Longitudinal (cleft)
Oblique fx
(also an
oblique fx
because of
the direction
of the
fracture line)
Spiral fx
Fracture line
rotates around
the bone,
usually from a
twisting force
Spiral fx.
Comminuted fx
2 or more fracture
lines = 3 or more
fragments
Crush fx
Severe
communited !
Impacted fx
Fractured
ends get
pushed
into one
another
Typical of a front seat
passenger in a car
crash !
Impacted fx.
Splinter fx
Fracture ends are
thin shards or
splinters like
wood.
(gunshot wounds)
Stellate fx
Specific to the
patellafracture lines
radiate out from
a center point in
a star-like
pattern.
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
C1 ring is
broken,
fragments move
outward.
Football
injuries, heavy
object dropped
on head.
C - 1 (atlas)
Blowout fx
Orbital floor
collapses
from direct
blow to
eyeball
(fist, baseball)
Depressed fx
Section of
bone
pushed into
center of an
area
(skull,
sternum)
Complicated fx
Fractured bone causes
damage to an internal
organ. Ex. - rib pierces
lung
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
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
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 !!