TRAUMA

Non modifiable factors: Modifiable factors:

Personal history of fracture as an adult Current cigarette smoking Low body weight
History of fracture in first degree relative Low calcium intake Alcoholism
Bone breakage
Female Recurrent falls Inadequate physical activity
Advanced age Poor health/frailty
Death of bone cells

Disruption in fracture hematoma due

Osteoblastic activity is immediately
stimulated, both intraossseous and
periosteal from osteoproginenitor
to displaced and comminuted bone
Bleeding typically occurs around the site
and into the soft tissues surrounding the
bone. The soft tissues are usually
damaged by the injury. Fixation or proper bone alignment is
needed to facilitate bone healing.

Immature new bone or callus Intense inflammatory reaction

is formed Open reduction internal fixation
Intramedullary nailing interlocking femur
vasodilation Left, open reduction internal fixation
Fibrin clot is soon reabsorbed Wiring patellar left
and the new bone cells are
slowly remodelled to from true Increased blood flow to the area of injury
Screws, wires, rods, nails or other
bone. fixation apparatuses hold both ends of
broken bone together
Leukocytes and mast cells accumulate
True bone replaces and
is slowly calcified.
Stress on the opposed of the broken
(several weeks to few Phagocytocis and removal of dead cell debris
bones, which accelerates osteoblastic
months) activity at the break leading to hastened
A fibrin clot (fracture hematoma) forms at the break and normal bone healing.
acts as a new network to which new cells can adhere.

Impaired skin and tissue
integrity related to surgical
repair, insertion of fixation
apparatuses
Risk for infection related
to tissue trauma
Skin and tissue breakage Maintenance of Impaired physical mobility
immobilization to facilitate related to musculoskeletal
bone healing impairment
Additional inflammation
aside from response
surrounding the bone.
Limited ROM and
Self care deficit related to
decreased muscle strength
immobility
Increased nociception

Risk for ineffective

Increased vital signs,
Risk for deficient fluid
volume related to blood
vessel damage secondary
to multiple fracture
tissue perfusion related
moaning, irritable, to immobility
guarding behaviour.
Risk for peripheral
Acute pain related
neurovascular dysfunction
to physical trauma
Ask questions about
operation and post
operative activities

Deficient knowledge
regarding fracture and
surgical treatment and care
related to lack of exposure