3.

Discuss the Following:

3.1 Kind of Fracture:

-- A fracture is the disruption in the continuity of bone structure and are classified
according to

Three characteristics:

a.) Location
b.) Type
c.) Degree of Break

Clinical Manifestations:

a.) Pain
b.) Loss of Function
c.) Deformity
d.) Shortening of the Extremity
e.) Crepitus
f.) Localized Edema
g.) Ecchymosis

Types:

i.) Avulsion
-- A fracture in which a fragment of bone has been pulled away by a
tendon and its attachment
ii.) Comminuted
-- Fracture in which bone has splintered into several fragments
iii.) Compression
-- Fracture in which bone has been compressed, most often seen in
vertebral fractures
iv.) Depressed
-- Fracture in which fragments are driven inward, most often seen in
fractures of skull and facial bones
v.) Epiphyseal
-- A fracture through the epiphysis
vi.) Greenstick
-- Fracture in which one side of a bone is broken and the other side is
bent
 vii.) Impacted
-- Fracture in which a bone fragment is driven into another bone
fragment
viii.) Oblique
-- Fracture occurring at an angle across the bone, less stable than a
transverse
ix.) Open
-- Damage also involves the skin or mucous membranes, also called a
compound fracture
x.) Pathologic
-- Fracture that occurs through an area of diseased bone
xi.) Simple
-- A fracture that remains contained, with no disruption of the skin
integrity
xii.) Spiral
-- Fracture that twists around the shaft of the bone
xiii.) Stress
-- Fracture that results from repeated loading of bone and muscle
xiv.) Transverse
-- Fracture that is straight across the bone shaft

3.2 Types of Cast

i.) Short-arm Cast

-- Extends from the axillary fold to the proximal palmar crease. Elbow
is usually immobilized at a right angle
ii.) Short-leg Cast
-- Extends from below the knee to the base of the toes. Foot is flexed
at a right angle in a neutral position
iii.) Long-leg Cast
-- Extends from the junction of the upper and middle third of the thigh
to the base of the toes. The knee may be slightly flexed
iv.) Walking Cast
-- A short or long leg cast reinforced for strength
v.) Body Cast
-- Encircles the trunk
vi.) Shoulder Spica Cast
-- A body jacket that enclosed the trunk, shoulder, and elbow
vii.) Hip Spica Cast
-- Encloses the trunk and lower extremity. A double hip spica cast
includes both legs
 FIBERGLASS CASTS PLASTER CASTS
 Composed of polyurethane resins  Costs Less
 Lighter in weight  Achieves a better mold
 Stronger durability  Takes up to 24 to 72 hours to dry
 More water Resistant  Can cause serious burns if exposed
 Better Radiographic imaging to the sun
 Achieves full rigidity within 30
minutes
 Difficult to mold, so it is only used
for simple fractures of the
extremities

4.) Guidelines in Cast Care

 Assess the client’s neurovascular status every hour for the first 24 hours and
every 1 to 4 hours thereafter to prevent neurovascular compromise
 Inform the client that it is imperative to keep the cast from getting wet
 Inform the patient properly of the condition and the treatment regimen to ensure
the patient’s active participation in the program
 Observe for signs of infection
 Assist in isometric exercises hourly while patient is awake
 Elevate affected part while sleeping
 Do not stick objects into the cast to scratch the skin
 Do not apply powders or deodorants to itching skin, if itching persists, inform the
doctor
 Inform the patient to move the uninjured fingers and toes of the affected arm to
prevent stiffness and muscular atrophy
 Apply ice around the cast and elevate cast when there is swelling