NCM-112N RLE

BONE
FRACTURE
PRESENTED BY: GULFAN, CLIFFORD &
NUNEZ, SHERYL ANN
Topic Outline
Definition
Statistics
Signs and Symptoms
Anatomy and Physiology
Pathophysiology
Laboratory Studies
Medical management
Surgical management
Nursing management
Prognosis

TODAY'S
DISCUSSION
 DEFINITION
What is a bone fracture?
A bone fracture is the medical definition for a broken bone.
Fractures are usually caused by traumas like falls, car accidents or sports
injuries. But some medical conditions and repetitive forces (like running) can
increase your risk for experiencing certain types of fractures.
If you break a bone, you might need surgery to repair it. Some people only
need a splint, cast, brace or sling for their bone to heal. How long it takes to
recover fully depends on which of your bones are fractured, where the
fracture is and what caused it.
 Statistics:
International:
- According to the World Health Organization (WHO),
globally, road traffic accidents are a major cause of
crush injuries and bone fractures, particularly in low-
and middle-income countries.
- There is limited specific data available on the
prevalence of crush injuries and bone fractures at the
international level.
STATISTICS
National
In the United States, around 6 million fractures occur each year, with women
experiencing more fractures than men due to factors like osteoporosis.
- Motor vehicle accidents, falls, sports injuries, and workplace accidents are common
causes of fractures in the United States.
- The American Academy of Orthopedic Surgeons estimates that more than 1.6 million
fractures occur due to sports-related injuries each year in the United States.
 Local Statistics:
- Local statistics on crush injuries and bone fractures
vary depending on the region. Data on local statistics
can typically be obtained from local health
departments, hospitals, or injury surveillance
systems.
- For example, local health authorities may track the
number of fractures caused by specific factors like
falls or workplace incidents within a municipality or
region.
- Local epidemiological studies or surveillance
systems can provide more detailed information on the
prevalence and causes of crush injuries and bone
fractures on a local level.
Signs and symptoms of bone fracture include:
Pain
Swelling
Tenderness
Inability to move a part of your body like you usually can
Bruising or Discoloration
A deformity or bump that’s not usually on your body
Infection (caused by bacteria that enter the body through the wound
Type of fracture And Description:
Transverse
Occurs straight across the long axis of the bone
Oblique
Occurs at an angle that is not 90 degrees
Spiral
Bone segments are pulled apart as a result of a twisting motion.
Comminuted
Several breaks result in many small pieces between two large segments.
Impacted
One fragment is driven into the other, usually as a result of compression
Greenstick
A partial fracture in which only one side of the bone is broken
 TYPES OF FRACTURE:
OPEN (OR COMPOUND)
A FRACTURE IN WHICH AT LEAST ONE END OF
THE BROKEN BONE TEARS THROUGH THE SKIN;
CARRIES A HIGH RISK OF INFECTION.
CLOSED (OR SIMPLE)
A FRACTURE IN WHICH THE SKIN REMAINS
INTACT
 TYPES OF FRACTURE:
OPEN (OR COMPOUND)
A FRACTURE IN WHICH AT LEAST ONE END OF
THE BROKEN BONE TEARS THROUGH THE SKIN;
CARRIES A HIGH RISK OF INFECTION.
CLOSED (OR SIMPLE)
A FRACTURE IN WHICH THE SKIN REMAINS
INTACT
 Anatomy and Physiology

TYPES OF FRACTURE:
OPEN (OR COMPOUND)
A FRACTURE IN WHICH AT LEAST ONE END OF
THE BROKEN BONE TEARS THROUGH THE SKIN;
CARRIES A HIGH RISK OF INFECTION.
CLOSED (OR SIMPLE)
A of FRACTURE
The healing IN ofWHICH
a bone fracture follows a series THE SKIN REMAINS
progressive steps:
INTACT
(a) A fracture hematoma forms.
(b) Internal and external calli form.
(c) Cartilage of the calli is replaced by trabecular bone.
(d) Remodeling occurs
 Anatomy and Physiology

TYPES OF FRACTURE:
OPEN (OR COMPOUND)
A FRACTURE IN WHICH AT LEAST ONE END OF
THE
Within about BROKEN
48 hours BONE
after the fracture, TEARS
chondrocytes THROUGH
from the endosteum have createdTHE SKIN;
an internal callus
CARRIES A HIGH RISK OF INFECTION.
(plural = calli) by secreting a fibrocartilaginous matrix between the two ends of the broken bone, while the
periosteal
CLOSED chondrocytes(OR and osteoblasts
SIMPLE) create an external callus of hyaline cartilage and bone, respectively,
Aoutside
around the FRACTURE
of the break ([link]b).IN WHICH
This stabilizes THE SKIN REMAINS
the fracture.
INTACT
Over the next several weeks, osteoclasts resorb the dead bone; osteogenic cells become active, divide, and
differentiate into osteoblasts. The cartilage in the calli is replaced by trabecular bone via endochondral
ossification ([link]c)
Eventually, the internal and external calli unite, compact bone replaces spongy bone at the outer margins of the
fracture, and healing is complete. A slight swelling may remain on the outer surface of the bone, but quite often,
that region undergoes remodeling ([link]d), and no external evidence of the fracture remains.
LABORATORY
STUDIES
X-RAYS
Bone x-ray uses a very small dose of
ionizing radiation to produce pictures of
any bone in the body. Fastest and easiest
way for your doctor to view and assess
bone fractures, injuries and joint
abnormalities.
MRI
Magnetic resonance imaging is a
noninvasive medical imaging test that
produces detailed images of almost every
internal structure in the human body,
including organs, bones, muscles and blood
vessels.
LABORATORY
STUDIES
CT scan
A CT scan will give your provider or surgeon
a more detailed picture of your bones and
the sorrounding tissue than an X-ray.
Bone Scan
Healthcare providers use a bone can to find
fractures that don’t show up on an X-ray.
This scan takes longer usually two visits
four hours apart but it can help find some
fractures.
PATHOPHYSIOLGY
MEDICAL
MANAGEMENT

Immobilization Closed Reduction

More severe breaks require a closed
if fracture is mild and your bones did not
reduction to set your bones. During this
move far out of place, you might need a
non-surgical procedure, your provider will
splint or a cast. Splinting usually lasts for
physically push and pull your body on the
three to five weeks.
outside to line up your broken bones inside
you.
MEDICAL
MANAGEMENT

Medication
Over-the-counter NSAIDs like aspirin or
ibuprofen can lead to bleeding and other
complications after surgery.
SURGICAL
MANAGEMENT

Internal Fixation External Fixation

Your surgeon will realign (set) your bones to
Your surgeon will put screws in your bone
their correct position and then secure them
on either side of the fracture inside your
in place so they can heal and grow back
body then connect them to a brace or
together. Surgeon inserts pieces of metal
bracket around the bone outside your body
into your bone to hold it in place while it
to temporary stabilize fracture.
heals.
SURGICAL
MANAGEMENT

Arthroplasty Bone Grafting

Also called joint replacement. Surgeon will
remove the damaged joint and replace it
with an artificial joint.
Surgeon will insert additional bone tissue to
rejoin your fractured bone. Youll be need
some combination of a splint, cast, brace or
sling before you can start using your
fractured bone.
 NURSING
MANAGEMENT
1. Limit the patients movement.
2. Apply sterile dressing in the fracture site to prevent infection
3. Encourage patients to use assistive devices to prevent further
damage
4. Anticipate the need for medical management such as drugs that
reduces the pain.
5. Keep all articles in the bedside at the reach of patient.
6. Elevate the affected extremity above the level of heart.
7. Patient teaching that includes self-care, medication information,
monitoring for potential complications, and the need for
continuing health care supervision
 PROGNOSIS

For most fractures, the whole process can take up to

18months, but in adults the strength of the healing bone is
usually 80% of the normal 3 months after the injury.
 REFERENCES
Cleveland Clinic. (2017). Bone Fractures. Cleveland Clinic; Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/15241-bone-fractures
Crush injury: MedlinePlus Medical Encyclopedia. (2016). Medlineplus.gov.
https://medlineplus.gov/ency/article/000024.htm
OpenStaxCollege. (2013). Fractures: Bone Repair. Pressbooks-
Dev.oer.hawaii.edu. https://pressbooks-
dev.oer.hawaii.edu/anatomyandphysiology/chapter/fractures-bone-
repair/OpenStaxCollege. (2013).
Fractures: Bone Repair. Pressbooks-Dev.oer.hawaii.edu.
https://pressbooks-
dev.oer.hawaii.edu/anatomyandphysiology/chapter/fractures-bone-
repair/#fig-ch06_05_02
THANK
YOU!
Do you have any questions?