You are on page 1of 25

m  


 m
SPRAIN, STRAIN, FRACTURE,
DISLOCATION

  

a A •  is a stretching or tearing of  •
 •,, the tough,
fibrous bands of tissue that connect bones to one another
at a joint
joint..
a A •  is a stretching or tearing of  or  •

tissue, commonly called a pulled muscle
muscle..
a Õ  
a Anything that places sudden or unaccustomed stress on --
or chronic overuse of -- joints or muscles may cause a
sprain or strain
strain..
a Falls, lifting heavy objects, exertion of an unfamiliar sport
a Being overweight, inactive, or in poor physical condition
boosts the likelihood of injury
injury..
a Improperly warming up and not stretching muscles before
intense physical activity
 

g   
• 
•   
•
g • 


  
  
÷        
a ÷hile the intensity varies, pain, bruising, swelling,
and inflammation are common to all three
categories of sprains: mild, moderate, severe.
a The individual will usually feel a tear or pop in the
joint.
a A severe sprain produces excruciating pain at the
moment of injury, as ligaments tear completely, or
separate from the bone.
a This loosening makes the joint nonfunctional.
a A moderate sprain partially tears the ligament,
producing joint instability,
instability, and some swelling.
a A ligament is stretched in a mild sprain, but there
is no joint loosening.


gTendinitis/ elbow
strain
g amstring & Achilles
tendon strain
÷        
a Typical indications include pain, muscle
spasm, muscle weakness, swelling,
inflammation, and cramping.
cramping.
a In severe strains, the muscle and/or tendon
is partially or completely ruptured, often
incapacitating the individual.
a Some muscle function will be lost with a
moderate strain, where the muscle/tendon is
overstretched and slightly torn.
a ÷ith a mild strain, the muscle/tendon is
stretched or pulled, slightly.





6    
  
  

 

G   
  
       
  
      
  


 

      


   
   
     
  
G        ! 
     
"    
       



  



  
      
          

     
 
 

 

G # $  $%  ! 
     
" 


     


     
    
 
        % 

  
 

 
  
   
  
a Grade 1 : stretching injury
a Grade 2 : partial tearing
a Grade 3 : complete tearing/torn
a Ê  
   
a Protection
a |•
a 


a ••
a Õ  
a Support
a Medication
a Ê 
a Progressive ROM exercises
a Passive Active assistive Active
Resistive
a ot / ÷arm compress
a   • •
a  •
a   
|•
   |
a   
  •

a  •

A surgeon looks inside the joint to see if there
are any loose fragments of bone or cartilage, or
part of the ligament caught in the joint.
a |
• 

A surgeon repairs the torn ligament with
stitches or suture, or uses other ligaments
and/or tendons found in the foot and around
the ankle to repair the damaged ligaments.

a The best way to prevent ankle sprains is to maintain
good strength, muscle balance and flexibility.
a Participate in a conditioning program to build muscle
strength
a Do stretching exercises daily
a Always wear properly fitting shoes
a Nourish your muscles by eating a well-
well-balanced diet
a ÷arm up before any sports activity, including practice
a Use or wear protective equipment appropriate for that
sport
a Pay attention to your body's warning signs to slow
down when you feel pain or fatigue
a Pay attention to walking, running or working surfaces
„



a Ê
 



a May be traumatic or pathologic
a Direct blow
a Sudden twisting
a Severe muscle contraction
a Sports--related injury
Sports
a Secondary to disease that has weakened the bones
 
a According to communication to the
environment
a Closed/ Simple fx
a Open/ Compound fx
a Completeness
a Complete fx
a Incomplete fx
a Anatomical position
a Proximal 1/3
a Middle 1/3
a Distal 1/3
a According to line of breakage/
breakage/
displacement
a Transverse fx
a Longitudinal fx
a Oblique fx
a Spiral fx
a Other classification
a Comminuted fx
a Greenstick fx
a Impacted fx
a Distraction fx
a Compression fx
a Garden¶s classification of femoral Fx
a Type I : incomplete femoral neck fx;
intertrochanteric crest fx
a Type II : complete femoral neck fx;
intertrochanteric + lesser trochanter fx
a Type III : complete femoral neck fx + <50% displacement;
intertrochanteric + greater trochanter fx
a Type IV : complete femoral neck fx + > 50% displacement;
intertrochanteric + lesser + greater trochanter fx
a Salter
Salter-- arris classification
a Type I : growth plate
a Type II : metaphysis and growth plate
a Type III : epiphysis and growth plate
a Type IV : metaphysis and epiphysis
a Type V : crushing injury
  !""
a Usually, you will know immediately if you have
broken a bone«
a may hear a snap or cracking sound
a The area around the fracture will be tender and
swollen
a A limb may be deformed,
deformed, or a part of the bone
may puncture through the skin.
a Stress fractures are more difficult to diagnose,
because they may not immediately appear on an
X-ray; however, there may be pain, tenderness
and mild swelling.
a Document neurovascular examination (and address
deficits immediately)
a Perform on initial exam and repeat before and
after any intervention
a Keep high index of suspicion for Compartment
Syndrome
a Check capillary refill and distal pulses
a Check motor and Sensory Examination
a Evaluate skin over fracture site
a Signs of open fracture
a Signs of displaced fracture (skin tenting)
a Clues suggesting fracture (swelling, Ecchymosis,
and point tenderness over fracture site)
a Devitalized skin at risk of necrosis
a Evaluate joints, muscles, ligaments, and tendons
above and below the fracture
 #
    

a Emergent referral indications


a Fracture with neurologic deficit
a Fracture with vascular deficit
a Fracture with secondary Compartment Syndrome
a Open fracture
a Severe crush or shearing injury resulting in skin
devitalization
   „ $
m"
a |
!•  |  
a Open reduction (e.g. ORIF), Closed Reduction /
Careful manipulation, Traction
a  "   


a Internal fixation (metal pins, rods, nails, screws,
plates), External fixation (casts, molds, braces),
Traction
a |    |•   

a Progressive exercises
›  
a Displacement of bones from its articulating
surfaces
› 

a May be congenital, traumatic and


pathologic

a    : bones are displaced and not


in contact to the articulating surface
a     : partial/subluxation; bones
are displaced but still in contact to its
articulating surface