Concepts I Exam IV

24-48 hours

how many hours after major fracture or bone manipulation in surgery are fat embolisms seen

angulation

fracture heals in abnormal position in relation to midline of structure

delayed union

fracture healing progresses more slowly than expected. healing eventually occurs

malunion

fracture heals in expected time but in unsatisfactory position. may cause deformity or dysfunction

myositis ossificans

deposition of calcium in muscle tissue at site of significant blunt muscle trauma or repeated muscle injury

nonunion

fracture does not heal despite treatment. no x-ray evidence of callus formation

pseudoarthrosis

type of nonunion occurring at fracture site in which a false joint is formed with abnormal

refracture

new fracture occurs at original fracture site

crepitus (subq emphysema)

air in tissues itself - typically seen when looking at lungs

• manual traction

• closed reduction

• skeletal traction

• open reduction

types of fracture reductions

• casting/splint

• skeletal tx

• external fixation

• internal fixation

types of fracture immobilization

• surgical debridement and irrigation

• TDaP (doesn’t matter when you last had it)

• prophylactic antibiotic therapy

medical management for open fractures

Buck’s

traction pulling on the skin of the extremity

48-72 hours

how long for buck’s traction

5-10 lbs

maximum weight for buck’s traction

skeletal traction

traction to align injured bone or joint with a pin directly in the bone

25-45 lbs

maximum weight for skeletal traction

q2h

how often to check 6Ps with general traction

q4h

how often to perform pin care

external fixation

trying to salvage extremity that would otherwise be amputated (bones are broken in many shards)

proprioceptions

spatial reality with the apparatus they have on

internal fixation

using plates and screws to line up bone fragments

15 minutes to set up and 36-72 hours to cure

how long to set up plaster and how long for it to cure

fiberglass

lighter weight casts that may allow weight bearing and was thought to be waterproof but really isn’t

q4h

how often to monitor 6Ps with cast care

first 24 hourx

how often to ice with cast

q1-2h

how often to monitor 6Ps with concern for compartment syndrome

fat embolism syndrom

fat globule from center of fracture (where matrix of bone is) that escapes and travels to the blood vessels in your lungs and brain

petechiae on neck, anterior chest, axilla, buccal membrane, conjunctive

hallmark of fat embolism syndrome

bivalve of cast by HCP

cut slit in cast to allow for expansion, then tape it

• protein

• vitamins B and D

• calcium, phosphorus, magnesium (Ca, P, Mg)

• high fiber

• fluids 2-3L

nutrition for fractures

• PVD

• DM ulcers and gangrene

• injury

• tumors

• osteomyelitis

• congenital limb disorder

common causes of amputations

arteriography

injecting dye into the area to make sure there is blood flow to the area via arteries

venography

injecting dye into the area to make sure there is blood flow to the area via veins

doppler studies

make sure you have blood flow to the area