Marc Ancheta FRACTURE:

1. COMPLETE FRACTURE: involves a break across the entire cross section of the bone
and is frequently displaced from normal position

2. INCOMPLETE FRACTURE: the break occurs through only part of the cross section of
the bone

3. CLOSED FRACTURE: does not produce a break in the skin. 4. OPEN FRACTURE: is graded: grade 1 is a clean wound less than 1 cm. Long; grade III
is a larger wound without extensive soft-tissue damage; and grade ffl is the most severe with extensive soft-tissue damage TYPES OF FRACTURE:

1. GREENSTICK: the bone bends without fracturing across completely, the cortex on the
concave side usually remaining intact. Common among children whose bones are soft and yielding.

2. TRANSVERSE: a fracture that is straight across the bone, usually caused by a force
applied to the site at which fracture occurs

3. SPIRAL OR OBLIQUE: a fracture twisting around the shaft of the bone usually caused
by violence forced through the limb from a distance

4. CRUSH: occurs in cancellous bone as a result of a compression force 5. BURST: usually occurs in a short bone such as vertebrae, resulting from strong direct
pressure leading to impaction of the disc

6. COMPRESSION: a fracture in which the bone has been compressed, seen in vertebral
fractures

7. PATHOLOGIC: a fracture that through an area of diseased bone (bone cyst, Pagets
disease, bony mestasis, tumor)

8. AVULSION: a pulling away of a fragment of bone by a ligament or tendon and its

attachment

9. EPIPHYSEAL: a fracture through the epiphysis 10. COMMITNUTED: a fracture with more than one fragments 11. COMPOUND: a fracture with a surface or open wound. It sometimes communicate
with an internal body surface such as a pelvic fracture may communicate with a rupture of a rectum or a rib fracture may penetrate a lung. Open fractures are potentially infected and urgently needs treatment and management.

12. IMPACTED: a fracture where the fragments are driven into one another
SIGNS OF FRACTURE:

1. TENDERNESS: the exact distribution must be determined

2. DEFORMITY: may or may not be evident. The limb may be bent or shortened, or there
may be a step in the alignment of the bone or joint.

3. SWELLING: is obviously seen superficially and a vascular rupture occurs for a gross
swelling. It takes some time to appear and may increase over the first 12-24 hours

4. LOCAL TEMPERATURE: increase as part of inflammatory response which occur

immediately after injury and evident even if the damage is confined to the soft tissues

5. ABNORMAL MOBILITY OR CREPITUS: (grating of the fracture ends) may be noticed 6. LOSS OF FUNCTION: is almost always found to some extent, that the patient finds it
difficult to move the adjacent joints MANAGEMENT OF FRACTURE: 1. Fracture reduction and immobilization. Reduction of a fracture (setting the bone) refers to the restoration of the fracture fragments into anatomic rotation and alignment. After the fracture has been reduced, bone fragments must be immobilized or held in correct position and alignment until union has taken place. Immobilization may be accomplished bye:

a. EXTERNAL FIXATION: which include bandages, casts, splints, continuous

traction, pin and plaster technique, or external fixators

b. INTERNAL FIXATION: (metal implants) include nails, plates, screws, wires and
rods. These serve as internal splints to hold the fractured bone in alignment while healing takes place. CLOSED REDUCTION: accomplished by bringing the bone fragments into appostion (ends in contact) by manipulation and manual traction. Traction is used to effect fracture reduction and immobilization. As the fracture heals callus formation is noted by X-RAY. When the callus is well established, a cast is frequently used as immobilization technique OPEN REDUCTION: the fracture fragments are reduced through the use of internal fixation devices in the form of metallic pins, wires, screws, plates nalis or rods, which may be attached to the sides of bone or inserted through the bony fragments or directly into the medullary cavity of the bone.

2. MAINTAINING AND RESTORING FUNCTION: Efforts are directed toward facilitating

bone and soft tissue healing. Gradual resumption of activities is promoted by encouraging the patient to participate in daily living activities, which help them restore independent fucntioning and self-esteem. TRACTION: DEFINITION: is the act of pulling and drawing which is associated with counter traction. Traction can either be FIXED or SLIDING. In the fixed type. The traction is applied against a counter force while the pull is continuous and intact. In the sliding type, the patients weight is balanced against an applied load making use of the gravitational pull ot counter balance the applied traction BALANCED SKELETAL TRACTION:

INDICATIONS: 1. 2. 3. 4. 5. 6. To provide immobilazation To prevent further deformity or correct deformity To reduce pain and muscle spasm To reduce fracture To maintain good body alignment For support

TRACTION HEAD HATTER PELVIC GIRDLE OVERHEAD SKELETAL BUCKS EXTENSION BRYANTS TRACTION BOOT CAST HALO FEMORAL NINETY DEGREES STOVE-IN-CHEST DUNLOPS SKIN TRACTION HAMMOCK SUSPENSION

INDICATIONS CERVICAL SPINE AFFECTION LUMBO-SACRAL AFFECTION, HERNILATED NUCLUES PULPOSUS FRACTURE OF HUMERUS FEMUR AND HIP AFFECTION FEMORAL FRACTURES, HIP INJURIES AMONG KIDS BELOW 3YRS OLD SCOLIOSIS SEVER SCOLIOSIS SUBTROCHONTERIC FRACTURE SEVER CHEST INJURY WITH MULTIPLE RIB FRACTURE SUPRACONDYLAR FRACTURE OF THE HUMERUS PELVIC AFFECTION, MALGAIN FRACTURE