Bone Fractures
A fracture, or discontinuity of the bone, is the most common type of bone lesion. Normal bone can withstand considerable compression and shearing forces and, to a lesser extent, tension forces. A fracture occurs when more stress is placed on the bone than it is able to absorb.
A bone fracture is a medical condition in which there is a break in the continuity of the bone. A bone fracture can be the result of high force impactor stress, or trivial injury as a result of certain medical conditions that weaken the bones, such asosteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then termedpathological fracture.
(http://en.wikipedia.org/wiki/Bone_fracture)
Cause for Bone Fractures
Bone Fractures Grouped according to cause, fractures can be divided into three major categories:
- Fractures caused by sudden injury
The most common fractures result from major trauma, such as a fall on an outstretched arm, a skiing or motor vehicle accident, and child, spouse, or elder abuse (shown by multiple or repeated episodes of fractures). The force causing the fracture may be direct, such as a fall, or indirect, such as a massive muscle contraction or trauma transmitted along the bone. For example, the head of the radius or clavicle can be fractured by the indirect forces that result from falling on an outstretched hand.
- Fatigue or stress fractures
A fatigue fracture results from repeated wear on a bone. Pain associated with overuse injuries of the lower extremities, especially posterior medial tibial pain, is one of the most common symptoms that physically active persons, such as runners, experience Stress fractures in the tibia.
- Pathologic fractures.
A pathologic fracture is fracture that occurs when the normal integrity and strength of bone have been compromised by invasive disease or destructive processes or tumors. Fractures of this type may occur spontaneously with little or no stress. The underlying disease state can be local, as with infections, cysts, or tumors, or it can be generalized, as in osteoporosis, Paget’s disease, or disseminated tumors.
Classification of Bone Fractures
Fractures usually are classified according to:
- Location
- Type
- Direction or pattern of the fracture line.
Fragment position
- Angulated, Bone fragments are at an angle to each other
- Avulsed, Bone fragments are pulled from normal position by muscle spasms, muscle contractions, or ligament resistance
- Comminuted, Bone breaks into many small pieces
- Displaced, Bone fragments separate and are deformed
- Impacted, A bone fragment is forced into another bone or bone fragment
- Nondisplaced, After the fracture, two sections of the bone maintain normal alignment
- Overriding, Bone fragments overlap, thereby shortening the total length of the bone
- Segmental
Fracture line
- Linear Fracture line is parallel to the axis of the bone
- Longitudinal Fracture line extends longitudinally but not parallel to the axis of the bone
- Oblique Fracture line crosses the bone at a 45-degree angle to the axis of the bone
- Spiral Fracture line coils around the bone
- Transverse Fracture line forms a 90-degree angle to the axis of the bone
A fracture of the long bone is described in relation to its position in the boneproximal, midshaft, and distal. Other descriptions are used when the fracture affects the head or neck of a bone, involves a joint, or is near a prominence such as a condyle or malleolus. The type of fracture is determined by its communication with the external environment, the degree of break in continuity of the bone, and the character of the fracture pieces.10
A fracture can be classified as open or closed. When the bone fragments have broken through the skin, the fracture is called an open or compound fracture. In a closed fracture, there is no communication with the outside skin.
The degree of a fracture is described in terms of a partial or complete break in the continuity of bone. A greenstick fracture, which is seen in children, is an example of a partial break in bone continuity and resembles that seen when a young sapling is broken. This kind of break occurs because children’s bones, especially until approximately 10 years of age, are more resilient than the bones of adults.
The character of the fracture pieces may also be used to describe a fracture. A comminuted fracture has more than two pieces. A compression fracture, as occurs in the vertebral body, involves two bones that are crushed or squeezed together. A fracture is called impacted when the fracture fragments are wedged together. This type usually occurs in the humerus, often is less serious, and usually is treated without surgery. Segmental fracture Bone fractures occur in two areas next to each other with an isolated section in the center
The direction of the trauma produces a certain configuration or pattern of fracture. Reduction is the restoration of a fractured bone to its normal anatomic position. The pattern of a fracture indicates the nature of the trauma and provides information about the easiest method for reduction. Linear fractures, Fracture line is parallel to the axis of the bone Transverse fractures are caused by simple angulatory forces. A spiral fracture results from a twisting motion, or torque. A transverse fracture is not likely to become displaced
Nursing Care Plans for Fractures
Nursing Diagnosis for Fractures
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