Trauma
Types of Musculoskeletal
Trauma
Causes
Emergency Care
ABC’s
Musculoskeletal
Trauma
– Assess
– Circulation
– Immobilize
First Aid Keys!
ABCs First
CMS
Immobilize
RICE
Sprains, Strains
Pain!
Strains
(tendons,muscle)
Acute
Chronic
Classification
– 1st degree
– 2nd degree
– 3rd degree
What kind
of injury?
Sprain or
strain?
Sprains
Ligamentous
Injury
Sites
Classification
– 1st degree
– 2nd degree
– 3rd degree
Management Sprains &Strains
Nursing Interventions
Diagnosis – Grade I=RICE
Immediate – Grade II
Care • Strain
• Sprain
– Rice
– Grade III
Knee Injuries
Types
Terrible trial (medial collateral,
anterior cruciate, medial
meniscus)
Assessment
Management
Identify the injury!
The terrible triad!
Dislocations/Subluxations
Definitions
Management
Assessment Reduce
Nursing Stabilize
diagnosis – Slings
Examples – Velpeau
bandage
– Immobilizer
– Splints
Hips also dislocate.
In what positions can a hip
dislocate?
How do you detect hip dislocation in
an infant?
Signs and symptoms
of hip dislocation:
anterior and
posterior
Your patient presents in
the ER with her hand
wrapped in a cloth.
What assessment would
you make?
What actions should you
take?
Fractures
Classifications By Direction
– Open – Transverse
– Closed, – Oblique
complete
– Spiral
– Incomplete
– Angulated
– Impacted
– Offset
– Comminuted
By Force
– Displaced
– Complicated By Physician
Joint Injury
Significance of Fracture
Description
Why?
Examples of Fracture
– Angulated
– Communiuted
– Oblique
– Stress Fx
– Compression
Test Your Skill!
Describe these fractures!
How would you
describe these
fractures?
Describe these fractures. Include
location and type.
Fractures of the epiphyseal plate. What
potential injury may result which has long
term implications?
Stress fracture
Salter Fractures (epiphyseal
plate fractures)
Steps in Bone Healing
Inflammation
Cellular Proliferation
Callus Formation
Ossification
Consolidation and Remodeling
Identify the steps in the
bone healing process.
What factors affect
bone healing?
These slides reflect bone
healing in a young
person. Determine what
stage of healing is
reflected in each picture.
Bone Healing Promoted by:
Influenced by Fracture
– Approximation Management
of Bone Ends Examples of
– Circulation Fractures
– Nutrition
– Type of bone
Nursing
diagnosis
Clinical Situation
JR, 44 yr. old male,
fell 12 feet; sustained
open communiuted l.
tibial fx. and closed
spiral fx midshaft l.
femur. Hx. 1 qt Wild List at least 7
Turkey daily. Wt. 240 factors that will
NEGATIVELY effect
H&H: 12; 36%; K:3.0;
JR’s bone healing.
albumin: 2.5g/dl;
amylase: 260 IU/L; T
102; FBS 150.
Fracture
Assessment/management
Circulation first
Deformity
Ecchymosis
Muscle spasm
Pain
Abnormal
movement
Crepitus
A fracture or a dislocation?
Common Fractures and Management
Colles: fx distal Clavicle fx: use fig.
radius 8 or clavicle strap
Open fx radius Pelvic fx: injuries to
bladder, iliac artery,
Supracondylar fx
sciatic nerve
humerus: use
Dunlop’s traction Open fx femoral
shaft: blood loss
Shaft of humerus;
use sling and Communiuted fx.
swath distal 1/3 tibia
Colles Fracture
Produces a “silverfork”
deformity
What
observations?
What assessment
is most critical?
Describe this
fracture. What is
the anatomical
location of the
fracture?
What type of
traction might
initially be
used?
A potential result of this
fracture is Volksman’s
ischemic contracture due
to compartment
syndrome.
Type of traction to initially treat a
supracondylar fracture of the humerous
Fracture of the
mid-shaft of the
Humerus
What potential
complications
might occur?
Fracture of the mid 1/3 of
the clavicle
Treatment with figure of 8 or
clavicle strap. What teaching
should be done?
Pelvic fractures
may be treated
surgically or
with a pelvic
fixator.
Pelvis fractures
vary in severity.
What potential
serious injuries
may result form a
pelvic fracture?
What method of treatment has been
selected for this person with a pelvic
fracture?
Describe the anatomy of
the hip joint.
Hip fractures
Describe
this
fracture.
What are
two major
concerns?
Treatment options: traction,
ORIF
Describe the fracture
including location.
Why might this site require
grafting?
How can you determine
is there is a fracture?