bony enlargement of a joint of the foot, caused by ill fitting shoes; joint enlarges due to body weight on ball of foot; enlargement leads to hallux valgus
What does a bunionectomy involve?
removal of the bony growth and realignment with pins
What are the effects of high heels?
misalignment of the spine
shortening of the Achilles tendon
What is a complete fracture?
an incomplete fracture?
a fracture is classified by the extent of the break-
Complete: the break is across the entire width of the bone in such a way that the bone is divided in two sections
incomplete fracture: does not divide the bone in two; the break is only through one part of the bone
What is an open fracture? a closed fracture?
Open and closed describe the extent of soft tissue damage
Open (compound): the skin surface over the bone is disrupted; causes an external wound
Closed (simple): does not extend through the skin; no visible wound
What is a pathological fracture? compression fracture?
fractures are also classified by their cause
Pathological (spontaneous): occurs after minimal trauma to the bone that has been weakened by disease (osteoporosis/bone cancer)
fatigue (stress) fracture: excessive strain and stress on bone ( recreational sports)
compression fractures: a loading force applied to the long axis of cancellous bone. Commonly occur in the vertebrae of elderly patients and are extremely painful
What is a displaced fracture?
What is non-displaced fracture?
What is a Comminuted fracture?
What is an oblique fracture?
What is a spiral fracture?
What is an impacted fracture?
What is a greenstick fracture?
displaced: The two ends of the bone do not line up
nondisplaced: bone remains aligned
Comminuted: fragmented, broken, splintered crushed in many pieces
Oblique: slanted fractures that occur when a force is applied at any angle other than a right angle to the bone
Spiral: occurring when torque (a rotating force) is applied along the axis of a bone
Impacted: is one whose ends are driven into each other. This is commonly seen in arm fractures in children
Greenstick: occurring typically in children, in which one side of the bone is broken and the other only bent (like a live stick/branch)
What are complications of a fracture?
Fat Embolism syndrome
What is compartment syndrome? Where is it most common? What is it caused by? What does it cause? Nursing Interventions?
The nerves and vessels are compressed within the fascia (a thin sheath of fibrous tissue enclosing a muscle or other organ);
most often in lower leg and/or arm
caused by: hemorrhage, edema, tight cast
Causes: pain, edema, decreased circulation, pallor, cyanosis, tingling, numbness, then severe pain, paralysis, necrosis, permanent damage
NI: Assess- circulation, sensory( numbness, tingling, pain, sensation, pain, motor( movement, toe/finger wiggles , skin color, temp of extrem., cap refill, pulses distal to site;
What is a fasciotomy?
an incision into the skin and fascia to release pressure; vessels are no longer compressed' capillaries are functional
What is a fat embolism?
Fat globules are released into the circulating volume usually within 2 days after an injury or on long bone surgery (fx, femur, hip)
altered mental status R/T low 02 levels
dyspnea and CP
petechiae on upper trunk
What is considered a delayed union?
fracture has not healed in six months.
What is the emergency care of a fracture?
quick assessment, look for other injuries
assess affected area
apply direct pressure
remove clothing and jewelry
Splint and dressing
*What is closed reduction?
manual traction applied to fracture
X-ray, AnteroPosterior and Lateral
What does casting do? What can be done to avoid/treat compartment syndrome?
permanently immobilizes bone ends post reduction;
CompartSyn: CMS checks, bivalve casts (cut in half to relieve pressure held with plastic wrap to splint); elevate cast above heart; apply ice to cast for first 24-48 hours
How long does it take plaster casts to dry? how should you handle it until it dries?
takes 24-72 hours
do not cover-allow to air dry
use palms to handle cast when wet
What is Bucks traction?
pulling applied to fracture to align bone ends prior to surgery
may be used for patients who are not surgical candidates as treatment for fracture
add 5-10llb/ make sure weights are hanging
What is Open reduction internal fixation?
an open surgery to reduce fracture and apply plates and screws to fix it
plates/screws can later be removed when fracture heals (most often removed in the ankles
one or more incisions are made; usual post-op care for incisions
What are external fixation devices?
developed by Dr. Ilizarov, circular fixation devices were used to lengthen limbs in people of small stature
pins go through the skin directly into bone or fixation
done under gen. anesthesia
"EX Fix" to limbs and pelvis
frame can be externally adjusted PRN by MD
Allows for direct visualization of skin, pin sites
clear drainage for first 3 days
pain management starts in PACU
What is bone grafting? What is it used for?
Cadaveric bone used or auto graft from pelvis
used to supplement bone ends, add length, replace comminuted bone
graft is wired or internally fixated to surrounding bone
What are hip fractures usually caused by? how are they classified? how are they fixed? and its risk factors?