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FRACTURES
FRACTURES
A fracture is a break or disruption in the continuity of the bone.Fractures in children differ from those in adults
FRACTURES
ETIOLOGY Most fractures in children are as a result of low velocity trauma such as a fall Upto age 2,most fractures are sustained as a result of child abuse. Abuse should be suspected in this age group Fractures in newborns and often the result of child abuse
FRACTURES
PATHOPHYSIOLOGY A bone fractures when the force applied to it exceeds the amount the bone can absorb. Childrens long bone are almost resilent then those of adults.they are able to withstand greater deflection without fracturing Childrens long bone also have thick periosteum
FRACTURES
Unique to fractures in children is the involvement of growth plates.The plate is weaker than the surrounding ligaments and tendons and joint capsules and is disrupted before these tissues are injured. Epiphyseal or physeal injuries The weakest point of long bones is the cartilage growth or epiphyseal plate.
FRACTURES
Types of fracture Complete( Bone fragments are separated) Incomplete( fragments remain attached
FRACTURES
The fracture line can be any of the following Transverse- cross wise at right angle to the long axis of the bone Oblique- slanting but straight between a horizontal and a perpendicular direction Spiral- slanting or circular, twisting around the bone shaft
FRACTURES
Simple or closed fracture Open or compound fracture Complicated fracture Communited fracture
FRACTURES
TYPES OF FRACTURE IN CHILDREN Bend (bent 45 degrees n more.mostly ulna and fibula) Buckle or torus (compression of
porus bone raised or bulging projection)
Green stick fracture (occurs when a bon eis angulated beyond the limits of bending)
FRACTURES
BONE HEALING AND REMODELLING Neonatal period 2 to 3 weeks Early childhood- 4 weeks Later childhood- 6 to 8 weeks Adolescence- 8 to 12 weeks
FRACTURES
Clinical manifestations Generalized swelling,pain or tenderness,deformity,diminishe d functional use of affected part Diagnostic evaluationhistory and radiographic examination
FRACTURES
Therapeutic management Goal To regain allignment and length of the body fragments To retain allignment and length To restore function to the injured parts to prevent further injury
FRACTURES
Therapeutic management Realignment by traction Closed manipulation Casting Weight bearing on lower extremities
FRACTURES
Nursing considerations Initial assessment Reassuring the parent and the child Reduction of pain Care of child in a cast Care of child in a traction
FRACTURES
Nursing alerts
Pain Pallor Pulselessness Paresthesia paralysis
Lower extremity
to immobilise ankle or knee
Spinal or cervical
immobilisation of the spine
Spica casts
to immobilise the hip and knee
Spica casts
Sunthetic cats
Types of traction
Upper extremity traction
Overhead suspension traction Dunlop traction
Cervical traction
DUNLOP TRACTION The arm is suspended horizontally using skin or skeletal attachment
BRYANT TRACTION
It is a type of running traction in which the pull is in only one direction.legs are flexed at 90 degree of the hips
Bryant traction
Bucks traction
Type of traction in which the legs are in extended position Used for short term immobilisation
Bucks traction
Rusell traction
Uses skin traction on the lower leg and a padded sling under the knee.two lines of pull one along the longitudinal line and the other perpensdicular to the leg
Cervical traction
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