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The document discusses the functions and types of bones, as well as fracture classifications and their causes, including the specifics of open and closed fractures. It outlines various treatment methods, including internal and external fixation options, and the complications associated with fractures. Additionally, it emphasizes the importance of prevention through nutrition, physical activity, and awareness of bone health, particularly in aging populations.

Health & Medicine◦
Provision Of The Frame Work Of The Body Giving attachment to muscle and tendons. Allowing movement of the body as a whole and parts of the body , by forming joints that are moved by muscles. Forming the boundaries of the cranial ,thoracic and pelvic cavities , protecting the organs they contain. Haemopoiesis , the production of blood cells in red bone marrow. Mineral storage , especially calcium phosphate- the mineral reservoir within bone is essential for maintenance of blood calcium levels, which must be tightly controlled. FUNCTION OF BONES:
TYPES OF BONES: Short bones: carpals Irregular bones : vertebrae and some skull bone Flat bones : sternum , ribs and most skull bones Sesamoid bones : patella ( knee cap)
DEFINATION OF FRECTURE  A fracture is a complete or incomplete disruption in the continuity of bone structure and is defined according to its type and extent. Fracture may be caused by direct blows, crushing forces , sudden twisting motions , and extreme muscle contractions.
TYPES OF FRACTURE  The simplest classification method based on whether the fracture is closed or open. Tissue damage can be extensive with open fracture , which are graded according to their severity:  Grade I. the wound is smaller than 1 cm;contamination is minimal  Grade II. The wound is larger than 2 cm;contamination is moderate.  Grade III. The wound exceeds 6 to 8 cm; there is extensive damage to soft tissue , nerve and tendon; there is high degree of contamination.
 Open fracture : A fracture in which damage also involves the skin or mucous membranes , also called a compound fracture
 Closed Facture: A fracture that remains contained , with no disruption of the skin integrity. And it is also called simple fracture.
 Green stick Fracture : A fracture in which one side of a bone is broken and the other side is bent.
 Transverse Fracture : A fracture that is straight line across the bone shaft.
 Oblique Fracture : A fracture occurring at an angle across the bone ( less stable than a transverse fracture )
 Spiral fracture : A fracture that twists around the shaft of the bone. Common in a twisting injury.
 Impacted Fracture : A fracture in which a bone fragment is driven into another bone fragment.
 Burst Fracture : Characterized by multiple pieces of bone, often occurs at bone ends or in vertebrae.
 Linear Fracture : Fracture line is intact ; fracture is caused by minor to moderate force applied directly to bone.
 Displaced Fracture : Fragment out of normal position at fracture site.  Non – Displaced Fracture : Fragment aligned at fracture site.
Displacement,Angulations Angulation Varus Apex lateral Valgus Apex medial Parallel No angulation
Road Traffic Accident Injuries From Sports Falls Down Directly strikes to your body CAUSES
PATHOPHYSIOLOGY: Soft tissue damage Disruption of muscle and blood vessels attached to the ends of the bone Disruption in the continuity of bone Injury in the bone Vehicular accident
Inflammatory Response Bone tissue surround the fractured site dies Hematoma forms in medullary canal Bleeding
CLINICAL MANIFESTATION Pain Abnormal Mobility and Crepitus Deformity - the limb looks out of place ( Displacement) Numbness and tingling swelling, redness, and Muscle spasm in the injured area Problems moving a limb Bruising ( Ecchymosis)
DIAGNOSTIC EVALUATION: physical examination X-RAY MRI CT SCAN
Principles of Treatment Methods of holding reduction: Sustained traction Cast splintage Functional bracing Internal fixation External fixation
Definitive Fracture Fixation Options  Casts and Splints  Appropriate for many fractures especially hand and foot fractures  Adults typically will get plaster splints initially transitioned to fiberglass casts as swelling decreases  Kids typically will get fiberglass casts
CONSERVATIVE TREATMENT
FUNCTIONAL BRACING  Braces are used to provide support ,control movement , and prevent additional injury.
TRCTION:  Traction by gravity  E.g.. Fractures of the humerus  Balanced Traction  Skin traction: Adhesive strapping kept in place by bandages.  Skeletal traction: It is applied directly to the bone by use of metal pin or wire.
INTERNAL FIXATION Types of Internal Fixation  Pin & wire fixation.  Screw fixation.  Plate & screws fixation.  Intra-medullary fixation.
PLATE & SCREWS FIXATION.  Open Reduction and Internal fixation with Plates and screws  Used for many fractures especially those involving joints
Intramedullary Fixation: Treatment of choice for most tibia and femur fractures Used in selected humerus and forearm fractures
INDICATIONS FOR INTERNAL FIXATION 1. Fractures that cannot be reduced except by operation 2. Fractures that are inherently unstable and prone to re- displacement after reduction 3. Fractures that unite poorly and slowly 4. Pathological fractures 5. Multiple fractures
External Fixation  Used primarily in the treatment of open fractures and pelvis fractures  Also useful as temporary stabilization prior to definitive fixation
INDICATIONS FOR EXTERNAL FIXATION 1) Fractures of the pelvis. 2) Fractures associated with severe soft- tissue damage where the wound can be left open for inspection, dressing, or definitive coverage. 3) Severely comminuted and unstable fractures, 4) Fractures associated with nerve or vessel damage. 5) Infected fractures, for which internal fixation might not be suitable.
COMPLIC -ATION Persistent bone or bone marrow infection Disruption of bone growth Bone death (avascular necrosis) Heals in the wrong position
COMPLICATIONS IN DETAIL  Heals in the wrong position - this is known as a mal union; either the fracture heals in the wrong position or it shifts (the fracture itself shifts).  Disruption of bone growth - if a childhood bone fracture affects the growth plate, there is a risk that the normal development of that bone may be affected, raising the risk of a subsequent deformity.
 Persistent bone or bone marrow infection - if there is a break in the skin, as may happen with a compound fracture, bacteria can get in and infect the bone or bone marrow, which can become a persistent infection (chronic osteomyelitis).  Patients may need to be hospitalized and treated with antibiotics. Sometimes, surgical drainage and curettage is required.  Bone death (avascular necrosis) - if the bone loses its essential supply of blood it may die.
PREVENTION Nutrition and sunlight Menopause Physical activity
PREVENTION IN DETAIL  Nutrition and sunlight - the human body needs adequate supplies of calcium for healthy bones. Milk, cheese, yoghurt, and dark green leafy vegetables are good sources of calcium.  Our body needs vitamin D to absorb calcium - exposure to sunlight, as well as eating eggs and oily fish are good ways of getting vitamin D.
 Physical activity - the more weight-bearing exercises you do, the stronger and denser your bones will be.  Examples include skipping, walking, running, and dancing - any exercise where the body pulls on the skeleton.  Older age not only results in weaker bones, but often in less physical activity, which further increases the risk of even weaker bones. It is important for people of all ages to stay physically active.
 Menopause - estrogen, which regulates a woman's calcium, drops during menopause, making calcium regulation much more difficult. Consequently, women need to be especially careful about the density and strength of their bones during and after the menopause.  The following steps may help reduce post-menopausal osteoporosis risk:  Do several short weight-bearing exercise sessions each week.  Do not smoke.  Consume only moderate quantities of alcohol, or don't drink it.  Get adequate exposure to daylight.  Make sure your diet has plenty of calcium-rich foods. For those who find this difficult, a doctor may recommend calcium supplements.
NURSING DIAGNOSIS:  pain related to fracture due to pressure on nerve endings.  Impaired physical mobility related to body weakness and disease condition (fracture).  Activity intolerance related to post operative condition  Deficient knowledge related to new condition and treatment.  Self care deficit related to musculoskeletal impairment secondary to fracture femur.  Constipation related to decrease physical activity.  Risk for infection related to wound secondary to fracture.  Risk for pressure ulcer related to immobility.
THANK YOU
BIBLIOGRAPHY  https://www.medicalnewstoday.com/articles/173312.php  https://www.scribd.com./document  ROSS AND WILSON TEXT BOOK OF “ ANATOMY AND PHYSIOLOGY”11THE EDITION PAGE NO : 380 - 419  JOYCE M.BLACK “ MEDICAL SURGICAL NURSING “ 8TH EDITION PAGE NO : 507- 525  BRUNNER AND SUDDARTH’S TEXT BOOK OF “ MEDICAL SURGICAL NURSING “12TH EDITION PAGE NO : 2084 - 2106