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BONE FRACTURE

DESCRIPTION

A bone fracture is a complete or incomplete break in a bone.
Following are the different types of fractures:
  • Complete fracture. The broken bone is completely separated.
  • Incomplete (greenstick) fracture. The broken bone is not completely separated.
  • Comminuted fracture. There are more than 2 bone fragments at the fracture site.
  • Open fracture (compound). The fractured bone has broken the skin.
  • Closed fracture (including stress fracture). The fractured bone has not broken the skin.
  • Compression fracture. The break occurs from extreme pressure on the bone.
  • Impacted fracture. The broken ends have been driven into each other.
  • Avulsion fracture. Force has been applied to a strong tendon, causing it to pull on and break off a portion of bone.
  • Pathologic fracture. A break that occurs from a minor injury in bone weakened or destroyed by disease. Appropriate health care includes:
  • Physician's monitoring of general condition and medications. Almost all fractures require immobilization with casts or splints.
  • Hospitalization for anesthesia and treatment of severe fractures.
  • Surgery if the fracture must be repaired with rods, plates, or screws.
  • Physical therapy for rehabilitation.
  • Self-care after diagnosis and treatment.

    SIGNS & SYMPTOMS

  • Pain and swelling at the fracture site.
  • Tenderness close to the fracture.
  • Paleness and deformity (sometimes).
  • Loss of pulse below the fracture, usually in an extremity (sometimes).
  • Numbness, tingling, or paralysis below the fracture.
  • Bleeding or bruising at the site.
  • Weakness and inability to bear weight.

    CAUSES
    Injury.

    RISK FACTORS

  • Tumors of the bone or bone marrow.
  • Activities that carry the risk of injury.
  • Reckless behavior that increases the chance of an auto accident.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Advise your adolescent not to drink alcohol or use mind-altering drugs and drive.
  • Have your child wear protective gear for sports.
  • Use auto seat belts or harnesses.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies to determine blood loss.
  • X-rays of injured parts.

    POSSIBLE COMPLICATIONS

  • Failure to heal (non-union).
  • Shock from blood loss.
  • Travel of a fat embolus (clump of fat cells) from the injury site to the lungs or brain.
  • Obstruction of nearby arteries.

    PROBABLE OUTCOME
    Usually curable with skillful first aid and aftercare. Your child's broken bone should be manipulated, realigned, and immobilized as soon as possible. Realignment is much more difficult after 6 hours. Healing time varies. Recovery is complete when there is no bone motion at the fracture site, and X-rays show complete healing.

    TREATMENT

    HOME CARE

  • See emergency first-aid instructions in the back of this book.
  • See Care of Casts, Appendix 41.

    MEDICATION
    Your doctor may prescribe pain relievers or muscle relaxants.

    ACTIVITY
    Your child may resume normal activities as soon as symptoms improve.

    DIET & FLUIDS
    No special diet. Give your child vitamin C supplements to promote bone healing.

    OK TO GO TO SCHOOL?

    When doctor advises that fracture is healing and activity will not cause harm.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of a bone fracture.
  • The following occurs after immobilization or surgery: -- Swelling above or below the fracture site. -- Severe, persistent pain. -- Blue or gray skin below the fracture site, especially under nails. -- Numbness or loss of feeling below the fracture site. Report any of the above signs immediately! ‡
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