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Open and Closed Fractures


DEFINITION-A break in the continuity of the bone.
CAUSES: – Direct blow or forces
-Crushing forces
-Severe injuries/twisting motions
-Extreme muscle contraction

TYPES:
• Complete fracture
• Incomplete fracture
• Communited fracture
• Open fracture
• Closed fracture

SIGNS AND SYMPTOMS:
 Pain
 Loss of function
 Deformity
 Shortening of extremity
 Crepitus
 Swelling and discolouration

DIAGNOSIS :
 X-Ray

MANAGEMENT
Treatment of bone fractures are broadly classified as surgical or conservative, the latter basically referring to any non-surgical procedure, such as pain management, immobilization or other non-surgical stabilization. A similar classification is open versus closed treatment, in which open treatment refers to any treatment in which the fracture site is surgically opened, regardless of whether the fracture itself is an open or closed fracture.

Pain management
In arm fractures in children, ibuprofen has been found to be as effective as a combination of acetaminophen and codeine.
Immobilization

A fractured limb is usually immobilized with a plaster or fiberglass cast or splint which holds the bones in position and immobilizes the joints above and below the fracture. When the initial post-fracture edema or swelling goes down, the fracture may be placed in a removable brace or orthosis. If being treated with surgery, surgical nails, screws, plates and wires are used to hold the fractured bone together more directly. Alternatively, fractured bones may be treated by the Ilizarov method which is a form of external fixator.

Surgery
Surgery is offered routinely because non-operative treatment results in prolonged immobilisation, which commonly results in complications including chest infections, pressure sores, deconditioning, deep vein thrombosis (DVT) and pulmonary embolism, which are more dangerous than surgery. When a joint surface is damaged by a fracture, surgery is also commonly recommended to make an accurate anatomical reduction and restore the smoothness of the joint.
bone grafting is used to treat a fracture.

COMPLICATIONS


Some fractures can lead to serious complications including a condition known as compartment syndrome. If not treated, compartment syndrome can eventually require amputation of the affected limb. Complications of fractures can be classified into three broad groups depending upon their time of occurrence. These are as follows –
1. Immediate complications – occurs at the time of the fracture.
2. Early complications – occurring in the initial few days after the fracture.
3. Late complications – occurring a long time after the fracture.

 

Author: Sonia John
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