NURSING CARE F

OR PATIENT WITH
FRACTURE

GROUP 5 :
APRI ZIAH RAHMAWATI
ASTRI DWI WULANDARI
NAIFAH REKA MEILINA
SABILA KHOIRUJANNAH

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 DEFINITION

A fracture also called broken bone. It can range from a thin crack to a complete break. Bone can fracture
crosswise, lengthwise, in several places, or into many pieces. If the broken bone punctures the skin, it is
called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports
injuries.

Fractures can be classified as closed or open, as well as incomplete or complete.

• Closed vs. open
A closed fracture is also called a simple fracture. In a closed fracture, the broken bone doesn’t break your
skin.
• Incomplete vs. complete
In an incomplete fracture, your bone doesn’t break completely. In other words, it cracks without breaking
all the way through
 DEFINITION

Types of incomplete fracture include:

1. Hairline fracture, in which your bone is broken in a thin crack
2. Greenstick fracture, in which your bone is broken on one side, while the other side is
bent
3. Buckle or torus fracture, in which your bone is broken on one side and a bump or
raised buckle develops on the other side
 ETIOLOGY
Most fractures are caused by a bad fall or automobile accident. Healthy bones are extremely tough and
resilient and can withstand surprisingly powerful impacts. As people age, two factors make their risk of
fractures greater: Weaker bones and a greater risk of falling. Children, who tend to have more
physically active lifestyles than adults, are also prone to fractures.

People with underlying illnesses and conditions that may weaken their bones have a higher risk of
fractures. Examples include osteoporosis, infection, or a tumor. As mentioned earlier, this type of
fracture is known as a pathological fracture. Stress fractures, which result from repeated stresses and
strains, commonly found among professional sports people, are also common causes of fractures.
 Pathophysiology

Usually when bone is broke and bleeding occurs around the site of fracture into the soft tissue around the
bone, the soft tissue also usually gets damaged. Bleeding reactions usually occur after a severe fracture.
White blood cells and mast cells accumulate causing an increase in blood flow to the place where
osteoblast activity is stimulated and new bone formation is called the callus.

The fibrin clot is reabsorbed and new bone cells undergo remodeling to form true bone. Vascular
insufficiency or nerve fiber compression associated with untreated swelling can reduce blood intake to
extremities and result in peripheral nerve damage.
 RISK FACTORS
Anyone can be experience a fracture. But more likely to
develop one if have brittle bones, or low bone density.
Anyone can more likely to develop brittle bones if:

Older
Have osteoporosis.
Have endocrine or intestinal disorders.
Taking corticosteroids.
Physically inactive.
Drink alcohol.
Smoke.

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 SIGNS AND SYMPTOMS

DISCOLORED SKIN
PAIN SWELLING BRUISING AROUND THE
AFFECTED

ANGULATION-THE AFFECTED AREA THE PATIENT IS UNABLE TO PUT

MAY BE BENT AT AN UNUSUAL WEIGHT ON THE INJURED AREA
ANGLE

THE PATIENT CANNOT MOVE THE

THE PATIENT CANNOT MOVE
AFFEVTED AREA
THE AFFECTED AREA.

THE AFFECTED BONE OR JOINT IF IT IS AN OPEN FRACTURE,

MAY HAVE A GRATING SENSATION. THERE MAY BE BLEEDING.
 COMPLICATIONS

01 Heals in the wrong position

02 Disruption of bone growth

03 Persistent bone or bone marrow infection

04 Patients may need to be hospitalized and

treated with antibiotics

05 Bone death (avascular necrosis)

 DIAGNOSIS AND TEST

According to the American Academy of Orthopaedic Surgeons, X-rays are the most common method of
fracture diagnosis. They can create images of your bone and reveal breaks or other signs of damage. X-
rays also help determine fracture type and location. In some instances, doctor may also order magnetic
resonance imaging (MRI) or computed tomography scans (CT scan) to examine your bones or surrounding
tissues.
 MEDICAL TREATMENTS

If patients are diagnosed with a fracture, the treatment plan will depend on its type and location. In general, do
ctor will try to put the broken bone pieces back into their proper positions and stabilize them as they heal. It’s
important to keep pieces of broken bone immobile until they’re mended.

In rare cases, patients may need traction to stabilize the injured area. Traction stretches the muscles and tendo
ns around bone. This system will produce a gentle pulling motion that doctor can use to stabilize the injured a
rea.

For more complex or compound fractures, patient may need surgery. Doctor may use open reduction, and inte
rnal fixation or external fixation to keep bones from moving .
 PREVENTION

Consume a nutrious Sunlight. Physical activity

diet.
 Case Study

Ms. Annisa, 19 years old, with medical record number 395-151, was admitted to the hospital last night, on 24th of
November, 2019 at 23.15. Around 3 hours before admitted to the hospital, Ms. Annisa was complained of pain in
upper right leg and couldn’t be moved because of traffic accident. She said that at 20.00 she was riding a
motorcycle. Suddenly a motorcycle from the back was hit hers and then hit her right foot. She wore a helmet and
didn’t consume alcohol. History of fainting (-), headache (-), and vomiting (+). There are several result of
laboratory examination on November 24, 2019: routine blood examination, blood gas artery, and chemical
chemistry, and also radiophotograph X-ray femur dextra lateral. Dr. William as a doctor who is on duty in
emergency departement’s is ordered Mefenamic acid 3 x 250 mg PO and Ceftriaxone 3 x 1000 mg.
 
This morning, patient looks weak, awareness composmentis, and her vital signs BP 110/70 mmHg,
P 92 x/minute, RR 24 x/minute, and T 37.1 oC. Temporary diagnosis is open closed fracture femur.
Patient and family had explained that the patient has a broken femur. At 10.00 please consult the
orthopedic surgeon for further treatment, and then accompanied doctor to explain to the patient's
family that surgery is needed for further treatment

Patient Post Operation ORIF. Medication: Ketorolac 30 mg, Tranexamid Acid, Mefenamic Acid
 Thank you
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