Orthopedic Nursing Care
Fracture of Humerus - ✔️✔️Complications: nerve and ligament damage, frozen or stiff
joints, and malunion--fractured fragments are not in good position... Fractures of the
proximal humerus are more common in older adults.
Fracture of the Elbow - ✔️✔️Usually distal humerus, common complications: nerve or
artery damage, hemiartrosis, Volkmann's contracture (claw deformity of hand and
fingers). Fall or direct blow is main report.
Fracture of the radius and/or ulna - ✔️✔️Complication: compartment syndrome,
delayed healing, decreased wrist and finger movement, infection. Care: alleviate pain,
immobilization, education. ***Tell MD if changes in sensation
RICE - ✔️✔️Rest Ice Compression Elevation 24-48hrs do RICE.
Joint dislocation - ✔️✔️Trauma or illness forces ends of the bones from normal
position. (Pain, deformity, limited motion, shorter limb) Care: Reduction by manual
traction or surgery immobilization, hip dislocation requires immediate reduction to
prevent complications to prevent necrosis.
Subluxation - ✔️✔️partial dislocation is which the bones of the joint remain in partial
contact
Necrosis - ✔️✔️Death of bone tissue
Electrical Bone Stimulation - ✔️✔️Used to treat fractures that aren't healing
appropriately, increases migration of osteoblasts and osteoclasts to fracture
site.Application of an electrical current
What to do for fracture of the skull? - ✔️✔️Assess patient for neurologic changes,
document LOC, depressed skull fracture can cause neurologic damage.
Fracture Care - ✔️✔️Emergency Care: Immobilize the fracture, maintain tissue
perfusion, prevent infection. Medications: Analgesics, NSAIDs,
antibiotics,anticoagulants, stool softeners, antacids. Surgery: External fixation device,
ORIF
What is the most commonly reported injuries? - ✔️✔️Contusions, Strains, and Sprains.
Contusion - ✔️✔️Blunt force-bleeding into soft tissue, but skin remains intact.
(Swelling, discoloration of skin) Least serious
, Strain - ✔️✔️Stretching injury to a muscle or a muscle-tendon unit. Caused by
mechanical overloading. (Pain, limited motion, muscle spasms/weakness, swelling.)
Most common: lower abck and Hamstring muscle
Sprain - ✔️✔️Stretch/tear of ligaments surrounding joint. (Loss of the ability to move or
use the joint, feeling a "pop" or tear, discoloration, pain, rapid swelling.) Most common:
ankles and knees
Fracture of the Face - ✔️✔️Manifestations: Hematoma, pain, edema, bony deformity.
Focus on airway, assess neurologic, body image disturbance, assess pain
Fracture of the Spine - ✔️✔️Cervical, lumbar, thoracic, or sacral...damage to spinal
cord. MOST SEVERE, can result in ischemia and cause permanent paralysis.
Fracture of the Clavicle - ✔️✔️Usually midclavicular, can damage subclavian vessels
or lung. Seen most common with falls
Wrist Fractures - ✔️✔️Colle's Fracture: the distal radius fractures after a fall onto an
outstretched hand. Patient presents with bony deformity, pain, numbness, weakness,
decreased ROM of fingers.
Hand Fractures - ✔️✔️Usually metacarpals and phalanges (Pain, edema, decreased
ROM) Complications: compartment syndrome, nerve damage, ligament damage,
delayed union.
Fracture of the Ribs - ✔️✔️Blunt chest trauma, Can damage the spleen, liver,
subclavian artery, or vein. Flail chest; Complications: pulmonary contusion,
pnuemothorax and or hemothorax, pneumonia, intra-abdominal bleeding
Flail Chest - ✔️✔️results from the fracture of two or more adjacent ribs in two or more
places and the formation of a free-floating segment that moves in the opposite direction
of the rib cage.Care: coughing, deep breathing, and splinting.
Fracture of the Pelvis - ✔️✔️Caused by trauma, patient presents with back or hip pain.
Complications: hemorrhage, damage to pelvic and extra-pelvic organs. Care: Tx
discomfort, maintaining immobilization, and identify potential complications.
Fracture of the Shaft of the femur - ✔️✔️Edema, deformity, pain in the thigh, inability to
move hip or knee. Complications: hypovolemia, fat embolism, hip and/or knee
dislocation, muscle atrophy, ligament damage. Provide pain meds, provide reassurance
and decreasing anxiety, assist with exercises of the lower legs, feet, and toes.
Circulation and sensation in affected extremity;skeletal traction, internal or external
fixation
Fracture of Humerus - ✔️✔️Complications: nerve and ligament damage, frozen or stiff
joints, and malunion--fractured fragments are not in good position... Fractures of the
proximal humerus are more common in older adults.
Fracture of the Elbow - ✔️✔️Usually distal humerus, common complications: nerve or
artery damage, hemiartrosis, Volkmann's contracture (claw deformity of hand and
fingers). Fall or direct blow is main report.
Fracture of the radius and/or ulna - ✔️✔️Complication: compartment syndrome,
delayed healing, decreased wrist and finger movement, infection. Care: alleviate pain,
immobilization, education. ***Tell MD if changes in sensation
RICE - ✔️✔️Rest Ice Compression Elevation 24-48hrs do RICE.
Joint dislocation - ✔️✔️Trauma or illness forces ends of the bones from normal
position. (Pain, deformity, limited motion, shorter limb) Care: Reduction by manual
traction or surgery immobilization, hip dislocation requires immediate reduction to
prevent complications to prevent necrosis.
Subluxation - ✔️✔️partial dislocation is which the bones of the joint remain in partial
contact
Necrosis - ✔️✔️Death of bone tissue
Electrical Bone Stimulation - ✔️✔️Used to treat fractures that aren't healing
appropriately, increases migration of osteoblasts and osteoclasts to fracture
site.Application of an electrical current
What to do for fracture of the skull? - ✔️✔️Assess patient for neurologic changes,
document LOC, depressed skull fracture can cause neurologic damage.
Fracture Care - ✔️✔️Emergency Care: Immobilize the fracture, maintain tissue
perfusion, prevent infection. Medications: Analgesics, NSAIDs,
antibiotics,anticoagulants, stool softeners, antacids. Surgery: External fixation device,
ORIF
What is the most commonly reported injuries? - ✔️✔️Contusions, Strains, and Sprains.
Contusion - ✔️✔️Blunt force-bleeding into soft tissue, but skin remains intact.
(Swelling, discoloration of skin) Least serious
, Strain - ✔️✔️Stretching injury to a muscle or a muscle-tendon unit. Caused by
mechanical overloading. (Pain, limited motion, muscle spasms/weakness, swelling.)
Most common: lower abck and Hamstring muscle
Sprain - ✔️✔️Stretch/tear of ligaments surrounding joint. (Loss of the ability to move or
use the joint, feeling a "pop" or tear, discoloration, pain, rapid swelling.) Most common:
ankles and knees
Fracture of the Face - ✔️✔️Manifestations: Hematoma, pain, edema, bony deformity.
Focus on airway, assess neurologic, body image disturbance, assess pain
Fracture of the Spine - ✔️✔️Cervical, lumbar, thoracic, or sacral...damage to spinal
cord. MOST SEVERE, can result in ischemia and cause permanent paralysis.
Fracture of the Clavicle - ✔️✔️Usually midclavicular, can damage subclavian vessels
or lung. Seen most common with falls
Wrist Fractures - ✔️✔️Colle's Fracture: the distal radius fractures after a fall onto an
outstretched hand. Patient presents with bony deformity, pain, numbness, weakness,
decreased ROM of fingers.
Hand Fractures - ✔️✔️Usually metacarpals and phalanges (Pain, edema, decreased
ROM) Complications: compartment syndrome, nerve damage, ligament damage,
delayed union.
Fracture of the Ribs - ✔️✔️Blunt chest trauma, Can damage the spleen, liver,
subclavian artery, or vein. Flail chest; Complications: pulmonary contusion,
pnuemothorax and or hemothorax, pneumonia, intra-abdominal bleeding
Flail Chest - ✔️✔️results from the fracture of two or more adjacent ribs in two or more
places and the formation of a free-floating segment that moves in the opposite direction
of the rib cage.Care: coughing, deep breathing, and splinting.
Fracture of the Pelvis - ✔️✔️Caused by trauma, patient presents with back or hip pain.
Complications: hemorrhage, damage to pelvic and extra-pelvic organs. Care: Tx
discomfort, maintaining immobilization, and identify potential complications.
Fracture of the Shaft of the femur - ✔️✔️Edema, deformity, pain in the thigh, inability to
move hip or knee. Complications: hypovolemia, fat embolism, hip and/or knee
dislocation, muscle atrophy, ligament damage. Provide pain meds, provide reassurance
and decreasing anxiety, assist with exercises of the lower legs, feet, and toes.
Circulation and sensation in affected extremity;skeletal traction, internal or external
fixation
