Surgical management of fractured neck of femur.

The fractured neck of femur is the classically described fracture in osteoporotic elderly patients. Further, the fracture has a strong predominance in post-menopausal women and, although relatively uncommon in both children and young adults, where present in this age group it is usually the result of significant trauma. In elderly patients, with an already weakened bone, even minimal trauma may be sufficient to cause fracture and as such a fractured neck of femur is often referred to as a fragility fracture.

Tibia fractures. An overview of evaluation and treatment.

The purpose of this article is to increase the reader's knowledge of tibial fractures, which are infrequently life threatening but are often life changing. The focus is on the continuum of care, starting with the mechanism of injury, classification of the tibial fracture and soft tissue involvement, approaches to stabilization and treatment options, postoperative care, potential complications, and considerations to discharge preparation. The parameters of nursing care extend to pain relief and positioning, nerve and vascular assessments, safe mobility, self-care, and prevention of complications.

Broken bones: common pediatric lower extremity fractures--Part III.

Lower extremity injuries and fractures occur frequently in young children and adolescents. Nurses are often one of the first healthcare providers to assess a child with an injury or fracture. Although basic fracture care and principles can be applied, nurses caring for these young patients must have a good understanding of normal bone growth and development as well as common mechanisms of injury and fracture patterns seen in children. Similar to many of the injuries in the upper extremity, fractures in the lower extremity in children often can be treated nonoperatively with closed reduction and casting. However, this article will also review several lower extremity fractures that frequently require surgical intervention to obtain a precise anatomical reduction. Common mechanisms of injury, fracture patterns, and current management techniques will be discussed. Teaching strategies and guidelines that will enable nurses and nurse practitioners to confidently educate parents, families, and other providers caring for these young patients will be reviewed.

Traumatic pelvic fractures.

Pelvic fractures can be a big challenge in caring for the injured patient. Pelvic fractures are important as a cause for morbitidy and mortality. The mortality can be 30% with unstable pelvic ring injuries, and 10-12% of this percentage alone is due to blood loss. Multiple complications can occur during a pelvic fracture. This article will help nurses assess and manage patients with pelvic injuries. Topics covered in the article include basic anatomy of the pelvis, diagnostic tests performed after a pelvic fracture, types of pelvic fractures, management of pelvic fractures, and complications.

Psychosocial issues relating to external fixation of fractures.

The use of external fixation devices has become increasingly popular for the treatment of fractures and for limb reconstruction procedures. This article reviews the nursing literature that examines psychosocial issues in the context of treatment with external fixation. Nearly all the evidence cited is anecdotal. Personal experience should not be ignored, but this review exercise highlights the lack of research-based evidence to back up provision of care in what is a fundamentally important aspect of the patient experience.

Kyphoplasty--minimally invasive vertebral compression fracture repair.

OSTEOPOROSIS is a skeletal disorder that compromises bone strength, predisposing a person to an increased risk of fracture. An estimated 700,000 spinal fragility fractures, such as vertebral compression fractures, directly related to osteoporosis occur annually. KYPHOPLASTY, a minimally invasive fracture reduction procedure, has become a treatment option for osteoporotic fractures. A balloon is used in place of the conventional bone tamp to reduce the fracture and create a void in cancellous spinal bone. Polymethylmethacrylate, a cement-like material, is injected into the void to stabilize the fracture. EARLY DIAGNOSIS AND TREATMENT of vertebral compression fractures with kyphoplasty allows normal anatomy to be restored, ultimately decreasing the risk of patient morbidity.

Hand and wrist fractures.

The upper extremities provide support, protection, and pleasure in the everyday activities of work, fun, sports, driving, and writing. When an upper extremity sustains an injury, it has a dramatic effect on quality-of-life issues. As professional caregivers, it is important to have a comprehensive understanding of the the effects of upper extremity fractures. The assessment of the patient with an upper extremity should consist of the general health of the patient after a traumatic event, determination of the mechanism of injury, assessment of the fracture site, confirmation of the exact injury, identification of potential complications, and assessment of the patient's social and professional statuses to identify potential problems that might affect treatment and rehabilitation

Hand and wrist fractures.

The upper extremities provide support, protection, and pleasure in the everyday activities of work, fun, sports, driving, and writing. When an upper extremity sustains an injury, it has a dramatic effect on quality-of-life issues. As professional caregivers, it is important to have a comprehensive understanding of the effects of upper extremity fractures. The assessment of the patient with an upper extremity should consist of the general health of the patient after a traumatic event, determination of the mechanism of injury, assessment of the fracture site, confirmation of the exact injury, identification of potential complications, and assessment of the patient's social and professional statuses to identify potential problems that might affect treatment and rehabilitation.

Cuidados de enfermería en niños con yeso pelvipedio / Nursing care in children with gypsum

El yeso pelvipedio se indica principalmente en niños con fractura de fémur como tratamiento postoperatorio, luego de realizada la reducción quirúrgica u ortopédica de la lesión. También se usa en niños operados de luxación congénita de caderas. En ambos casos los niños permanecen un período de 20 a 60 días con este tratamiento en su hogar. Este tipo de inmovilización que incluye pelvis, muslo y pierna según el caso, genera una serie de problemas reales o potenciales que requieren cuidados especiales de enfermería con el propósito de ofrecer al niño las mejores condiciones para su recuperación. En este artículo se dan a conocer los más importantes, especialmente para la primera etapa

Perioperative nursing care of patients with craniofacial injuries.

Craniofacial injuries are the result of deceleration, blunt, or penetrating trauma. Depending on the mechanism of injury, craniofacial fractures can be minor and go undetected, or they can produce devastating facial deformities. With the advent of intermaxillary fixation devices, surgeons can manipulate facial bone structures and repair soft tissue damage in the majority of patients with craniofacial trauma injuries. Most patients experience optimal results from their craniofacial surgical procedures and return to normal lives after surgery.

Surgical treatment of patients with open tibial fractures.

Open tibial fractures are true surgical emergencies because of the risk of extensive infection to bone and devitalized soft tissue. The most serious consequence of open tibial fractures is osteomyelitis, which usually can be prevented by prompt surgical intervention within six to eight hours after injuries occur. Open tibial fractures often are the result of trauma from motor vehicle collisions, farm accidents, falls from heights, or gunshot wounds. Initial management of patients with multiple trauma injuries focuses on their life-threatening injuries before or during orthopedic surgical intervention for open tibial fractures. Orthopedic surgeons often work in collaboration with general, vascular, and plastic surgeons and perform multiple surgical procedures (eg, fasciotomy procedures for compartment syndromes, irrigation and debridement of wounds, application of external fixation devices, placement of intramedullary nails, possible limb amputations). The type and extent of open tibial fractures and soft tissue injuries determine the best treatment options for patients. Perioperative nurses should help patients focus on treatment choices for their open tibial fractures that ensure optimal surgical outcomes and maintain their quality of life.