Principles of Fracture Management

Clinical features
Swelling Deformity Loss of function Bruising Laceration

 Approach to the pt: History: Mechanism, Duration & Site of injury, Past medical history PE:
Systemic,

Evidence of shock Associated injury Disease that cause pathological# e.g. rickets,osteoporosis

Local,
Look swelling , deformity & wound Feel tenderness , distal pulses , test sensation Move abnormal movement , joint movement

 X-RAY
Rules of two

Fracture description:

Mgt Principles
I. Mgt of Closed Fx

A. Resuscitation . ABC of life B. Reduction adequate apposition & alignment C. Retention immobilization D. Rehabilitation Active\ Passive joint movt

A. Resuscitation
ABC-

B. Reduction
The greater the contact surface area b/n fragments, the more likely is healing to occur. With contact & proper alignment, some overlap at fracture surfaces is permissible; Except? 2 types closed & open

Closed Reduction

 Closed Reduction;
indications; Minimal displacement Most Fx in children Fxs that are stable after reduction Methods Gravity, traction, close manipulation.

Open Reduction; Failure of cl. reduction displaced intra articular fracture Unstable fracture Traction fracture

C. Retention
Is Prevention of displacement Available methods include; Traction Plaster of paris