Following a fall or an accident, your doctor would probably require you to undergo an X-ray or a bone scan to rule out a bone fracture.
A bone fracture is a crack or a break in the bone. It is common damage after an impact to the bone, that can range from a crack to a complete fracture. The break could be lengthwise, crosswise, can change the form of the bone, or can even split the bone into two or several fragments.
What Causes Bone Fracture?
Our bones are very strong and through the years they consistently break and repair themselves naturally. But if the formation of new bones does not keep up, it can lead to breakage. This condition is also known as Osteoporosis. It is a disease commonly found in older adults that develops due to lack of calcium and is a common cause of bone fracture.
Trauma due to a vehicular accident or after being tackled at a football practice can also be a cause of bone fracture. A break or crack can develop if the outside force or pressure is greater than what your bone can support.
Over-usage and repetitive movements can also cause bone damage. The repeated force causes stress injuries to the bones and may occur during a long-distance run or carrying heavy loads on long walks.
Complications of Bone Fracture
Bone fractures can lead to other related complications. The risk increases if the injuries damage the underlying blood vessels, skin, and other vital organs of the body.
- Damage to the blood vessels– Long bones on our arms and legs have a rich supply of blood carried by the blood vessels. When these veins and arteries are damaged during a bone fracture it can lead to excessive bleeding or hemorrhage. Most fractures often cause a noticeable bruising around the injury which means that internal bleeding has occurred. A dislocated knee could disrupt the flow of blood in the leg prohibiting the tissues to get enough blood supply leading to ischemia. If not treated immediately, the tissues could die and could lead to necrosis which may require amputation to prevent further damage.
- Damage to the nerves– A bone dislocation could also damage the nerves following a bone injury. Nerves travel close to the bones together with the blood vessels. Fractures or dislocation could be very painful and the damage to the nerves may not be noticed immediately. Nerves are sometimes stretched, crushed, or even torn during a bone fracture especially after a direct hit or damage by sharp fragments of bones. Nerve injuries can naturally heal on their own after a month depending on how severe the injury is but there are cases that damaged nerves never heal completely.
- Pulmonary embolism– It is a blockage in the blood vessel due to a clot. It can be a severe complication of a pelvic or a femoral bone fracture. It can happen when a blood clot from the veins of the leg becomes an embolus, travels to the lungs, and blocks an artery, leaving the body with not enough supply of oxygen.
- Infection- This is one of the common complications of bone fractures. It occurs when bacteria enter the body or the wound after an injury or during surgery. When the skin is torn open or when the bones are broken the wound could become infected if not treated immediately.
Signs and Symptoms of a Bone Fracture
- Tenderness and swelling around the area of the injury
- Sudden pain with movement on the injury
- Powerless and not able to bear weight
- Crepitus or crackling sounds with movement due to broken fragments of bones rubbing together
- Erythema and edema on the site of injury
- The patient may look pale when a large bone is damaged such as femur or pelvis
- Deformity of an extremity after an injury or trauma
Types of Bone Fracture
- Open Bone Fracture: Also known as a compound fracture. It is when a bone fracture causes an open wound on the flesh that often occurs when a sharp fragment punctures the skin. The risk for infection in this type of bone fracture is higher since bacteria and other contaminants can easily infiltrate the open wound.
- Close Bone Fracture: When the skin remains intact after a bone injury. It may still require proper treatment but is not as urgent as that of an open bone fracture. Soft tissue or nerve damage is associated with this type of bone fracture.
- Complete Fracture: It is when the bones are completely separated into fragments after an injury.
- Greenstick Fracture: This is a break or a crack on the side of a long bone in the legs or in the arms. The crack could possibly extend all through the bone. It commonly occurs in children since their bones are more brittle than that of adults. Treatment of these types of fractures includes immobilization of the affected area.
- Transverse Fracture: When the fracture is perpendicular to the long part or shaft of the bone.
- Spiral Injury: It occurs after a rotational or twisting movement or force that causes the breaking of the bone.
Nursing Intervention for Bone Fractures
Nursing care for patients with bone injuries should focus on the prevention of complications or further damage. Performing an accurate assessment of the fracture can help the nurse manage the patient’s pain and prevent complications properly.
- After the injury, place the patient somewhere safe and out of harm. Immobilize the injury using a splint to keep him from using the affected area. The goal is to place the bone in its original place and help it heal properly.
- If there is bleeding following a bone fracture, applying pressure with a cloth to stop the bleeding is necessary. Assessing the bone fracture before applying pressure is important to prevent further damage when applying pressure.
- If the bone fracture is an open fracture, applying a sterile dressing on the wound is important to prevent infection.
- Elevation of the affected extremity helps to decrease swelling.
- Applying ice wrapped in a clean towel could also help to decrease the swelling.
- During pain management: patients taking pain medications should be monitored closely for any untoward signs of medication reactions and how the medication relieves pain.
- Assessment of the patient’s neurovascular status (including the nerve function, blood flow, and possible case compartment syndrome) should be done to know the extent of bone fracture.
