Fracture

Definition

A fracture is a partial or complete break in bone continuity, caused by trauma, stress, or pathologic weakening.

Types

• Closed (simple): Skin intact.
• Open (compound): Bone protrudes through skin, such as infection risk, surgical emergency.
• Greenstick: Incomplete. Common in children.
• Comminuted: Multiple bone fragments.
• Spiral: Rotational force; suspicious for abuse in young children.
• Compression: Vertebral, osteoporosis-related.
• Pathologic: Through diseased bone (tumor, osteoporosis).

Nursing Priorities

• Assess neurovascular status (6 P's)
• Immobilize. Splint 'as it lies' in the field
• Pain management
• Monitor for complications: compartment syndrome, fat embolism (long-bone fractures), DVT, infection, delayed healing
• Prevent complications of immobility

Healing Stages

Hematoma → fibrocartilaginous callus → bony callus → remodeling. Takes weeks to months. Nutrition (protein, calcium, vitamin D) supports healing.

NCLEX Relevance

6 P's assessment. Fat embolism after long-bone fracture = respiratory distress + petechiae + neuro changes.