1-800-MALPRACTICE Website
Fractures/Broken Bones
A fracture, which is another term for a broken bone, is a common injury usually resulting from a fall, motor vehicle accident or other type of trauma.
Fractures can occur in any part of the body that contains bones; from the skull to the ankle and everywhere in between. Fractures vary widely in terms of type and severity.
Medical professionals usually classify fractures into one of the following categories:
Single Fracture: This is the term for a bone that is broken in only one place.
Complete Fracture: This describes a bone that is clearly broken into two separate pieces.
Bending Fracture: This term refers to a bone that has an unusual bend but does not actually crack. This is rare but may
…show more content…
Although the bone is broken, the break does not go across the entire bone.
Comminuted Fracture: Also called a shatter fracture or crushed bone fracture, this term describes a bone that is broken into more than two pieces. Often, traumatic events like automobile accidents cause this type of fracture.
Open Fracture: This type of fracture, where the bone penetrates the skin, usually results from significant trauma, such as a serious automobile collision or gunshot wound. Typically, an open fracture requires surgery and creates a risk of infection to the bone and the area surrounding the wound.
Treatment of Broken Bones
For serious breaks, the most common treatment methods are reductions and casts.
Reductions
To treat a fracture, a physician may need to perform a reduction, a procedure that lines up the broken pieces of the bone and sets them back into place so the bone can heal properly. After a reduction procedure, the natural regenerative qualities of the bone will cause it to unify at the spot of the fracture. The cells on the ends of the bones and the blood vessels cause this healing process to occur over time.
Some reductions are classified as closed reductions and others as open
…show more content…
- A cast that was incorrectly or unnecessarily applied, or left on too long, can result in Reflex Sympathetic Dystrophy (RSD), also called Chronic Regional Pain Syndrome (CRPS) (link to section on RSD).This is a serious neurological condition that can result in chronic pain and long-term disability.
Broken Bones Caused by Nursing Home Abuse and Neglect (link to Falls in Nursing Home Neglect/Abuse section)
Falls are one of the leading causes of injury for residents in nursing homes and other assisted living facilities. While most nursing homes and the caregivers they employ strive to provide proper care, some facilities do not have the time or budget to implement and maintain safety precautions such as adequate lighting, comprehensive staff training, and effective security measures. Caregivers can be overworked or improperly trained.
Here are some of the steps nursing homes can take to minimize the risk of falls:
- Identify residents who are most at risk of falling and place signs near their beds and give them special bracelets or other identifying accessory to
Peel, N. M., Travers, C., Bell, R. R., & Smith, K. (2010). Evaluation of a health service delivery intervention to promote falls prevention in older people across the care continuum. Journal Of Evaluation In Clinical Practice, 16(6), 1254-1261. doi:10.1111/j.1365-2753.2009.01307.x
The National Patient Safety Goal (NPSG) for falls in long term care facilities is to identify which patients are at risk for falling and to take action to prevent falls for these residents. (NPSG.09.02.01). There are five elements of performance for NPSG: 1. Assess the risk for falls, 2. Implement interventions to reduce falls based on the resident’s assessed risk, 3. Educate staff on the fall reduction program in time frames determined by the organization, 4. Educate the resident and, as needed, the family on any individualized fall reduction strategies, and 5. Evaluate the effectiveness of all fall reduction activities, including assessment,
The most dangerous fractures are those of the hip especially for elderly people. Studies have found that only about a third of people who get a hip fracture return to normal even after treatment. In fact, about 20 percent of the elderly people who get this fracture die within a year.
A fall is an “untoward event which results in the patient coming to rest unintentionally on the ground” (Morris & Isaacs, 1980). When it comes to patient safety in health care, there isn’t any subject that takes precedence. Patient falls are a major cause for concern in the health industry, particularly in an acute-care setting such as a hospital where a patient’s mental and physical well being may already be compromised. Not only do patient falls increase the length of hospital stays, but it has a major impact on the economics of health care with adjusted medical costs related to falls averaging in the range of 30 billion dollars per year (Center for Disease Control [CDC], 2013). Patient falls are a common phenomenon seen most often in the elderly population. One out of three adults, aged 65 or older, fall each year (CDC, 2013). Complications of falls are quite critical in nature and are the leading cause of both fatal and nonfatal injuries including traumatic brain injuries and fractures. A huge solution to this problem focuses on prevention and education to those at risk. ...
A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization (Swartzell et al. 2013). Because the multi-etiological factors contribute to the incidence and severity of falls in older society, each cause should be addressed or alleviated to prevent patient’s injuries during their hospital stay (Titler et al. 2011). Therefore, nursing interventions play a pivotal role in preventing patient injury related to hospital falls (Johnson et al. 2011). Unfortunately, the danger of falling rises with age and enormously affect one third of older people with ravages varying from minimal injury to incapacities, which may lead to premature death (Johnson et al. 2011). In addition, to the detrimental impacts on patient falls consequently affect the patient’s family members, care providers, and the health organization emotionally as well as financially (Ang et al. 2011). Even though falls in hospital affect young as well as older patients, the aged groups are more likely to get injured than the youth (Boltz et al. 2013). Devastating problems, which resulted from the falls, can c...
Treatment depends on the location of the fracture and whether the bone is out of place (displaced). Treatment may be surgical or nonsurgical:
The patient is a 27 year old male who came in the hospital with pain and swelling in his left ankle. He had said he jumped off a porch and landed on a root. A three view ankle x-ray was ordered. The doctor found that there was an oblique spiral fracture of the distal one third diaphysis of the tibia. There is approximately 1 centimeter of lateral displacement of the distal fracture fragment with respect to the proximal fragment. Spiral fracture is caused by a twisting force. The result is a spiral-shaped fracture line above the bone, like a staircase. Depending on how much force causes the fracture, spiral fractures can be displaced or stable. A displaced fracture is when the broken ends of the bone are separated. Stable fractures happen when
Fall can lead to serious injuries and death which, increase the health care cost. Hence prevention of fall is an important public health issue in the hospital for patient safety. We had many falls incidents reported in our unit every month. Therefore, it is essential to implement prevention strategies through multidimensional approach by interdisciplinary team. Through the proposed fall management program, we can reduce fall rate drastically.
Complete means when a fracture is completely though the bone. A communited fracture is when the broken bone has shattered into numerous smaller pieces. Intertrochanteric is when a fracture is located between the greater trochanter and lesser trochanter of the femur.
When taking steps to analyze and apply intervention strategies for falls, we must examine the factors that cause these occurrences. There are numerous reasons that falls occur, such as intrinsic and or extrinsic risk factors. Intrinsic risk factors for falls may be due to changes that are part of the normal aging process and acute or chronic conditions. According to Zheng, Pan and Hua et al. (2013), about 35-45 percent of individuals who are usually older than 65 years and other 50 percent of the elderly individuals report cases of fall every year. Extrinsic factors are those related to physical environment such as lack of grab bars, poor condition of floor surfaces, inadequate or improper use of assistive devices (Currie). Patient falls is not an easy thing to eliminate. With many clinical challenges, there’s no easy answer to the challenges posed by patient falls; howe...
One of the most common fractures accompanying perimortem trauma is a ‘butterfly fracture’, commonly located on long bones like the fibula (as seen in Figure 1). The analysis of perimortem trauma was also aided by detailed identifying characteristics of fracture-like topographies. Out of 111 perimortem skeletal traumas observed in this study, 38 (34.2%) of them featured these types of characteristics (Moraitis, et al, 2008). Figure 2 details the breakdown of these characteristics.
An ankle fracture is a break in one or more of the three bones that make up the ankle joint. The ankle joint is made up by the lower (distal) sections of your lower leg bones (tibia and fibula) along with a bone in your foot (talus). Depending on how bad the break is and if more than one ankle joint bone is broken, a cast or splint is used to protect and keep your injured bone from moving while it heals. Sometimes, surgery is required to help the fracture heal properly.
Hemothorax. Retrieved from http://emedicine.medscape.com/article/2047916-overview#aw2aab6b2b4 Norvell, J. G. (2013, June 11). Tibia and Fibula Fracture Clinical Presentation. Retrieved from http://emedicine.medscape.com/article/826304-clinical Queensland Government.
Osteoporosis is a disease in which the bones become so weak and brittle that even a cough can cause enough stress on the bone that it will cause the bone to facture. The most commonly broken bones are the hip, wrist, and the spine. Although it affects men and women of all races, post-menopausal Caucasian and Asian women are more commonly affected than those of other ethnicities and sexes. In fact, thirty percent of all post-menopausal women in the US and Europe will be diagnosed with Osteoporosis and at least 40 percent of those will suffer from a fracture in their lifetime.
An open fracture, also called a compound fracture, is a fracture in which the broken bone may pierce the skin exposing the bone and deep tissues. Closed fractures, also known as simple fractures, are broken or cracked bones that do not puncture the skin. Open fractures are more complex to treat than closed fractures because the punctured skin is exposing the tissues and to prevent osteomyelitis (bone infection) a specialist would be needed to cleanse the site. There are a number of different types of fractures, including but not limited to: avulsion, Salter-Harris, comminuted, greenstick, and