Fractures and dislocations Z. Rozkydal Fractures - etiology • •Traumatic (acute violence) •Pathological (pathological lesion) •Stress fractures •Traumatic fracture Zl spiral •Pathological fracture Zl •Tumors •Infections •Osteopaties •Congenital diseases • Stress fracture Zl Fosa-skelet Zl násilí •Fractures from direct violence •Fractures from indirect violence •Mechanism of injury •traction •angulation •rotation •vertical compression •torsion •Missile fractures Zl Zl násilí •Mechanism of injury •High energy trauma – large lesion of soft tissue • •Low energy trauma - small lesion of soft tissue Classification of fractures • • • • • • • • • • Zl •Complete Zl •Incomplete - fissures - infractions •- impressions •- subperiostal Classification of fractures • • • • • • • • • • Zl •Stable fracture •Broken bone ends •do not move Zl •Unstable fracture •Broken end move •May damage soft tissues Localisation of fractures • •Epiphyseal •Metaphyseal •Diaphyseal Zl •epiphysis •metaphysis •diaphysis •metaphysis •epiphysis Clinical symptoms of fractures •Pain and tenderness •Swelling, haematoma, bruising •Deformity, shortening or bending •Crepitus •Difficulty in moving the extremity •A wound – in open fractures •Signs of shock •Open fractures •A wound at the fracture site •Damage of the skin •Damage of the soft tissues •Bacterial contamination B25 •First aid •It depends on the stage of injury • •Check the airways •Check the breathing •Stop bleeding •Check the answer of the casualty •CPR •Support cervical spine •Hypovolemic shock- raise the leggs •Immobilisation of the extremity •Cover the wound with a sterile dressing •Check the circulation •Pneumothorax • • •First aid • •Immobilisation •Upper limb- with a sling or bandage •Lower limb- secure it to an unaffected one •Place padding around the injury for extra support • • •Injury to the joints • •Contusion- direct blow • •Sprain - ligaments, tendons, muscles • • •First aid • •R- rest the injured part •I - apply ice pack or a cold pad •C- provide comfortable support •E- elevace the injured part •Injury to the joints • •Subluxation •Dislocation •Haemarthrosis • •Signs •Pain, difficulty to move, deformity of the joint • •Keep the casualty still •Do not try to reduce it •Upper limb- apply a bandage around • the chest or apply a sling •Lower limb- secure it to the unaffected one • •Do not allow the casualty to drink or eat •