Bone Injuries and treatment Fractures and Dislocations

State Standards 16) Understand principles of and successfully perform skills related to Emergency Medicine, incorporating rubrics from the American Heart Association or American Red Cross for the following: c. Basic First aid for bone and joint injuries 21) Understand principles of and successfully perform skills related to Athletic Training, incorporating rubrics from textbooks or clinical standards of practice for the following: a. Assessment of athlete with injured ankle or wrist

Objectives Students will identify signs and symptoms of fractures and dislocations. Students will describe the location of fractures through applying knowledge of the different bones. Students will demonstrate knowledge of the different types of fractures through a diagnostic lab activity.

Common Signs and Symptoms of a Fracture or Dislocation Pain Swelling Deformity (bent or longer) Discoloration Loss of function in the extremity Audible “pop” or “snap”

Discussion With a partner discuss…. What happens to the tissues surrounding a fracture? Applying what you know about homeostasis, what body systems have the potential to be impacted by this type of injury?

Dislocation Vs. Fracture Ligament- short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint Fracture- Traumatic bone injury in which the bone tissue becomes damaged or completely severed. Dislocation-displacement of the bone out of its socket resulting in tearing or stretching of ligaments. Sprain- injury to a joint caused by sudden motion, causing the ligaments to tear. The joint is not dislocated.

Discussion Discuss with a partner…. Applying the definitions you just learned, determine the type of injury in the scenario. Rachel fell from a tree and has injured her arm. She heard a pop in her arm when she landed and the arm appears longer than her other arm.

Open vs. Closed Fracture Closed Fracture- the bone is broken but the bone ends do not pierce through the skin Open Fracture- most serious type of fracture, the bone ends pierce through the skin. Discussion: Applying what you know about homeostasis and the protection measures of the body, why would an open fracture be the most dangerous? What might be impacted with this type of injury?

Comminuted Fracture Bone Injuries 3 or more fragments of bone Hard, direct blow Fall in awkward position Often seen in the elderly

Depressed Fracture Bone Injuries Often occurs in flat bones Falling on hard, immovable surface Hit with a hard object Discussion: Applying what we learned about bone anatomy, which bones are considered flat bones?

Transverse Fracture

Bone Injuries Greenstick (Fissure) Fracture The bone bends much like a green tree branch. Occurs in immature bone that has not completely ossified Discussion: Applying what you learned about the make up of bone, what type of bone tissue would be present when the bone has not completely ossified. Ex. A child

Bone Injuries Impacted Fracture Bone is compressed Fall from a height Immediate splinting and traction are required Discussion: Applying what you just learned about an impacted fracture and what you know about how a dislocation looks, what will an extremity with an impacted fracture look like?

Longitudinal Fracture Bone Injuries Longitudinal Fracture Bone splits along its length Jumping from a height

Oblique Fracture Bone Injuries Twisting injury Twisting on end of the bone while the other end is stabilized Longitudinal and oblique fractures usually occur in the long bones. Discussion: Applying what you learned about how longitudinal and oblique are caused, what long bones do you think are most effected?

Types of Fractures Spiral Fracture S-shaped separation of bone Ex. Foot is firmly planted and the body is rotated in the opposite direction

Avulsion  injury to the bone in which part of the bone is pulled off by an attaching tissue. Discussion: Applying what you know about the tissues that attach to bone, which one, ligament or tendon, would cause an Avulsion? 

Fissure or hairline fracture An incomplete bone fracture; multiple small lines are often visible, but do not pass through the entire bone.

Activity With a partner complete the identifying x-rays activity. Read the information at the top of the activity that discusses fractures, dislocations, and x- rays. Complete the questions that go along with each x-ray example. Complete the questions at the end of the activity individually.

First Aid treatment of bone and joint injuries

State Standards 16) Understand principles of and successfully perform skills related to Emergency Medicine, incorporating rubrics from the American Heart Association or American Red Cross for the following: c. Basic First aid for bone and joint injuries 21) Understand principles of and successfully perform skills related to Athletic Training, incorporating rubrics from textbooks or clinical standards of practice for the following: a. Assessment of athlete with injured ankle or wrist

Objectives Students will demonstrate knowledge of how to assess for an injury to an extremity. Students will demonstrate knowledge of first aid care of a fracture or dislocation. Students will apply knowledge of first aid care in injury scenarios.

Assessing for an Injury 1st Examine the scene and make sure it is safe. 2nd Determine if the victim is having difficulty breathing, if so take care of this first. 3rd. Assess for bleeding, apply pressure without causing trauma. Discussion: Applying what you know about the anatomy of the skeleton, What type of fracture could cause difficulty with breathing?

Assessing for Injury If the victim is conscious, ask questions about what happened. The victim may have heard a bone snap at the time of injury. Ask the victim where they are hurting, what it feels like, and ask them to rate the pain from 1 to 10 Examine the injured area for swelling and/or deformities, lacerations and puncture wounds. Gently feel along the length of the bone for tenderness, swelling and deformities. Check the circulation to the surrounding tissues by checking the pulse and looking at the color of the skin. Discussion: What would the skin look like if it has decreased circulation?

Assessing an Injury DO NOT encourage the casualty to move the injured part in order to identify a fracture or dislocation. If you are not sure whether a bone is fractured, treat the injury as if it is. Do not move a victim if you suspect a fracture to the skull, neck, or spine. Discussion: Applying what you know about the nervous system, why would you take special care to not move a victim with a suspected fracture of the neck or back?

First Aid treatment Splints A splint can be any long firm object. Before applying the splint assess circulation and feeling below the injury Immobilize the joints above and below the fracture Prevents the sharp edges of the bone from moving and cutting tissue, muscle, blood vessels, and nerves. Immobilizing fractures reduces pain. Assess for circulation and feeling after applying the splint. Discussion: Why would you assess circulation and feeling before and after applying a splint?

First Aid treatment Slings Goal is to further immobilize the injury Provides support to the injury Used for an upper extremity injury.

Video https://www.youtube.com/watch?v=Z5K-6q36Hlk

Activity In your small groups you will be given a scenario. Applying what you have learned from anatomy of the skeletal system and bone injuries, work together to determine the type of injury your victim is suffering from. You need to provide the appropriate emergency treatment for the injury following the provided grading rubric. You will present your scenario and your first aid treatment to the class to be graded using the rubric.