Radial Ulnar Fracture Dislocation/ Galeazzi Fracture (The “S” Arm)

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Alex Bultman, Alyson DelPoso, and Natalie Titcomb

  • Caused by a fall onto an outstretched arm with a flexed elbow
  • Ensure the patient has full range of motion in the shoulder
  • Elbow, wrist, and hand exercises are only begun after a physician prescription
  • To test for motor function, ask the patient to make the ‘OK’ sign by toughing the tips of the first and second fingers with the thumb. The radial nerve can be tested by having the patient extend their fingers or wrist against resistance, and the ulnar nerve can be tested by having the patient separate their fingers against resistance.
  • Treatment depends on the type of fall. If there are fragments, internal fixation is used. If there are no fragments, it is treated by closed reduction with a long arm cast

fracture

Image retrieved from:  http://kidshealthwa.com/guidelines/forearm-fractures/

Tibia/Fibula Fracture “Fun Facts”

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– Only the tibia bears weight, so isolated fibula fractures allow for ambulation.

– Most fractures to the lower leg are open.

– Tibia fractures are the most common long bone fractures (40%)

– Can cause compartment syndrome (pressure build-up inside a space in the body, can require surgery)

– Can be low-engery (falls/athletics) or high energy (motor vehicle accidents/gun shots

(http://emedicine.medscape.com/article/826304-overview)

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(https://www.pinterest.com/pin/273030796135219537/)

Protected: Broken Ankle with Pinning

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Compartment Syndrome

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  • Unrelieved or disproportionate pain may indicate complications- compartment syndrome is the most serious complication of casting and splinting
  • Must be reported immediately to primary provider to avoid necrosis, neuromuscular damage, and possible paralysis, which can occur within a few hours if action is not taken.
  • pain is relentless and is not controlled by modalities such as elevation, application of ice or cold, and usual dosages of analgesic agents.
  • S/S: dusky, pale appearance of exposed extremity; cool skin temp., delayed cap refill, parenthesis; and unrelenting pain.
  • Hallmark sign: pain that occurs or intensifies with passive range of motion.

 

compartment syndrome

 

-Brenda Valencia, Jennifer Zuniga Leon

Open fractures (ouch!)

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  • An open fracture is one in which damage also involves the skin and/or mucous membranes; also known as a compound fracture.
  • Risks of open fractures include osteomyelitis, tetanus, and gas gangrene.
  • Primary nursing objectives include: preventing infection of wound, tissue, and bone and to promote healing; administering prescribed IV antibiotics and tetanus toxoid if indicated.
  • Other nursing interventions include: wound irrigation; sterile dressing changes; elevation of extremity to minimize edema.
  • Accurate and frequent assessment of neurovascular status, vitals, and the wound is necessary to monitor for s/s of infection or other complications.

    http://nursingguides.org/wp-content/uploads/2015/01/Open_fractures_8a_540.jpg
    http://nursingguides.org/wp-content/uploads/2015/01/Open_fractures_8a_540.jpg

Multiple Sclerosis

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Fun facts:

  1. Common symptoms are fatigue, depression, weakness, numbness, difficulty in coordination, loss of balance, and pain.

2. Women are more likely to develop osteoporosis

3. You get visual disturbances from the optic nerve lesions. this can lead to blurred vision or blindness.

4. You get spasticity in the lower extremities.

5. You get ataxia

Shoulder dislocation FUN FACTS

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1. The shoulder is the most commonly dislocated joint the in body.
2. High activity level is the greatest predisposing factor for shoulder dislocation.
3. Dislocation hurts.
4. The shoulder is the most mobile joint in the body. It is capable of circumduction, rotation, and has a range of motion of more than 180 degrees in all axes.
5. Pain can cause vagal symptoms including syncope, nausea, and vomiting.

Parkinson’s Disease

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  • Neurodegenerative disorder from depletion of dopamine impairing voluntary movements.
  • Daily exercise is important to increase muscle strength, improve coordination, and reduce rigidity.
  • Problems repositioning ensure that patients are being repositioned and turned.
  • Swallowing difficulties, must sit in an upright position.
  • Increased risk for fall because of impaired gait.

Total hip arthroplasty fun facts!

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  1. aka total hip replacement- replacement of a severely damaged hip with an artificial joint.
  2. indications: osteoarthritis, rheumatoid arthritis, femoral neck fracture (hip fracture)
  3. complications are associated with dislocation of the hip prothesis, excessive wound drainage, VTE, infection, heel pressure ulcers
  4. long-term complications: formation of the bone in the periprosthetic space, avascular necrosis, & loosening of the prosthesis
  5. patient should not cross legs at any time, and should maintain protective positioning including: maintaining abduction and avoiding internal and external rotation & hyperextension

Five Fun Facts on Achilles Tendon Rupture

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  1.  Generally occurs during activities when there is a sudden contraction of the calf muscle with the foot fixed firmly to the floor or ground.
  2. Occurs most commonly in healthy men ages 30 – 50.
  3. Key components to enhance functional outcomes and reduce disability include a thorough assessment, early recognition and comprehensive management.
  4. Diagnosis is made by MRI or ultrasound.
  5. Non-weight baring cast is used to keep the foot in plantar-flexion for 6 – 8 weeks, followed by progressive physical therapy.

photo credit: http://openi.nlm.nih.gov/detailedresult.php?img=3178860_yjbm_84_3_289_g02&req=4

By: Heidi Dittmar

Lauren Barnett

Rachel Alan