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Pediatric Factures. Jan Bazner-Chandler RN, MSN, CNS, CPNP. Fractures. Treatment determined by type of fracture. Fractures. Comminuted fracture. RW Chandler MD. Salter Fracture Classification. Salter-Harris Classification.
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Pediatric Factures Jan Bazner-Chandler RN, MSN, CNS, CPNP
Fractures Treatment determined by type of fracture
Fractures Comminuted fracture RW Chandler MD
Salter-Harris Classification • If injury involves growth plate in an immature bone, growth disturbance may follow. • Classification system describes the injury and the potential for growth disturbance.
Traction • Used to stabilize the fracture site until a cast or surgery
Principles of Traction • Counter traction with weights. • Make sure all ropes and pulleys are aligned and weights are hanging freely. • Do not remove weights unless instructed to do so – you do not want to displace the fracture. • Traction must be applied at all times. • Physician order should include amount of weight to be applied.
Bryant’s Traction • Used for child under3 years • Hip dysplasia / fractured femur • Buttocks do not rest on mattress • Assess neurovascular and restriction by ace bandages – compartment syndrome.
External Fixation RWChandler MD
Pin Care • Provide pin care as ordered. • Cleanse area around pin with normal saline or half-strength hydrogen peroxide. • Have parent / caretaker demonstrate pin care before discharge.
External Fixator RW Chandler MD
Plates and Pins Plates, screws, and wires are used to align bone fragments. R.Chandler MD
Post-operative Care • Assess color, sensation, cap refill, movement, pain, and pulses. • Circle any drainage noted on cast or dressing. • Pain control • Edema = ice to area • Pulmonary function = C&DB
Pulmonary Embolism • A complication of a fracture especially of the long bones. Fat escapes the marrow when the bone is fractured and can travel through the blood stream and become lodged in small vessels like the arterioles and capillaries of the lung. • Primary symptom is shortness of breath and chest pain.
Interventions • Place patient in high fowlers • Administer oxygen • Call MD • Chest x-ray • Outcomes are better for a healthy person; poorer for person with pre-existing lung problems.