Classification of Fractures
Fractures can be classified based on various criteria, including the mechanism of injury, location, pattern of the break, and whether the bone is displaced or not. Common types of fractures include:
- Closed (Simple) Fracture: The bone breaks but does not penetrate the skin.
- Open (Compound) Fracture: The broken bone penetrates through the skin, increasing the risk of infection.
- Greenstick Fracture: Common in children, the bone bends and partially breaks, similar to a green twig.
- Comminuted Fracture: The bone shatters into multiple fragments.
- Transverse Fracture: The break occurs in a straight line across the bone.
- Oblique Fracture: The break is at an angle to the bone's long axis.
- Spiral Fracture: The fracture spirals around the bone due to torsional forces.
- Impacted Fracture: The bone fragments are driven into each other.
- Pathological Fracture: Occurs in weakened bones due to underlying conditions like osteoporosis or cancer.
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Questions on Classification of Fractures
Correct Answer is B
Explanation
<p>A separation of bone fragments at a joint: This description is more in line with a dislocation, where the bone separates from its normal position at a joint.</p>
Correct Answer is C
Explanation
<p>Spiral fracture: A spiral fracture is characterized by a twisting or spiraling break along the bone, but it does not result in multiple pieces.</p>
Correct Answer is C
Explanation
<p>Avulsion fracture: An avulsion fracture occurs when a piece of bone is torn away by a ligament or tendon, not bending and partial breaking.</p>
Correct Answer is C
Explanation
<p>Decreased bone density: Decreased bone density, often seen in osteoporosis, contributes to fractures in older adults.</p>
Correct Answer is D
Explanation
<p>A closed fracture is a fracture where the skin remains intact over the fractured bone, and there is no open wound at the site of the fracture.<br />
</p>
Correct Answer is D
Explanation
<p>A closed fracture is a fracture where the skin remains intact over the fractured bone, and there is no open wound at the site of the fracture.<br />
</p>
Correct Answer is B
Explanation
<p>Comminuted fracture: In a comminuted fracture, the bone breaks into multiple pieces, which is different from breaking straight across the bone.</p>
Correct Answer is C
Explanation
<p>Comminuted fracture: In a comminuted fracture, the bone breaks into multiple pieces, which is not associated with twisting forces.</p>
Correct Answer is C
Explanation
<p>Impacted fracture: An impacted fracture occurs when the bone fragments are driven into each other, often seen in a fall or compression injury, not involving ligament or tendon tears.</p>
Correct Answer is A
Explanation
<p>Stress fracture: A stress fracture occurs due to repetitive stress on the bone, not involving one side breaking and the other side bending.</p>
Correct Answer is B
Explanation
No explanation
Correct Answer is D
Explanation
<p>Osteoporosis is a condition characterized by weakened and porous bones, leading to an increased risk of fractures, especially in the hip, spine, and wrist.<br />
</p>
Correct Answer is A
Explanation
<p>Middle-aged adults: Middle-aged adults may experience fractures related to osteoporosis, trauma, or other factors, but they are not the primary population at risk for stress fractures.</p>
Correct Answer is C
Explanation
<p>Maintaining a healthy body weight: Maintaining a healthy body weight is beneficial for overall health, but it is not specifically associated with an increased risk of fractures.</p>
Correct Answer is C
Explanation
<p>Asthma: Asthma is a respiratory condition that affects the airways and lungs and is not linked to an increased risk of fractures.</p>
Correct Answer is C
Explanation
<p>Open wound with bleeding at the fracture site: An open wound with bleeding is characteristic of an open or compound fracture, not a closed fracture.</p>
Correct Answer is B
Explanation
<p>Warmth and redness at the fracture site: Warmth and redness are signs of inflammation and increased blood flow to the injured area, which is normal during the healing process.</p>
Correct Answer is C
Explanation
<p>Inability to bear weight on the affected limb: Inability to bear weight may be present in some fractures, but it is not a specific characteristic of stress fractures.</p>
Correct Answer is D
Explanation
<p>Colles' fracture is a type of distal radius fracture that results in angulation and swelling of the distal forearm near the wrist joint.<br />
</p>
Correct Answer is D
Explanation
<p>Severe pain, pallor (pale skin color), and loss of pulses distal to the fracture are concerning signs of compartment syndrome, a serious complication that requires immediate medical intervention.<br />
</p>
Correct Answer is A
Explanation
<p>Increased range of motion at the joint: Increased range of motion may occur in some injuries, but it is not a reliable indicator of a fracture, especially if there is swelling and bruising present.</p>
Correct Answer is A
Explanation
<p>Ultrasound: Ultrasound is primarily used for imaging soft tissues and may not provide sufficient detail for evaluating fractures. X-rays are more appropriate for initial assessment.</p>
Correct Answer is C
Explanation
<p>Inability to bear weight on the affected limb: Inability to bear weight may be present in some fractures, but it is not a specific characteristic of stress fractures.</p>
Correct Answer is C
Explanation
<p>Evaluating liver function: Evaluating liver function is not directly related to the assessment of a suspected fracture.</p>
Correct Answer is C
Explanation
<p>External fixation: External fixation involves using pins and an external frame to stabilize fractures, and it is typically used for complex or open fractures.</p>
Correct Answer is D
Explanation
<p>Closed reduction is a non-surgical procedure used to manually realign the fractured bone to its normal position without making an incision. It is often followed by cast immobilization or other forms of stabilization.<br />
</p>
Correct Answer is A
Explanation
<p>Delayed wound dressing changes: Appropriate wound care is crucial for preventing infection and ensuring proper healing. Delayed wound dressing changes may increase the risk of infection.</p>
Correct Answer is C
Explanation
<p>Bisphosphonates: Bisphosphonates are used to treat osteoporosis and other bone disorders but are not typically prescribed specifically for fracture healing.</p>
Correct Answer is D
Explanation
<p>Patients with external fixation require close monitoring of the pin sites for signs of infection, as they are at risk of developing pin site infections.<br />
</p>
<p>Stiffness and limited range of motion in nearby joints: Stiffness and limited range of motion may occur after a fracture but are not as urgent as neurovascular compromise.</p>
<p>Osteomyelitis: Osteomyelitis is a bone infection that can develop as a complication of fractures, but it does not typically present with warmth and redness at the site.</p>
<p>Hypertrophic nonunion occurs when there is excessive callus formation at the fracture site, but the bone ends fail to unite. This can lead to persistent pain and limited function.<br />
</p>
<p>Osteomyelitis: Osteomyelitis is a bone infection that can occur as a complication of fractures and is not specifically related to increased pressure within a closed space.</p>
<p>Osteomyelitis: Osteomyelitis is a bone infection that can develop as a complication of fractures, but it may or may not cause persistent pain and limited function, depending on its severity and treatment response.</p>
<p>Removing the cast if it becomes loose is not within the patient's scope of practice. If the cast becomes loose or uncomfortable, the patient should seek immediate medical attention for evaluation and adjustment by a healthcare professional.</p>
<p>Instructing the patient to use assistive devices only during walking is not enough to ensure appropriate weight-bearing. The patient should follow specific weight-bearing restrictions as advised by the healthcare provider, even when using assistive devices.</p>
<p>Keeping the cast exposed to air for long periods may lead to dirt and debris getting trapped in the cast and increasing the risk of infection. The patient should be cautious and avoid exposing the cast to dirt and contaminants.</p>
<p>Using a heating pad to alleviate discomfort is not recommended, as excessive heat can lead to skin irritation and may weaken the cast. The patient should use ice packs or follow the healthcare provider's instructions for pain management.</p>
<p>Instructing the patient about cast care is necessary, but it is not the priority consideration when the patient's neurovascular status is at risk.</p>
<p>Providing a soft foam mattress overlay can enhance patient comfort but may not be sufficient to prevent skin breakdown and pressure ulcers in patients with prolonged immobilization.</p>
<p>: Educating the patient about signs of neurovascular compromise, such as changes in sensation, color, or temperature of the limb, is essential to ensure early detection of potential complications and timely intervention.<br />
</p>
<p>Assessing the quality of pain experienced by the patient is important for pain management but is not the priority over assessing for signs of infection in an open fracture.</p>
<p>Before applying a cast, the nurse should obtain a baseline neurovascular assessment of the extremity to establish normal function. This assessment will serve as a reference for comparison throughout the cast's application and during the healing process.<br />
</p>
<p>Stress fracture: A stress fracture is a tiny crack in the bone caused by repetitive stress and overuse. It does not involve bone crushing or fragmentation.</p>
<p>Oblique fracture: An oblique fracture occurs when the bone breaks at an angle, but it does not involve one side bending and the other side breaking.</p>
<p>Spiral fracture: A spiral fracture occurs when the bone is twisted, resulting in a spiral-shaped fracture line. It does not involve the bone breaking into two separate pieces.</p>
<p>Stress fracture: A stress fracture is a tiny crack in the bone caused by repetitive stress and overuse. It does not involve the bone penetrating the skin.</p>
<p>Patient's occupation: The patient's occupation may be considered in the treatment plan, but it is not the primary factor in determining weight-bearing status after a fracture.</p>
<p>Ultrasound: Ultrasound is useful for certain soft tissue evaluations but is not commonly used for diagnosing fractures.</p>
<p>Regularly monitoring neurovascular status, including assessing pulses, capillary refill, sensation, and motor function, is essential for early detection of compartment syndrome, which can occur after a fracture. Compartment syndrome is a serious condition where increased pressure within the muscl
<p>Minimizing the risk of infection is crucial, particularly in open fractures, but it is not the primary goal of fracture reduction and immobilization.</p>
<p>Administering analgesics for pain relief is important, but it does not directly relate to assessing for neurovascular compromise before moving the limb.</p>
<p>Educating the patient to keep the cast exposed to air for prolonged periods is not recommended, as dirt and debris can get trapped inside the cast, increasing the risk of infection. The patient should follow the healthcare provider's instructions for cast care.</p>
<p>Transverse fracture: A transverse fracture is a type of fracture where the fracture line is perpendicular to the long axis of the bone.</p>
<p>Stress fracture: A stress fracture is a small crack or incomplete break in the bone, often caused by repetitive stress and overuse.</p>
<p>Oblique fracture: An oblique fracture is a type of fracture where the fracture line is diagonal to the long axis of the bone and can occur in both children and adults.</p>
<p>Impacted fracture: An impacted fracture occurs when the broken ends of the bone are driven into each other, often seen in long bones like the femur or humerus. It can occur in individuals of all ages.</p>
<p>Greenstick fracture: A greenstick fracture is an incomplete fracture seen in children, where the bone bends and partially breaks on one side but remains intact on the other side. It is not specifically at an angle to the long axis of the bone.</p>
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