FRACTURES

Fracture Principles

Talking about indications for ORIF

Failure to obtain & maintain adequate closed reduction
Fractures that unite poorly
Pathological fractures
- NOF fractures
- Multi-trauma
Nursing difficulties

Reduction Principles

Apply traction in the long axis of the limb
Reverse the mechanism that produced the fracture
Align the fragment that can be controlled with the one that cannot
Maintaining the soft tissue linkage
- Ie. soft tissue hinge between fragments is very important
Blocks to reduction include
- Soft tissue
- Haematoma

Plaster

Roll of muslin stiffened by dextrose or starch
Impregnated with the Hemi-hydrate of Calcium Sulfate
- AKA Dehydrated Gypsum
When water is added, Calcium Sulfate takes up its water of crystallization
- CaSO4 + H2O + H2O » CaSO4-2H2O + heat
- Exothermic

Fiberglass

Knitted fiberglass
- 45% Polyurethane Resin
- 55% Fiberglass
Pre-polymer is Methylene Bisphenyl Di-isocyanate (MDI), which converts to a nontoxic Polymeric Urea Substance
MDI molecules have Isocyanate end-groups that react with any molecule containing an active hydrogen
Exothermic reaction
Use smaller rolls as tendency to “ridge” at curves
More elastic, so apply tighter