Fractures

Non-Displaced Fracture

The bone is boken, however both sections of the bone are still aligned and once healed does not inhibity the function of the limb or area of the body.

  • Provide pain medication as needed
  • Ice for swelling and pain management
  • If possible, place the limb in a cast
    • Spine and Skull are non castable and may require fixing
    • Ribs are non castable and will heal over time on their own
  • Apply UV Curing to the cast if needed with /e weld

Displaced Fracture - Non-Skull

The bone is boken, sections of the bone are no longer aligned and before proper healing can occur the bones must be aligned

  • Provide pain medication as needed
  • Ice for swelling and pain management
  • Evaluate if you can set the bone without surgery
    • Non-Surgical
      • This will require physical manipulation. Pulling and or turning limbs to re-align bone fragments
      • New Imaging to insure bone alignment
      • Once confirmed proceed to casting
    • Surgical
      • Anesthetize the Patient and Intubate or do a Local Nerve block to limb if possible with o2 mask
      • Large enough incision to gain access to affected area
      • Saline and Bacitrcin to flush loose debri
      • Suction to clear surgical area
      • Align Fragments and fixate - This may include plates, screws, pins, rods to imobilize fragments
      • Saline and Bacitrcin to flush loose debri
      • Suction to clear surgical area
      • Close surgical site, apply ointment, cover with clean/sterile guaze
  • then (if possible) cast the limb - For Surgical procedures make the cast removable for wound care
    • Spine, Ribs are non castable.
    • Ribs will heal over time on their own,
    • Spine will require fixation.

Skull Fracture

The integrity of the skull has been compromised

  • Pain management
  • Evaluate if the skull requires surgery
    • Non-Surgical (Linear Skull Fracture-No Movement of bone)
      • Confirmed with imaging no bone movement and either of the following
        • If no brain swelling, bleeding, etc seen continue this treatment course
        • If TBI suspected move to Neurological Treatment page
      • No intervention neccessary just pain management - resume normal activity within a few days
    • Surgical (Depressed Skull Fracture-Bone has been depressed into the brain tissue)
      • Anesthetize the Patient and Intubate
      • Large enough incision to gain access to affected area
      • Saline and Bacitrcin to flush loose debri
      • Suction to clear surgical area
      • Align Fragments and fixate - This will likely include a plate and pins
        • If the Brain is swelling, you may delay this procedure to a second surgery in order to give room for the brain to swell without causing damage (requires icu or helmet to be worn till replacement)
        • Sutue the bone fragment in place just under the skin between skull to preserve the bone fragment or may be discarded and a synthetic material used on follow-up surgery
      • Saline and Bacitrcin to flush loose debri
      • Suction to clear surgical area
      • Close surgical site, apply ointment, cover with clean/sterile guaze