Musculoskeletal Disorders: Fractures, Immobilization, and Osteoporosis

Introduction

• Importance of active learning and participation.
• Emphasis on acquiring knowledge, skills, and attitudes for patient care.

Fractures

Understanding Fractures

• Interruption of bone integrity, classified as complete or incomplete.
• Causes: trauma, pathological fractures, stress fractures, avulsion fractures.
• Types: stable/unstable, simple/compound, displaced/undisplaced, linear, impacted, etc.

Clinical Presentation

• Signs and symptoms: pain, immobility, muscle spasms, deformity, edema, warmth, ecchymosis, numbness, tingling, crepitus.
• Important assessments: musculoskeletal system, skin, pain assessment, patient safety.

Medical Management

• Diagnostic imaging: X-ray, CT, MRI.
• Reduction and immobilization: aligns bones, aids healing, decreases pain.
• Pain management: address swelling, pain, muscle spasms.

Immobilization Techniques

• External Fixation:
  • Devices to hold bones in place.
  • Pin site care: sterile cleaning, monitor for infection.
• Traction:
  • Types include Buck’s traction for muscle spasms.
  • Ensure weights hang freely for proper alignment.

Complications

• Open Fractures: Risk of severe infection.
• Compartment Syndrome: Compromised blood flow and nerve conduction.
• Fat Embolisms: Common with long bone fractures.
• Immobilization Issues: Deterioration due to inactivity.

Special Types of Fractures

• Hip Fractures: Common in older adults, risk for pneumonia, DVTs, pressure injuries.
• Rib Fractures: Risk of atelectasis, need for deep breathing and coughing.
• Humerus Fractures: Safety concerns due to impaired balance.

Osteoporosis and Osteopenia

Definition and Causes

• Osteoporosis: Degenerative bone disease, reduced mass and strength.
• Primarily affects women post-menopause.

Clinical Manifestations

• Often undetected until fracture or bone scan.
• Affects balance and lung capacity due to posture changes.

Management and Prevention

• Family history, nutrition, calcium, and vitamin D.
• Weight-bearing exercises promote bone health.
• Medications can help slow deterioration or promote bone growth.
• Surgical options: ORIF, kyphoplasty for spine strength.

Patient Education

• Teenagers: Focus on prevention, nutrition, and exercise.
• Older Adults: Management, safety, and treatment adherence.

Review and Self-Assessment

• Review content, notes, and reading.
• Test understanding against learning objectives.
• Address any gaps in knowledge.