Precautions for small splint fixation after fracture:
1. Pay attention to the blood circulation of the limb: If one of the following situations occurs (1) increased pain (2) numbness of the hands and feet, slow response to pins and needles (3) limited movement of the fingers or toes of the injured limb (5) pallor or bruising of the hands and feet (6) cold of the injured limb and so on, which indicates poor circulation in the limb. Should immediately report to the doctor for treatment.
2, can not release the small splint, so as to avoid fracture displacement or fracture re-fracture.
3, in the outside of the splint, dripping (oozing) about 30~50ml of yellow water, once a day, do not dripping, in order to avoid skin edema.
4, to prevent fracture re-displacement, after the injury to protect the affected limb, to prevent external collision or other causes of fracture re-displacement.
5, functional exercise: after the fracture is reset, you can do the functional exercise of the affected limb, such as clenching the fist, muscle contraction and diastole, joint flexion and extension, etc., and with a variety of physical therapy, to promote the disappearance of swelling and fracture healing.
2. Information on small splint fixation after fracture
Commonly used external fixation methods include small splints, plaster bandages, adductor frames, continuous traction and pinning external fixators.
Small splint fixation is commonly used for fractures of the humerus, ulnar radius, tibial fibula, distal radius, and ankle. Some intra-articular fractures, fractures near the joint and femur fractures are not suitable for small splint fixation.
For osteoarthritic injuries and postoperative external fixation of osteoarthritic joints, plaster bandages are often used.
For serious shoulder and elbow trauma, as well as after some upper limb orthopedic surgery, the application of adductor fixation.
Continuous traction can be divided into manual traction, skin traction and bone traction. Manipulative traction is mostly used for fracture displacement and joint dislocation correction, skin traction is less traction force, suitable for pediatric femur fracture traction treatment, the traction of humerus instability fracture and adult lower limb fracture postoperative auxiliary traction and lower limb skeletal traction auxiliary traction. If you need a larger traction force and longer traction time, you can choose bone traction, and according to the different indications are divided into different parts of the bone traction.
(1) ulnar humeral traction: for humeral neck, stem, humeral condyle and intercondylar comminuted fracture displacement and local swelling is serious, and can not be immediately reset and fixed, as well as old shoulder dislocation will be manipulated to reset the person.
(2) Distal radial-ulnar traction: for open radial-ulnar fractures and old posterior elbow dislocation.
(3) Supracondylar femoral traction: for displaced femur fracture, displaced pelvic ring fracture, centric dislocation of the hip joint and old posterior dislocation of the hip joint.
(4) Tibial tuberosity traction: the indications are the same as (3).
(5) Distal tibiofibular traction: for open tibiofibular fracture or knee fracture is not suitable for tibiofibular nodal traction.
(6) Achilles traction: for early treatment of unstable tibiofibular fractures, certain heel fractures and mild contracture deformities of the hip and knee.
(7) Metatarsal 1-4 proximal end traction: this technique is mostly used with heel traction pins *** mounted bone external fixation frame for traction or fixation to treat compression fractures of the cuneiform and navicular bones.
(8) Cranial traction: for cervical spine fractures and dislocations, especially fracture dislocation with spinal cord injury.
(9) Cephalic ring traction: for spinal fractures or dislocations.
In addition, there are some other methods of traction using a traction belt:
(1) Occipital-mandibular belt traction: for mild cervical spine fracture or dislocation, cervical disc herniation and radiculopathy.
(2) Pelvic girdle traction: for lumbar disc herniation.
(3) Pelvic suspensory band traction: for pelvic fractures with significant separation displacement or pelvic ring fractures with upward displacement and separation displacement.
(4) Thoracolumbar suspensory band traction technique: for thoracolumbar vertebral compression fractures.
For open fractures or infected fractures, fracture nonunion, limb lengthening, multiple fractures of the femur or tibia, unstable comminuted fractures, and arthrofusion, an extraosseous penetrating pin external fixator can be applied.
3. What are the nursing observation points of small splint fixation
The nursing observation points of small splint fixation are:1.
Anxiety: assess the degree of anxiety, explain the purpose of using the splint, explain the use of the splint after the possible discomforts, such as severe anxiety, can consider the use of medication to treat, and to understand the patient's feelings. 2.
Peripheral blood vessels, nerves, and the risk of injury before and after splint fixation. 2. Risk of peripheral vascular and nerve injury Assess vascular and nerve function before and after splinting bedside shift, assess vascular and nerve function every shift and record, check: pain, swelling, skin temperature, skin color, sensory abnormality, pulse weakening, and activity dysfunction, etc. Check the tightness of the splint every shift and adjust it in time, generally take the standard of being able to move up and down the splint by lcm after lifting up the bandage with two fingers to lift up and down the limb, and encourage the patient to move around. Non-fixed joints to guide the patient to report numbness, tingling or pain aggravation of the ischemic limb strictly not to do ***, hot packs, to prevent the increase of local metabolism, aggravate tissue ischemia. 3.
Pain: assess the cause, frequency, nature, changes in pain, if necessary, the use of painkillers and observe the efficacy . Instruct the patient in relaxation techniques Observe the efficacy of splint immobilization and whether the immobilization is appropriate Instruct the patient to promptly report pain that cannot be relieved or exacerbated.
4. Risk of damage to the integrity of the skin: assess the patient's skin condition before splinting, check the tightness of the splint on a shift basis, and make timely adjustments, pay attention to the patient's complaints, and release the splint in time for examination.
4. What to pay attention to after plaster or splint fixation
What to pay attention to after plaster or splint fixation
(1) After splinting or plaster external fixation, the limb should be elevated about 30 degrees, in order to facilitate the blood return and limb swelling subside, the affected limb can be raised with a brace or pillow;
(2) Closely observe the injured limb's blood flow, sensation, and motor function. Especially in 1-4 days after the rehabilitation, we should pay attention to observe the arterial pulsation of the end of the injured limb, the degree of swelling, temperature, color sensation and active activities. If you observe the swelling of the extremity, the skin is cold and pale, skin sensation loss and other symptoms, you should promptly remove the external fixation and come to the hospital for review, in order to prevent complications such as ischemic contracture of the limb;
(3) pay attention to the presence of fixed pain points. If there is fixed pain outside the limb splint fixation or at the ends of small splints, the splint should be removed in time for examination to avoid pressure ulcers or nerve and blood vessel injuries;
(4) Pay attention to the warmth of the injured limb in the cold season. Hot season should pay attention to ventilation, to keep the splint, plaster clean, especially children should avoid wet urine, stool soaked and other pollution.
5. What are the main points of care for external fixation frame
The main points of care for external fixation frame are (1) to publicize to the patient the therapeutic principle of external fixation bracket, the purpose of use, the use of the method of use, the precautions and other related knowledge, so that the patient has a certain degree of understanding, in order to cooperate with the treatment.
(2) According to the patient's condition, choose the appropriate external fixation stent of large, medium and small size, and strictly carry out disinfection and sterilization. (3) Strictly aseptic operation when resetting and fixing, the skin needle should be covered with alcohol gauze, sterile gauze bandage, and the stent should be properly fixed with a bandage after the operation.
Keep the needle eye clean and dry, report to the doctor if there is blood or fluid seepage, and use antibiotics reasonably to prevent infection. (4) After the external fixation stent is firmly fixed, use the special stent to support the cover.
When the patient must be moved, both hands should support the upper and lower ends of the fracture to keep it stable and avoid pulling, touching and hitting the stent by mistake and affecting the fixation effect. (5) In the process of using external fixation devices, if there is obvious discomfort accompanied by pain, numbness, then promptly investigate the cause and adjust the treatment.
(6) Instruct the patient on the correct way of functional exercise. (7) Regular X-ray examination to understand the effect of immobilization.
6. What are the methods and indications for small splint fixation after fracture
After fracture, a small splint can be made of wood, bamboo, or cedar bark, etc., and then cut into a long and wide splint for fixation.
When fixing the fracture, the small splint and the skin should be padded between some cotton things, with a bandage or cloth fixed in the small splint better, in order to prevent damage to the flesh. This method of fixation range is smaller than the plaster bandage, but can effectively prevent and control the displacement of the fracture end, because it does not include the upper and lower joints of the fracture, so it is convenient to carry out functional exercise in a timely manner to prevent the occurrence of joint stiffness and other complications, has the advantages of reliable, fast healing of the fracture, good functional recovery, and low cost of treatment.
After fracture, the indications for small splint fixation are: ◆ Closed tubular fracture of the extremities. ◆ Open fracture of the limbs with small trauma and the wound has healed after treatment.
◆Old limb fracture suitable for maneuvering into position.
7. What are the complications to be prevented by external fixation of small splints
The complications to be prevented by external fixation of small splints are: (1) Osteofascial compartment syndrome: it is the most likely and serious complication.
Due to . Tight bandage, not timely and careful observation; poor fracture repositioning, vascular compression can not be released in time; serious local injury or incorrect restoration; not to the patient and his family to do a good job of health education and other reasons caused by tissue ischemic necrosis. (2) Pressure ulcers: the patient's complaints should be taken seriously, to avoid the rough edges of the splint friction, extrusion of the skin, or over-tightening and other reasons, so that the local skin or tissues of the limb for a long time under pressure and ischemia necrosis, ulceration occurs.
(3) Displacement of the fracture end: it may be caused by loose fixation of the splint, improper placement of the affected limb, incorrect functional exercise, premature removal of the splint, and so on, so we should do a good job of educating the patients, and strictly in accordance with the progress of the fracture healing and reasonable guidance of functional exercise, and timely follow-up.