Page 2107 - Saunders Comprehensive Review For NCLEX-RN

1. Immobilize the affected extremity with a cast or splint.
2. Assess the neurovascular status of the extremity.
3. Interventions for a fracture: Reduction, fixation,
traction, cast

If a compound (open) fracture exists, splint the extremity and

cover the wound with a sterile dressing.
E. Reduction restores the bone to proper alignment.
1. Closed reduction is a nonsurgical intervention
performed by manual manipulation.
a. Closed reduction may be performed
under local or general anesthesia.
b. A cast may be applied following
reduction.
2. Open reduction involves a surgical intervention; the
fracture may be treated with internal fixation
devices.
F. Fixation
1. Internal fixation follows an open reduction (Fig. 60-2).
a. Internal fixation involves the
application of screws, plates, pins,
wires, or intramedullary rods to hold
the fragments in alignment.
b. Internal fixation may involve the
removal of damaged bone and
replacement with a prosthesis.
c. Internal fixation provides immediate
bone stabilization.
2. External fixation is the use of an external frame to
stabilize a fracture by attaching skeletal pins through
bone fragments to a rigid external support (Fig. 60-3).
a. External fixation provides more
freedom of movement than with
traction.
b. Monitor pin stability and provide pin
care to decrease infection risks.
c. Risk of infection exists with both
fixation methods.
d. External fixation is commonly used
when massive tissue trauma is present.
G. Traction (Fig. 60-4)
1. Description
a. Traction is the exertion of a pulling
force applied in 2 directions to reduce
and immobilize a fracture.
b. It provides proper bone alignment and

2107