Fracture Care of Upper limb Care Plan

A fracture is a broken bone. A bone may be completely fractured or partially fractured in any number of ways (crosswise, lengthwise, in multiple pieces)Co-management

Types of bone fracture:
Different types of fracture include:
Closed (simple) fracture: the broken bone has not pierced the skin
Open (compound) fracture: the broken bone juts out through the skin, or a wound leads to the fracture site. Infection and external bleeding are more likely
Greenstick fracture: a small, slender crack in the bone. This can occur in children, because their bones are more flexible that an adults bones
Hairline fracture :the most common form is a stress fracture, often occurring in the foot or lower leg as a result of repeated stress from activities such as jogging or running
Complicated fracture: structures surrounding the fracture are injured. There may be damage to the veins, arteries or nerves, and there may also be injury to the lining of the bone (the periosteum)
Comminuted fracture :the bone is shattered into small pieces. This type of complicated fracture tends to heal more slowly
Avulsion fracture :muscles are anchored to bone with tendons, a type of connective tissue. Powerful muscle contractions can wrench the tendon free and pull out pieces of bone. This type of fracture is more common in the knee and shoulder joints
 Compression fracture: occurs when two bones are forced against each other. The bones of the spine, called vertebrae, can have this type of fracture. Older people, particularly those with osteoporosis, are at higher risk.

The most common causes of fractures are:

Trauma. A fall, a motor vehicle accident, or a tackle during a football game can all result in fractures.
Osteoporosis. This disorder weakens bones and makes them more likely to break.
Overuse. Repetitive motion can tire muscles and place more force on bone. This can result in stress fractures. Stress fractures are more common in athletes.
 

Many fractures are very painful and may prevent you from moving the injured area. The symptoms of a fracture depend on the particular bone and the severity of the injury, but may include:

• Pain
• Swelling
• Bruising
• Deformity
• Inability to use the limb.

Possible complications of a bone fracture may include:

• Poor alignment of the limb
• Infection
• Wrongly fitted plaster cast (for example, too tight or too loose).
• Other problems caused by bone fracture can include:
• Blood loss - bones have a rich blood supply. A bad break can make you lose a large amount of blood
• Injuries to organs, tissues or surrounding structures
• Stunted growth of the bone - if a child's long bone breaks close to the joint where the growth plates are found.
• Damaged muscle, nerves or blood vessels around the fracture - this can occur during the initial injury (often caused by a sharp piece of broken bone) or during surgery. This may lead to loss of movement or feeling, or may affect the blood supply to the limb.

Rehabilitation typically begins after a few weeks of keeping the arm still by using a cast or brace. In many cases, a physical therapist will help with rehabilitation, beginning with gentle exercises to increase range of motion, and gradually adding exercises to strengthen the arm.

During your recovery you will likely lose muscle strength in the injured area. Specific exercises will help you restore normal muscle strength, joint motion, and flexibility.

More severe fractures can take between three and six months to fully heal. Some fractures can take even longer, especially open or comminuted fractures.

The hospital may book regular physiotherapy appointments to help you maintain or regain muscle strength, movement and flexibility. This will include specific exercises to do before and after the cast is removed. It is important to follow the physiotherapist's advice to avoid delaying your recovery.

The pain of the injury usually stops before the bone is fully healed so aim to gradually introduce regular activities, especially sports or manual labour.

You should not drive while in a cast. Seek advice from your doctor about when you can drive again.