Complications of Fractures
Fracture is a break in the continuity of the bone. A break in the bone occurs when it cannot withstand outside forces that takes place such as direct blows, twisting injuries or falls. Descriptions of what fracture is based on the following:
- The location where the break in the bone occurred.
- How the bone fragments are aligned
- Presence of complications
Complications of fracture could either be early or delayed. The early complications of fracture are the following:
- Fat embolism
- Compartment syndrome
- Disseminated intravascular coagulation (DIC)
Shock results from the loss of blood when there is fracture. The bleeding could either be external or not visible. Also, shock results from the loss of extracellular fluid into the damaged tissues that occurs when there is fracture. Large quantities of blood are lost in fracture as bone is a vascular structure especially those in femur and pelvis.
- Restoration of blood volume
- Relieving patient’s pain
- Providing adequate splinting
- Protecting the client from further injury
FAT EMBOLISM SYNDROME
Fat emboli may develop after fracture of long bones or pelvis, multiple fractures or crush injuries occur in a young male adult about 2- to 30 years of age. Presence of fracture causes the fat globules to move into the blood because of the higher pressure in the marrow than those in the capillaries. Aside from that, catecholamines are increased when fracture occurs as the body’s reaction mobilize fatty acids and promote fat development in the bloodstream. Once these fat globule combine with platelets, an embolus is formed. Presence of embolus could block the small blood vessels that are supplying blood to the brain, lungs, kidneys, liver and other organs.
The clinical manifestations of fat embolism syndrome are the following:
- Cerebral disturbances: mental status change, mild agitation and confusion to delirium and coma
- Respiratory response: tachypnea, dyspnea, crackles, wheezes, large amounts of thick white sputum, tachycardia
- Blood gases: PO2: below 60 mmHg, respiratory alkalosis (early), respiratory acidosis (later)
- Typical snow storm infiltrate exhibited by Chest X-ray
- Pale (Systemic embolization)
- Petechiae in the buccal membranes and conjunctival sacs, hard palate, fundus of the eye and over the chest and anterior axillary folds (Systemic embolization)
- Kidney failure