Complications of Fractures
Compartment can be prevented by:
- Controlling edema, which is achieved by elevating the injured extremity to heart level and applying ice after injury as prescribed.
- Restrictive dressings must be loosened
- Fasciotomy – needed when conservative measures do not restore tissue perfusion and does not provide relief for pain.
Post Fasciotomy – Nursing Interventions:
- Leave the wound open and cover it with moist sterile saline dressings. Wound suturing is not done in compartment syndrome.
- A splint is placed on the limp to promote a functional position.
- Passive range of motion (ROM) exercises prescribed every 4 to 6 hours
- In 3 to 5 days when edema has resolved and tissue perfusion has been restored the wound is debrided and closed
Infection is one of the most common complications of fracture. This is noted in open fractures in which the wound is contaminated by organisms from outside the body. Simple treatment is required for superficial wound infection. However, when the infection reaches the bone osteomyelitis may occur. if left untreated, necrosis of bone tissue might occur leading to bone death.
- Regular wound dressing
- Removing or shaving off infected parts of the bone
DISSEMENATED INTRAVASCULAR COAGULATION (DIC)
DIC includes a group of bleeding disorders with diverse causes, including massive trauma of the tissue. This is a condition where blood clots are continuously formed throughout the body’s small blood vessels. DIC is an acquired disease of blood clotting and it results from massive trauma or similar underlying stimulus. Excessive amount of blood clots in the body can reduce or block flow of the blood vessels. This, in return can damage body organs.
Clinical Manifestations of DIC include:
- Uncontrolled bleeding from puncture sites of IVT or injections
- Bleeding is noted on multiple sites of the body
- Decrease in blood pressure
- Pale, cyanotic and mottled fingers and toes
- IV administration of heparin.
- Blood transfusion (for blood loss)
- Treat underlying disease condition
The delayed complications of fractures are the following:
- Delayed union and nonunion
- Avascular necrosis of bone
- Reaction to internal fixation devices