1. Orthopedic Injuries
Fractures and Dislocations

2. State Standards
24) Research and evaluate National Trauma Triage Protocol. Identify and perform skills to
manage life threatening injuries based on assessment findings of a patient with trauma
emergencies, utilizing rubrics from textbooks, National HOSA guidelines, or clinical
standards of practice in the following areas:
a. Internal and external bleeding
b. Chest trauma such as sucking chest wound and impaled objects in chest
c. Abdominal trauma such eviscerations and impaled objects
d. Orthopedic trauma such as fractures, dislocations, amputations
e. Soft tissue trauma, burns, dressings, and bandages
f. Head, facial, neck and spine trauma such as head injuries, scalp injuries, and injuries to spine
g. Environmental emergencies such as submersion and exposure to heat and cold
h. Multi-system trauma

3. Objectives
Students will identify signs and symptoms of fractures and dislocations.
Students will describe the location of fractures through applying knowledge of the different bones.
Students will demonstrate knowledge of the different types of fractures through a diagnostic lab activity.

4. Common Signs and Symptoms of a Fracture or Dislocation
Pain
Swelling
Deformity (bent or longer)
Discoloration
Loss of function in the extremity
Audible “pop” or “snap”

5. Discussion
With a partner discuss…. What happens to the tissues surrounding a fracture? Applying what you know about homeostasis, what body systems have the potential to be impacted by this type of injury?

6. Dislocation Vs. Fracture
Ligament- short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint
Fracture- Traumatic bone injury in which the bone tissue becomes damaged or completely severed.
Dislocation-displacement of the bone out of its socket resulting in tearing or stretching of ligaments.
Sprain- injury to a joint caused by sudden motion, causing the ligaments to tear. The joint is not dislocated.

7. Discussion Discuss with a partner….
Applying the definitions you just learned, determine the type of injury in the scenario.
Rachel fell from a tree and has injured her arm. She heard a pop in her arm when she landed and the arm appears longer than her other arm.

8. Open vs. Closed Fracture
Closed Fracture- the bone is broken but the bone ends do not pierce through the skin
Open Fracture- most serious type of fracture, the bone ends pierce through the skin.
Discussion: Applying what you know about homeostasis and the protection measures of the body, why would an open fracture be the most dangerous? What might be impacted with this type of injury?

9. Comminuted Fracture Bone Injuries 3 or more fragments of bone
Hard, direct blow
Fall in awkward position
Often seen in the elderly

10. Depressed Fracture Bone Injuries Often occurs in flat bones
Falling on hard, immovable surface
Hit with a hard object
Discussion: Applying what we learned about bone anatomy, which bones are considered flat bones?

11. Transverse Fracture

12. Bone Injuries Greenstick (Fissure) Fracture
The bone bends much like a green tree branch.
Occurs in immature bone that has not completely ossified
Discussion: Applying what you learned about the make up of bone, what type of bone tissue would be present when the bone has not completely ossified. Ex. A child

13. Bone Injuries Impacted Fracture Bone is compressed
Fall from a height
Immediate splinting and traction are required
Discussion: Applying what you just learned about an impacted fracture and what you know about how a dislocation looks, what will an extremity with an impacted fracture look like?

14. Longitudinal Fracture
Bone Injuries
Longitudinal Fracture
Bone splits along its length
Jumping from a height

15. Oblique Fracture Bone Injuries Twisting injury
Twisting on end of the bone while the other end is stabilized
Longitudinal and oblique fractures usually occur in the long bones.
Discussion: Applying what you learned about how longitudinal and oblique are caused, what long bones do you think are most effected?

16. Types of Fractures Spiral Fracture S-shaped separation of bone
Ex. Foot is firmly planted and the body is rotated in the opposite direction

17. Avulsion
 injury to the bone in which part of the bone is pulled off by an attaching tissue.
Discussion: Applying what you know about the tissues that attach to bone, which one, ligament or tendon, would cause an Avulsion? 

18. Fissure or hairline fracture
An incomplete bone fracture; multiple small lines are often visible, but do not pass through the entire bone.

19. Activity With a partner complete the identifying x-rays activity.
Read the information at the top of the activity that discusses fractures, dislocations, and x- rays.
Complete the questions that go along with each x-ray example.
Complete the questions at the end of the activity individually.