1. fractures

2. Causes a fracture
Fractures occur when there is more force applied to the bone than the bone can absorb. Bones are weakest when they are twisted. Breaks in bones can occur from falls, trauma, or as a result of a direct blow to the body. A child's bone differs from adult bone in a variety of ways:
A child's bone heals much faster than an adult's bone. The younger the child, the faster the healing occurs.
Bones are softer in children and tend to bend rather than completely break.

3. Symptoms of Fractures
The list of symptoms mentioned in various sources for Fractures includes:
Pain in the injured area
Local Bleeding
Local Swelling and discoloration of the skin
Deformity or dislocation
Symptoms of associated nerve damage:
Numbness
Paralysis

4. Loss of pulse below fracture
Difficulty using or moving the injured area in a normal manner
Warmth, bruising, or redness in the injured area
In fracture of long bones, there is actually shortening of the extremity because of the contraction of the muscle that is attached above and below the site of the fracture.

5. Diagnostic Tests for Fractures
Physical examination and symptoms of the patient
X-rays
Computed tomography scan (CT scan.)

6. Complications list for Fractures:
Bleeding
Hemorrhage
Shock : Hypovolemic or traumatic shock, resulting from hemorrhage
Death
Embolism
Circulatory problems
Neurovascular compromise
Skin breakdown
Diminished muscle function

7. Treatments for Fractures
Treatment may include:
Splint/cast - immobilizes the injured area to promote bone alignment and healing to protect the injured area from motion or use.
Medication (for pain control)
Traction - the application of a force to stretch certain parts of the body in a specific direction. Traction consists of weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone to allow the bone ends to align and heal.

8. Surgery - required putting certain types of broken bones back into place. Occasionally, internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place to allow alignment and healing.

9. Casts

10. Casts
It is applied to maintain the reduced fracture in proper alignment. It is made of Plaster of Paris “POP” or synthetic materials.
Casts are used to keep an injured part of the body from moving so it can heal. A cast can be made of plaster or fiberglass.. The cast feels hard 10 to 15 minutes after it is applied. However, it takes 24 hours to dry completely, so be careful with it for the first day, while it still can easily crack. Casted extremities need to be observed frequently during the drying process.

11. “FOUR Ps” Remember to check the pulse distal to the cast Pain Pallor
Paresthesia

12. “When casting material inhibits palpation of peripheral pulse, assess for edema, comfort level, and other parameters of “CMS” Circulation, Motion, sensation, as an indication of neurovascular status.
Casted extremity should be assessed every ½ hour for 2 hours, then every hour for 24 hours, then every 4 hours for 48 hours.

13. CAST CARE TIPS
1. Swelling due to the injury may cause pressure in the splint or cast for the first 48 to 72 hours. This may cause the injured arm or leg to feel snug or tight in the splint or cast. To reduce the swelling:
Elevate the injured arm or leg above the heart by propping it up on pillows or some other support.
Exercise the fingers or toes to decrease swelling and prevent stiffness and to increase circulation.

14. Apply ice to the splint or cast
Apply ice to the splint or cast. Place the ice in a dry plastic bag or ice pack and loosely wrap it around the splint or cast at the level of the injury.

15. 4. File down any rough spots with an emery board.
5. To ease any discomfort from itching, you may blow cool air inside the cast with a hair dryer.
6. Check circulation by pressing on the nail bed. The nail should turn pale when pressed, but normal color should return immediately when the pressure on the nail is removed. If this does not happen, contact your physician.

16. Warning signs following splint or cast application.
After application of a splint or cast, it is very important to elevate the injured arm or leg for 24 to 72 hours.
Inform the patient if any of the following warning signs were experienced, immediately informed the nurse:-
Increased pain and swelling which is not controlled with ice, elevation, and/or pain medication.
A feeling that the splint or cast is too tight.
Numbness and tingling in the hand or foot.

17. Burning and stinging.
Excessive swelling below the cast.
Loss of active movement of toes or fingers, which requires an urgent evaluation by the doctor.