Chapter 21: Orthopedic Surgery; Short Answer: Closed Reduction

List the three types of traction. What is the purpose of traction?

1) Manual 2) Skin 3) Skeletal (most common) Purpose: Used to immobilize a joint, reduce a fracture, and align a body part.

As you set up the room for a closed reduction, you lay out the items to be used in order. Put the steps of a closed reduction in order. (1-8)

1) Prepare a bucket of lukewarm water 2) Use scissors to prepare the stockinette of appropriate length 3) Pass the Webril (cotton)/plaster or Dacron/fiberglass (open 2 to 3 inches; open end down) 4) Drop the plaster or fiberglass vertically 5) Wait for all bubbles to cease; compress to remove excess water 6) Pass plaster roll or fiberglass (open 2 to 3 inches; end down) 7) Elevate on pillow using flat of hand 8) Air dry or use the cast drier/plaster or cold cream/ultraviolet light/fiberglass

Following closed reduction, what method of immobilization is commonly used?

A cast or splint is the most commonly used method to maintain anatomic position.

As Susie fell when she was pushed, she fell onto her outstretched hand, fracturing the distal radius; this is called a(n) _______ fracture.

Colles'

If a fracture has more than two pieces, it usually occurs due to a direct crushing force and is called a(n) ______ fracture.

Comminuted (segmental)

What complication can occur if the cast is placed too tight?

Compartmental syndrome and intracompartmental bleeding can occur.

A complete fracture that penetrates the skin is a(n) _______ or ______ fracture.

Compound; Open

What complication can occur from excessive weights on the traction or inadequate immobilization with casting?

Delayed union can occur.

The patient slides off the roof, compressing the ends of the tibia into each other, creating a(n) ________ fracture.

Impacted

A(n) _____ fracture is caused by disease such as osteoporosis or bone cancer.

Pathological

A partial fracture that has not broken the skin would be called a(n) _____ _____ or ______ fracture. If this occurred in a pediatric patient, it would be termed a(n) ______ fracture.

Simple incomplete; Partial; Greenstick

Describe how skeletal traction is applied.

Skeletal traction is a sterile procedure. Includes #15 knife blade, hand or power drill, Steinman pins, traction bow, and pin cutter. Traction frames are placed on the patient's postoperative bed and weights are used to apply the traction.