Clinical manifestation : Fractures

Clinical manifestation

  • Localized pain
  • Decreased function
  • Inability to bear weight or use
  • Guard against movement
  • May or may not have deformity
  • Immobilize if suspected fracture

Manifestation

Description

Significance

Edema and swelling

Disruption or penetration of skin or soft tissues by bone fragments, or bleeding into surrounding tissues

Unchecked bleeding and swelling in closed space can occlude blood vessels and damage nerves (e.g., increased risk of compartment syndrome).

Pain and Tenderness

Muscle spasm due to involuntary reflex action of muscle, direct tissue trauma, increased pressure on nerves, movement of fracture fragments.

Pain and tenderness encourage the patient to splint muscle around fracture and reduce motion of injured area.

Muscle Spasm

Irritation of tissues and protective response to injury and fracture.

Muscle spasms may displace nondisplaced fracture or prevent it from reducing spontaneously

Deformity

Abnormal position of extremity or part as result of original forces of injury and action of muscles pulling fragment into abnormal position. Seen as a loss of normal bony contours.

Deformity is cardinal sign of fracture. If uncorrected, it may result in problems with bony union and restoration of function of injured part.

Contusion

Discoloration of skin (bruising) as a result of extravasation of blood in subcutaneous tissues.

Bruising may appear immediately after injury and may appear distal to injury. Reassure patient that process is normal and discoloration will eventually resolve.

Loss of Function

Disruption of bone or joint, preventing functional use of limb or part.

Fracture must be managed properly to ensure restoration of function to limb or part

Crepitation

Grating or crunching of bony fragments, producing palpable or audible crunching or popping sensation

Crepitation may increase chance for nonunion if bone ends are allowed to move excessively

Micromovement of fragments (postfracture) assists in osteogenesis (new bone growth).