Matters needing attention in small splint fixation after fracture;

1. Pay attention to blood circulation of limbs: If one of the following conditions (1) indicates poor blood circulation of limbs (2) numbness of hands and feet, slow acupuncture response (3) limited movement of fingers or toes of injured limbs (5) pale or blue hands and feet (6) frostbite and cold limbs, you should immediately report to a doctor for treatment.

2. Don't loosen the small splint without permission to avoid fracture displacement or fracture refolding.

3. Spray (infiltrate) about 30 ~ 50 ml of yellow water on the outside of the splint once a day. Don't spray more, so as not to make your skin swollen.

4. Prevent the fracture from shifting again, protect the injured limb, and prevent the fracture from shifting again due to external force collision or other reasons.

5. Functional exercise: After fracture reduction, you can do functional exercises of the affected limb, such as clenching fist, muscle contraction and relaxation, joint flexion and extension, etc. And cooperate with various physical therapies to promote swelling disappearance and fracture healing.

2. Data of small splint fixation after fracture

Commonly used external fixation methods include small splint, plaster bandage, bracket, continuous traction and needle-piercing external fixator.

Small splint fixation is often used for fractures of humerus, ulna and radius, tibia and fibula, distal radius and ankle joint. For some intra-articular fractures, near-articular fractures and femoral fractures, it is not suitable for small clamp fixation.

Gypsum bandage is often used for external fixation after bone and joint injury and bone and joint surgery.

For severe shoulder and elbow injuries, and after some upper limb orthopedic operations, abduction should be used for fixation.

Continuous traction can be divided into manual traction, skin traction and bone traction. Manual traction is mostly suitable for the reduction of fracture displacement and joint dislocation, and the traction of skin traction is small, which is suitable for traction treatment of femoral fracture in children, traction of unstable fracture of humerus, auxiliary traction after operation of adult lower limb fracture and auxiliary traction of lower limb bone traction. If you need more traction and longer traction time, you can choose bone traction, which can be divided into different parts according to different indications.

(1) Olecranon traction: It is suitable for those with severe displacement and local swelling of comminuted fractures of humeral neck, humeral shaft, supracondyle and intercondylar, and those with old dislocation of shoulder joint, and will be manually reduced.

(2) Distal radioulnar traction: it is suitable for open radioulnar fracture and old posterior dislocation of elbow joint.

(3) Supracondylar traction of femur: it is suitable for displaced femoral fracture, displaced pelvic ring fracture, central dislocation of hip joint and old posterior dislocation of hip joint.

(4) Tibial tubercle traction: The indications are the same as (3).

(5) Distal tibiofibular traction: It is suitable for open tibiofibular fracture or knee joint fracture, but not for tibial tubercle traction.

(6) Calcaneal traction: it is suitable for the early treatment of unstable fracture of tibia and fibula, partial calcaneal fracture and mild contracture deformity of hip and knee joint.

(7) Proximal metatarsal traction 1-4: This technique is often combined with calcaneal traction needle to install external fixator for traction or fixation to treat wedge-shaped and navicular compression fractures.

(8) Cranial traction: it is suitable for cervical fracture and dislocation, especially for fracture and dislocation with spinal cord injury.

(9) Head-ring traction: it is suitable for the reduction of spinal fracture or dislocation.

In addition, there are some methods of traction with traction belt:

(1) Occipital-jaw traction: it is suitable for mild cervical fracture or dislocation, cervical disc herniation and cervical spondylotic radiculopathy.

(2) Pelvic traction: suitable for lumbar disc herniation.

(3) Pelvic sling traction: it is suitable for separating pelvic fractures with obvious displacement or pelvic ring fractures with upward displacement and separation displacement.

(4) Thoracolumbar suspension traction technology: it is suitable for thoracolumbar compression fractures.

For open fracture or infectious fracture, nonunion, limb lengthening, multi-segment fracture of femur or tibia, unstable comminuted fracture and joint fusion, external fixator with external bone nail can be applied.

3. What are the nursing observation points of small splint fixation?

Nursing observation point of small splint fixation: 1.

Anxiety: Evaluate the degree of anxiety, explain the purpose of using splint, and explain the discomfort that may occur after using splint, such as severe anxiety. You can consider medication to understand the patient's feelings. 2。

Before and after splint fixation, the vascular and neurological functions were evaluated and bedside displacement was made. Vascular and neurological functions were evaluated and recorded in each shift. Check the tightness of splint in each shift, such as pain, swelling, skin temperature, skin color, abnormal sensation, decreased pulse and motor dysfunction, and adjust it in time. Generally speaking, moving lcm up and down on the splint with two fingers can raise the limbs. 3。

Pain: Evaluate the cause, frequency, nature and change of pain, use painkillers when necessary and observe the curative effect. Instruct patients to relax, observe the curative effect of splint fixation, and instruct patients to report the pain that cannot be relieved or aggravated in time.

4。 Danger of skin integrity damage: evaluate the patient's skin condition before splint fixation, check the splint tightness in each shift, adjust and pay attention to the patient's chief complaint in time, and loosen the splint in time.

4. What should I pay attention to after plaster or splint fixation?

What should I pay attention to after plaster or splint fixation?

(1) After external fixation with splint or plaster, the affected limb should be raised about 30 degrees to facilitate blood return and swelling of the affected limb, and the affected limb can be raised with a bracket or pillow;

(2) Closely observe the blood supply, sensory and motor functions of the affected limb, especially within 1-4 days after reduction, and pay attention to the pulsation, swelling degree, temperature, color vision and active activity of the artery at the end of the affected limb. If there are symptoms such as swelling of extremity, cold and pale skin, hypoesthesia, etc., external fixation should be lifted in time and re-examined in hospital to prevent complications such as ischemic contracture of extremity;

(3) Pay attention to whether there is a fixed pain point. If there is fixation pain outside the limb splint or at both ends of the small splint, the splint should be disassembled in time to avoid compressive ulcer or neurovascular injury;

(4) The injured limbs should be kept warm in cold season. Pay attention to ventilation in hot season, keep splint and plaster clean, especially children should avoid pollution such as wet urine and stool.

5. What are the nursing points of external fixator?

The nursing point of external fixator is (1) to publicize the treatment principle, purpose, method and matters needing attention of external fixator to patients, so that patients can have a certain understanding and cooperate with the treatment.

(2) According to the patient's condition, select appropriate large, medium and small extra fixators, and carry out strict disinfection and sterilization. (3) Strict aseptic operation should be carried out during reduction and fixation, the skin needle should be covered with alcohol gauze and bandaged with sterile gauze, and the stent should be properly fixed with bandage after operation.

Always keep the needle eye clean and dry, report to the doctor in time if there is blood leakage or liquid leakage, and use antibiotics reasonably to prevent infection. (4) After the external fixing bracket is fixed firmly, prop up the quilt with a special bracket.

When the patient must be moved, hold the upper and lower ends of the fracture with both hands to keep it stable, so as to avoid pulling, bumping and bumping the bracket by mistake, which will affect the fixation effect. (5) If there is obvious discomfort accompanied by pain and numbness during the use of the external fixator, the reasons should be clarified in time and adjusted according to the symptoms.

(6) Instruct patients with correct functional exercise methods. (7) Check the X-ray film regularly to understand the fixation effect.

6. What are the methods and indications of small splint fixation after fracture?

After the fracture, it can be fixed with small splints such as wood, bamboo or fir bark.

When fixing the fracture, some cotton things should be put between the small splint and the skin, and it is best to fix it on the small splint with bandages or cloth strips to prevent damage to the skin. The fixation range of this method is smaller than that of plaster bandage, but it can effectively prevent the fracture end from shifting. Because the upper and lower joints of the fracture are not included, it is convenient to carry out functional exercise in time and prevent complications such as joint stiffness. It has the advantages of reliability, fast fracture healing, good functional recovery and low treatment cost.

The indications of small splint fixation after fracture are: ◆ Closed tubular fracture of limbs. ◆ Open fracture of limbs with small wound surface, which has healed after treatment.

◆ Old fractures of limbs are suitable for manual location.

7. What are the complications of external fixation with small splint that need to be prevented?

Complications that need to be prevented by small splint external fixation are: (1) Osteofascial compartment syndrome: it is the easiest and most serious complication.

Because the dressing was too tight, it was not observed carefully in time; Poor fracture reduction, vascular compression failed to be relieved in time; Severe local injury or incorrect reduction; Failure to provide health education to patients and their families leads to tissue ischemia and necrosis. (2) Compression ulcer: Attention should be paid to the patient's chief complaint, so as to avoid the local skin or tissue necrosis and ulcer of limbs for a long time due to the primary causes such as burr grinding, skin squeezing or over-tightening.

(3) Fracture end displacement: It may be caused by loose splint fixation, improper limb placement, incorrect functional exercise, premature splint removal, etc. It is necessary to do a good job in patient education, reasonably guide functional exercise in strict accordance with the progress of fracture healing, and make timely follow-up visits.