CLAVICLE - Patients assume protective shoulder slump position. Treatment goal is aligning the shoulder by means of reduction and immobilization. Surgical intervention only when fracture is located in distal third space, or severly displaced. , HUMERAL NECK - Presents with moderate to severe shoulder pain, with the affected arm hanging limp at the side or supported by the uninjured hand. In significantly displaced fractures treatment consists of closed reduction with splinting, ORIF, hemiarthroplasty, and reverse shoulder arthroplasty., HUMERAL SHAFT - Patients present with considerable swelling and severe pain in the area of the fracture that may be referred to the shoulder or elbow. Shortening of the upper arm may indicate significant displacement. Treatment is functional bracing., ELBOW - Often very painful and may result in injury to the brachial artery or median nerves. Prompt reduction and stabilization is needed. If not displaced, it is immobilized in a posterior split for 2-3 weeks. Displaced includes ORIF, excision of bone fragments, and external support with a splint. Total elbow arthroplasty may be indicated in the presence of significant comminution., PROXIMAL RADIUS - Localized swelling over the lateral elbow, tenderness, and decreased motion, pain increases with passive rotation., WRIST - Colles fracture. Presents with deformity, swelling, weakness, and limited finger ROM. Possibly reports tingling in the affected hand, which may indicate injury to the median nerve, HIP - Pain over the outer thigh or in the groin and limited ROM. Significant discomfort with any attempt to flex or rotate the hip. Leg may be shortened, adducted, and externally rotated., FEMORAL SHAFT - Edematous, deformed, painful thigh, and cannot move the hip or knee., TIBIA & FIBULA - Presents with severe pain, deformity, or instability of the leg, obvious hematoma, swelling, and inability to walk or bear weight on the leg., RIBS - Main goal is to control pain and decrease chest wall splinting and subsequent atelectasis. Nurses may splint the chest with their hands, or educate the patient on the use of a pillow. Chest binders to immobilize the rib fracture, are not used, because decreased chest expansion may result in atelectasis and pneumonia., THORACIC CAGE - A spinal brace or plastic thoraco-lumbar-sacral orthosis is applied for support during progressive ambulation. Bed rest, with the use of a special turning device or bed to maintain spinal alignment. Within 24 hours of the fracture, open reduction, decompression, and fixation with spinal fusion and instrument stabilization are usually accomplished. Nurses must monitor neurologic status closely.,

FRACTURE MANIFESTATIONS, TREATMENTS.

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