Principles of management
Early treatment (neurovascular problems)
The
principle of management of fractures is to deal with life-and limb-saving
problems first. This means paying attention to ABC (airway, breathing and
circulation) and to the neurovascular status of the limb before dealing with
the fracture itself. If there is vascular compromise and the limb is distorted,
it is always worth straightening the limb as far as possible in case it is
simply the pressure of the displaced bone which is causing the problem.
Reduction of fractures and dislocations
Some
fractures may not need reduction, especially if the minimal malunion which
results will cause no cosmetic or
Holding
a fracture
Once
a fracture has been reduced it needs
to be held until it has united (the bone ends have joined together).
Rehabilitation
Once
the fracture is stabilised, the patient may need help with rehabilitation so that they can return to as full and as independent
a life as possible (Table 21.3).