Different Types of Bone Fractures (Nursing)

00:01 Now let's talk about spine fractures.

00:03 Remember we asked you earlier on? What does osteoporosis have to do with back pain? Remember older Mandy she was... doing that? Well, take a look at the spine of our character on the one end of the screen.

00:17 She's standing very erect.

00:19 And then you can see as she ages as her hair gets grayer, and grayer, and grayer.

00:23 Look what happens to her spine.

00:25 Now, osteoporosis can cause spine fractures.

00:29 They're also called vertebral compression fractures.

00:33 Look at that spine and how they've drawn them for you.

00:35 It's beautiful, how they've drawn this out for you.

00:39 Instead of being erect, you see how the pressure is distributed differently on that spine, as the person ages.

00:46 This can cause severe back pain.

00:48 It also makes it very hard for the client to stand, walk, sit, or lift objects.

00:55 Okay, so think about this.

00:57 You start out with no problems at all, as a younger person.

01:00 And as you age, if osteoporosis develops in your spine, this is part of what you're going to see.

01:06 And those vertebral compression fractures are happening because the bones have been more fragile, right? They're not as thick, they're not as strong.

01:14 And that's why they're having these compression fractures.

01:17 Now, if it progresses, and it becomes severe, you end up shorter.

01:22 Now, this may not seem alarming to you, but I'm only 5'2.

01:25 I do not have much crown to lose here.

01:28 So that's why as women age or men age, and they have that experience, see how she is in the very end.

01:35 You're going to lose height and kind of look hunched.

01:38 You may have even seen someone who they can kind of almost have a hard time turning to talk to you.

01:44 That's what's going on.

01:45 So I'm not asking you to necessarily go up and ask someone, "Excuse me, ma'am, or sir, do you have verticular compression fractures?" But I want you to be aware when you're out in the public.

01:55 And you notice this in someone recognize the cause.

02:00 Now, let's take a closer look at that.

02:02 We talked about osteoporosis can cause these fractures.

02:05 But I want you to see up, close, and personal.

02:08 How you went from the younger person who could stand erect without pain, to the older person who's hunched over.

02:14 Because take a look at that vertebra.

02:16 Man, the artist has done an incredible job giving you a visual of what that looks like.

02:21 See, this is what osteoporosis can do to the vertebrae.

02:24 It causes them to weaken, to the point that they kind of crumble and collapse.

02:28 So look at that second vertebra, the one in the middle.

02:32 See that darkened spot? That's what we're representing there.

02:35 Because of the osteoporosis, the bone becoming more porous, it's weak, it's starting to crumble there and it will collapse.

02:44 And that's when you end up with that posture is it progresses to a severe level where someone will be shorter, and hunched over, and in pain.

02:53 This is what we mean when we say a compression fracture.

02:57 When it happens in the spine is considered a vertebral compression fracture.

03:02 Okay, now we talked about the first example, which was vertebral compression fractures.

03:08 Now, we're going to look at one that I think is absolutely the scariest, right.

03:12 It's a hip fracture. So look at what you have there.

03:16 Right. That's a pelvis without the rest of the person.

03:19 We're just looking at their pelvis, and we're looking where their femur bones connect in that capsule.

03:25 And this is how we walk, right, because we have the ability to do that.

03:29 Now, with osteoporosis, we know we have decreased bone thickness and strength.

03:35 So we have an increased risk of fractures.

03:38 Neither of those are good news for us.

03:41 But we've placed lines there to represent common places when a patient has a hip fracture that they occur.

03:48 So we're going to look on the patient's right side and on the patient's left side.

03:53 So orient yourself, which side of this drawing would be the patient's right side? Good. Hopefully you picked this side.

04:01 Now, let's take a look at the names of these.

04:04 Now, there's the capsule.

04:06 so we're going to highlight the capsule for you there.

04:09 So you know what we're talking about.

04:10 That's right where it sits in there.

04:13 The bone sits in that socket or in that capsule, and then we are allowed to move it and that's what allows us to have mobility or to walk.

04:22 Now, that first fracture, it's nondisplaced.

04:26 That means the bones are still kind of together, but you've got a fracture.

04:30 So nondisplaced extracapsular.

04:34 That means that it's outside of the capsule.

04:37 Trochanteric, that's referring to the bone, the trochanter fracture.

04:41 Now, why are we spending this much time talking about specific fractures? Well, when you're reading, X-ray reports, reports from the radiologist.

04:50 When you're caring for a patient, when you're doing a history and assessment of a patient.

04:56 It matters that you understand and you can visualize where this fracture is.

05:01 So if you're slow down nondisplaced extracapsular trochanteric fracture, that will make sense to you, you have a visual of what needs to be fixed for this patient.

05:13 Now, let's go to the another one on the patient's right side.

05:17 It's nondisplaced, just like the other.

05:19 So it's, got a fracture, but it's not separated, still together.

05:24 It's extracapsular.

05:26 Okay, so it's outside of the capsule.

05:29 Sub meaning below trochantric fracture.

05:33 Okay, so the trochantric pressure.

05:35 That's a mouthful, isn't it? The trochantric fracture, you see where it is on the right side on the top.

05:42 it's right there on the? Trochanter. Right.

05:45 But below the trochanter we call it a subtrochantric.

05:49 So this helps physicians, nurses, physical therapists, the whole healthcare team work together when we all speak the same language.

06:00 So we're talking about two of the most common fractures, We talked about vertebral compression fractures.

06:06 Now we're talking about hip fractures.

06:08 And we're giving you three examples of the hip fracture.

06:11 So we've got one up here, that's extracapsular.

06:14 But on the trochanter.

06:16 We've got one down here, that is below the trochanter.

06:21 Neither one of those are displaced.

06:23 Now, let's look at the patient's left side. Okay.

06:28 It's nondisplaced, intracapsular hip fracture.

06:33 Now we think about orthopedic surgeons, they do incredible stuff.

06:37 In fact, I can take a lot of things.

06:40 But the power tools that are often involved in orthopedic surgery is almost more than my stomach can take when you watch one of these.

06:49 But they're gonna have to look at this, like an engineer, like a builder.

06:53 How do they fix either any of these breaks, and give the patient's stability, right? Because we've got some challenges here.

07:03 We need that trochanter to be firmly in that capsule, right? And we needed to be able to move freely.

07:10 And we also need that bone to be strong.

07:13 Now they're going to have different strategies based on where it is.

07:17 But I'm going to talk about some other challenges.

07:20 So I want you to picture your favorite old person.

07:24 And I want them to be really advanced in age.

07:27 But picture someone you really care about.

07:30 Now, they've taken a fall. Sorry about that.

07:32 I know it's a little skid than that.

07:34 But they've taken a fault, they've broken a hip.

07:37 I want you to think through what they're going to experience.

07:42 Hip fractures can be extremely painful, first of all.

07:46 So we've got some challenges, and then we have to think about repairing it.

07:50 So in just a moment, we're going to talk about one of the types of surgical procedures that are done to repair hip fracture.