4 to 6 weeks after fracture and can continue for up to 1 year, depending on the
severity of the injury and the age and health of the patient.
13. Fractures, Traction and Bone Healing
Identify care for pincare (p.1042)
Pay particular attention to the pin sites for signs of inflammation or infection.
In the first 48 to 72 hours, clear fluid drainage or weeping is expected.
Although no standardized method or evidence-based protocol for pin-site care
has been established, recommendations have been made based on the
evidence available regarding pin-site care.
Because the pins go through the skin and into bone, the risk for infection is
high. Monitor the pin sites at least every 8 to 12 hours for drainage, color,
odor, and severe redness, which indicate inflammation and possible infection.
Follow agency policy for how to clean the pin-site areas.
Complications of surgery for fractures (p.1042)
Patients with open-reduction with external fixation are at greater risk for
infection related to the pin sites.
Proper hand hygiene and strict infection
control practices are used to prevent infections or osteomyelitis. Educate
patients on antibiotic medication adherence.
When infected, what actions are taken?
Identify the difference between compartment syndrome and poor circulation (p.1033)
Acute compartment syndrome (ACS) is a serious, limb-threatening condition
in which increased pressure within one or more compartments reduces
circulation to the area. The most common sites for this problem in patients
with musculoskeletal trauma are the compartments in the lower leg (tibial
fractures) and forearm
Related to the muscle, blood vessels and nerves are caught within the fascia
leading to the increase in the venous pressure and the resulting edema.
The edema leads to increasing pain which is unrelieved by pain medication.
The edema continues to increase and leads to tissue necrosis and possible
If unrelieved could lead to amputation distal to the compartment syndrome.
May appear 6 – 8 hours following an injury or can take up to 2 days to appear.