How should fracture patients be cared for?

Some fracture patients need hospitalization surgery, and some can go home for rest after outpatient reduction, plaster fixation or other treatment. The process of fracture healing is slow, and it usually takes 6 ~ 8 weeks to reach the clinical healing stage. Old people are long, and most of them need bed rest, so family care is extremely important.

(1) First of all, it is necessary to relieve the worries of patients after fracture and relieve their psychological pressure. Most patients have complex psychology after fracture, which can make them eat badly and sleep badly, not to mention functional exercise with treatment. Nurses must patiently and kindly persuade and encourage, indicating that only by actively cooperating with treatment and nursing can they restore their functions as soon as possible and alleviate their pain.

(2) After fracture, the appetite and digestive function are often affected by braking posture and pain, and it is inconvenient to urinate and defecate, which makes patients reluctant to drink more water and eat. Family members should be patient, adjust fancy varieties according to patients' eating habits and hobbies, and eat more digestible and nutritious foods, such as bean products, meat, fish and eggs, fruits and vegetables, so as to enhance the healing power of fracture wounds. It is also necessary to eat cellulose foods properly to facilitate defecation. Patients with upper limb fracture need nursing, feeding and drinking water.

(3) Patients who have been bedridden for a long time due to fractures often worry about defecation. One is afraid of difficulty in defecation, and the other is afraid that eating too much, defecating too much and urinating too much will increase others' troubles. Nurses should take the initiative to care, ask questions frequently, see how to deal with them frequently, and assist in defecation in bed. Female patients should clean perineum and anus after defecation. Encourage patients to drink plenty of water to prevent urinary tract infection and urinary calculi. If defecation is difficult, do abdominal massage every day and take laxatives, such as paraffin oil or Maren Pills.

(4) In order to make bedridden patients feel comfortable and happy, "three shortcomings" and "three cleanness" should be achieved. "Three short" means short hair, short beard and short toenails. "Sanjie" means the cleaning of head, feet and perineum, the cleaning of oral skin and the cleaning of bed. To this end, children should be regularly washed, washed, bathed, manicured, shaved and changed in time. Bedridden patients should do deep breathing exercises every day, pat their backs regularly to help cough up phlegm, keep warm, and prevent eating, choking and swallowing trachea by mistake. Under the premise of ensuring the fixation of fracture site, they should change their body position as planned and massage the long-term stressed skin, which is beneficial to prevent bedsores and pneumonia.

(5) Always pay attention to the correct posture of the patient in bed. For example, patients with lumbar fracture should take supine position for lumbar hyperextension, and pillows can be placed at the waist of hard bed. Always check the condition of the affected limb, such as whether the skin of the affected limb fixed with plaster or splint is compressed, whether the color and temperature of the toe end have changed, and whether the plaster is too loose or too tight. If there is any abnormality, it should be handled properly in time.

Generally, the affected limb can be raised with pillows or bedding, which is better than the level of the heart, but the principle of not shifting the right bone is conducive to swelling and blood return. Keep the plaster inside clean. If the patient feels itchy skin in the plaster, he can put the blunt needle into it and gently move it up and down to relieve itching (not for those with wounds). For patients with lower limb femoral fracture, the ankle joint of the affected limb should be kept at 90 flexion to prevent foot drop. In order to prevent the limbs from external rotation and adduction, a horizontal lath can be nailed to the sole to maintain effective traction.

(6) Fracture healing needs definite fixation after reduction, which is contradictory to functional exercise. To deal with this contradiction, it is mainly to carry out functional exercise correctly, step by step, from less to more, from light to heavy, and gradually increase, so as to avoid muscle atrophy or joint stiffness of the affected limb, promote blood circulation, and be conducive to fracture healing. Patients should be encouraged, guided and urged to carry out functional exercise at different stages.

65438+ 0 ~ 2 weeks after fracture: muscle contraction, upper limbs holding hands and lifting shoulders, lower limbs stretching and flexing ankle joints, toe joint movements and quadriceps femoris tightening and contraction movements (on the premise of joint inactivity) are mainly carried out. If you can't exercise because of pain, you can guide them to exercise their limbs first, and then exercise the affected limbs together.

3 ~ 6 weeks after fracture: In addition to continuing to exercise muscle contraction, you can start more joint activities, make fists in upper limbs, and then practice shoulder flexion and extension. Lower limbs can gradually practice stretching and bending of hips and knees, and try to lift legs. After four weeks, you can get out of bed with crutches and walk without touching the ground, but someone must hold it from the side to avoid falling down again.

6 ~ 8 weeks after fracture, the number of comprehensive exercises and range of activities can be increased.

(7) After the fracture is healed, remove the plaster or splint, and the skin wrapped with plaster for a long time will be dry and desquamate. After washing with soap and mild warm water, apply cold cream to protect the skin. If there is swelling, you can raise the affected limb or wear elastic socks during sleep to facilitate blood return and reduce edema. After rehabilitation, the affected limb should continue to exercise and strive to restore joint function, muscle strength and independent living ability as soon as possible.