Our Lady Of Fatima University

Degloving injury with complete open fracture on left middle maleous

A partial fulfillment for Orthopedic Affiliation

Submited By: Reygel G. Pineda Gift Moses Deiar Y. Pangilinan BSN 4y-2 Group H2

Submitted to: Ms. Jennifer A. Sales RN, MAN

INTRODUCTION

Degloving is An avulsion-type injury in which the skin and subcutaneous tissue of the hand are torn off in a glove-like fashion, leaving the muculofascial plane intact. an injury most commonly to an extremity or digit in which the skin and subcutaneous tissue are separated from the deeper tissue layers thereby depleting its blood supply and increasing the risk of tissue necrosis.

A fracture is a break in the continuity of bone. A fracture occurs when the stress placed on a bone is greater than the bone can absorb. The stress may be mechanical (trauma) or related to a disease process (pathologic). Muscles, blood vessels, nerves, tendons, joints, and body organs may be injured when fracture occurs. Complications of include problems associated with immobility (muscle atrophy, joint contracture, sores), growth problems (in children), infection, shock, venous stasis and thromboembolism , pulmonary emboli and fat emboli, and bone union problems. It is A break, especially the breaking of a bone or cartilage.

In psychosocial developmental theory of Eric Erickson He belongs to industry vs. inferiority where children develop a sense of competence by mastering new skills. In the psychosexual development theory of Sigmund Freud He belongs to latent period; The libido's energy is suppressed and children are focused on other activities such as school, friends and hobbies. In the theory of Robert Havighurst He belongs to middle childhood. He get along with age mates, physical skills necessary for ordinary games

Nursing assessment

Patients name: Lloyd Vincent D. Atienza Address: Dama De Noche St. Brgy Alas Asin Mariveles Bataan Age: 11 years old Birthday: august 04, 2004 Date admitted: march 04, 2012 Reason for hospitalization: hit by a truck Doctor in charge: DR. Lim Diagnosis: Degloving injury with complete open bone fracture on his left middle maleous

IV. PATHOPHYSIOLOGY

Separated Soft Tissues from deeper tissue layers (Degloving Injury)

Depleting blood supply

Rupture of the calf Pain

Dorsiflexion of the foot

Rupture of the tendo achilles

swelling brusing

inability to maintain a tiptoe position

Fracture of the neck of the talus Subtalar dislocation with ankle Dislocation of the calcaneum Total dislocation of the middle maleous

ILLUSTRATION

RECOMMENDATION

Philippine orthopedic center is one of the biggest hospitals in the Philippines in regards to orthopedic. I recommend POC for having a good service.

The Philippine Orthopedic Center is a government medical facility under the Department of Health, which is tasked to provide health care delivery to patients afflicted with musculoskeletal disorder and related conditions.

It was designed to serve as the center for trauma and orthopedics in the country. Being fully subsidized by the government both its services and facilities are available for free to the indigent segment of our community.

As a researcher in this case study, the student nurse recommends the patient to adjust in usual lifestyle and responsibilities to accommodate limitations imposed by fracture and to prevent recurrent fractures safety considerations, avoidance of fatigue and proper footwear. The patient is instructed about exercises to strengthening upper extremity muscles, If crutch walking is planned, methods of safe ambulation walker, crutches, care, emphasizes instructions concerning amount of weight bearing that will be permitted on fractured extremity, teaches symptoms needing attention, such as numbness, decreased

function, increased pain and elevated temperature and explains basis for fracture treatment and need for patient participation in therapeutic regimen. The patient and the family were also informed that the patient must have an adequate balanced diet to promote bone and soft tissue healing.

REYGEL G. PINEDA
Address: 124 Sta. Maria St. Brgy Holy Spirit Quezon E-mail Add: reygel_pineda@yahoo.com Phone no: 09333505006

EDUCATIONAL ATTAINMENT

Primary

Ruth Christian School (1997-2003)

Secondary

Ramon Magsaysay (Cubao) High School (2003-2007)

Tertiary

Our Lady of Fatima University Bachelor of Nursing

PERSONAL BACKGROUND

Birthday Birth Place Age Religion Marital Status Nationality Height Language Spoken

June 20, 1990 Quezon City 21 Born Again Christian Single Filipino 5'3 Tagalog ; English

GIFT MOSES DEIAR Y. PANGILINAN

Address: 78 E. Aguinaldo St. area 1 vet. Vill. Brgy pasong tamo Q.C. E-mail Add: gift_pangilinan@yahoo.com Phone no: 09238256402

EDUCATIONAL ATTAINMENT Primary Shalom Learning Center (1996-2002)

Secondary

New Era high School (2002-2006)

Tertiary

Our Lady of Fatima University Bachelor of Nursing

PERSONAL BACKGROUND Birthday Birth Place Age Religion Marital Status Nationality Height Language Spoken July 11, 1989 Quezon City 22 Born Again Christian Single Filipino 5'7 Tagalog ; English