Fractures & Immobilization Devices

Fractures are described as closed (skin intact) or open/compound (bone exposed or breaking the skin, carrying a high infection risk requiring urgent surgical management) and by pattern (e.g., transverse, spiral, comminuted). Regardless of type, the nursing priority after any suspected fracture is a neurovascular check distal to the injury — commonly remembered as the "6 Ps": pain (especially pain out of proportion to the injury), pallor, pulselessness, paresthesia, paralysis, and poikilothermia (coolness). These checks are repeated on a set schedule after casting, splinting, or traction, since a worsening trend is what actually signals a developing complication.