Nursing Care and Management of Humerus Neck Fracture

This presentation addresses the nursing care of humerus neck fractures, a common orthopedic injury. It begins by outlining the pathophysiology of the fracture, differentiating between the anatomical and surgical necks of the humerus, and discussing the impact of displacement and fracture type. The presentation then delves into foundational nursing concepts, including the biopsychosocial and family-centered models of care, and the principles of nursing care in fracture management. It covers medical and surgical management approaches such as closed and open reduction, internal fixation, and hemiarthroplasty, along with associated nursing responsibilities, including pain management, wound care, and rehabilitation. The presentation emphasizes the application of bioethical principles and the NMBA nursing standards throughout the care process, including assessment, care planning, intervention, and evaluation. The presentation uses cited references to support its content, and is designed to meet the requirements of a presentation assignment, including PowerPoint slides and a written component. The presentation aims to equip nurses with the knowledge and skills necessary to provide comprehensive and evidence-based care for patients with humerus neck fractures.

Nursing in humerus neck fracture

Fracture neck of humerus
• Proximal humerus fracture is one of the most common fractures that occurs in the arm
region and fracture in the neck of humerus is also very common.
• There are two neck regions of the humerus that are marked anatomically – 1. the anatomic
neck and 2. the surgical neck. The surgical neck is the weakest spot in the bone and most
prone to the deforming forces, causing its fracture (Santy-Tomlinson, Hertz and Kaminska,
2018).
• Picture link - https://biology.stackexchange.com/questions/53726/surgical-vs-anatomical-
neck

Fracture neck of humerus
• A fracture can be displaced or non displaced, closed or an
open fracture.
• The pathophysiology resulting in signs and symptoms
following a fracture includes the pain, spasm and the oedema
that are to be critically managed.
• Picture link : https://www.orthobullets.com/trauma/1015/proximal-
humerus-fractures

The concept of nursing in fracture
management
The concepts of nursing that are most pertinent in the fracture management
is :-
1. Biopsychosoical model of health – in which all the three aspect of
physical, social and psychological aspects are taken into consideration by
the nursing and the medical teams in the fracture management cases.
Picture link : https://www.ncbi.nlm.nih.gov/pubmed/847460

The concept of nursing in fracture
management
• Family centred nursing – if the patient is elderly or young and is at other
health risks too. A family centred care is important fracture management
cases of orthopaedic nursing.
Picture link : http://www.pedsnurses.org/page/core-competencies

Nursing medical and surgical management
• The surgeries that are generally done to treat the fracture neck humerus are closed
reduction, open reduction and internal fixation as well as hemiarthroplasty.
• The post surgical management by a nurse includes managing of pain, swelling, dressing, Spica
casts and the plasters, suture lines, oedema, sensorimotor and self care deficits rehabilitation
(in collaboration with an occupational therapist or a physical therapist), nutrition ( with a
nutritionist).
• Prevention of complications like blood loss, hypovolemia, malunion, delayed union, infections
(Biz et al., 2019)
• Medical management with medications such as antihypertensives, analgesics and others.
• Picture link : https://www.nsc.org/safety-training/first-aid

Principles of nursing care in fracture
management
• It is critical that orthopaedic nurse incorporates all the bioethical principles of nursing such as beneficence,
non-maleficence, informed consent, autonomy, integrity and totality in her care process (Jensen, Hertz
and Mauthner, 2018)
• Applying the NMBA nursing standard 1 – the orthopedic nurse should critically analyse and think in
accordnace with fracture management.
• Applying NMBA nursing standard 2 – the orthopedic nurse should involve in a culturally compentent
therapeutic and professional relationship with patients and other professionals.
• Applying NMBA nusring standard 3 – the orthopedic nurse should self manage her stress and anxiety to
prevent burnout
• Appling NMBA nusring standard 4 - the nurse should perform the fracture related physical examination,
pain examination and neurological examination to understand the deficits.
• Picture link : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913818/

Principles of nursing care in fracture
management
• Applying NMBA nursing standard 5 – assessing the fracture patient’s condition well
and comprehensively, the plan of care with proper clinical reasoning and rationale
should be developed by the nurse.
• Applying NMBA nursing standard 6 – the registered nurse to provide a safe and
high quality patient centred care. Any nursing errors should be avoided to prevent
patient complication.
• Applying NMBA nursing standard 7 – the orthopaedic nurse should be able to
evaluate the outcomes to better the informed practice.
Developing a safe therapeutic communication with the patient and incorporating
nursing clinical decision making skills is most important to the fracture management
such as that of proximal humerus fracture.

References
• Biz, C., Fantoni, I., Crepaldi, N., Zonta, F., Buffon, L., Corradin, M.,
Lissandron, A. and Ruggieri, P., 2019. Clinical practice and nursing
management of pre-operative skin or skeletal traction for hip fractures in
elderly patients: a cross-sectional three-institution study. International
journal of orthopaedic and trauma nursing, 32, pp.32-40.
• Jensen, C.M., Hertz, K. and Mauthner, O., 2018. Orthogeriatric Nursing in
the Emergency and Perioperative In-Patient Setting. In Fragility Fracture
Nursing (pp. 53-65). Springer, Cham.
• Santy-Tomlinson, J., Hertz, K. and Kaminska, M., 2018. Orthogeriatric
Nursing 12. Fragility Fracture Nursing: Holistic Care and Management of
the Orthogeriatric Patient, p.147.