This chapter aims to highlight the principles of orthopaedic nursing and the skills required to perform effective musculoskeletal care of orthopaedic injury in children. Musculo-skeletal injury is one of the most frequently encountered problems in children’s nursing. Almost 20% of children who present with injury have sustained a fracture (Hart et al., 2006). When children have fractures, they are generally brought to emergency departments. Whether the fractures are simple or complex, or they require surgical intervention or not, fractures produce a great deal of anxiety for children and their families. Children’s nurses are in an ideal situation to use their nursing knowledge to provide optimal care for children with musculo-skeletal injury. The initial assessment and immediate treatment of an injured extremity is fundamentally important in ensuring a good outcome. Delay in recognition of neurovascular compromise can lead to a condition known as compartment syndrome (CS). If ignored, a limb can become seriously compromised, which could eventually lead to amputation of the limb or even the death of the patient. However, having the foundation of knowledge regarding total neurovascular function can equip the nurse with accurate assessment skills and the knowledge of the need for immediate action. Neurovascular assessment used correctly provides the best patient care with the best possible outcome. Compartment syndrome is a possible complication for every patient with a fracture, sprain, or following orthopaedic surgery. Any deviation from the normal range of the neurovascular parameters should be highlighted immediately. Early identification of the symptoms will prompt immediate treatment and prevent any compromise of the limb. In addition the immature skeleton of children has unique properties that directly affect the management of fractures in children. By the end of this chapter you will be able to: ● Explain the nursing assessment you would undertake for an infant/child presenting with musculo-skeletal injury. ● Understand the principles of neurovascular assessment and complete all the aspects involved in assessing neurovascular status. ● Understand the rationale and purpose of the musculo-skeletal nursing skills outlined such as care of the child with a cast.
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