NURSING CARE RELATED TO THE
Section I. INTRODUCTION TO ORTHOPEDIC NURSING
THE MUSCULOSKELETAL SYSTEM
a. The musculoskeletal system is composed of bones, joints, muscles, cartilage,
ligaments, and tendons. The skeleton provides a structural framework for the body and,
because bones are rigid, provides support and protection for vital organs and softer
tissues. Skeletal muscles and bones work together to make body movement possible.
Blood cell formation (called hematopoiesis) occurs in bone marrow, and bones store
minerals such as calcium and phosphorus.
b. Orthopedics is the branch of medicine and surgery that is concerned with the
preservation and restoration of the function of the skeletal system, its articulations
(joints), and its associated structures by medical, surgical, and physical means.
c. Refer to figure 1-1 to refresh your knowledge of the names and locations of
the major muscles and bones.
a. The challenge in caring for the orthopedic patient is in carrying out basic
nursing care procedures while understanding and working with orthopedic devices used
in the treatment of musculoskeletal diseases and injuries. To avoid self-injury, those
engaged in orthopedic nursing must also understand and apply principles of good body
b. Many orthopedic patients are immobilized by casts, traction, or other means
for long periods of time. Orthopedic nursing includes maintaining muscle tone and
circulation to prevent contractures, deformity, and pressure sores by frequently
changing the position of immobilized patients.
c. Often confined to bed and in many cases immobile, the orthopedic patient
may require a great deal of assistance with daily living activities. His bedding should be
kept clean, dry, and wrinkle free. Because he is susceptible to skin breakdown and
pressure sores, he should be assisted and encouraged to change positions within the
limits prescribed by the physician. He should be encouraged to be as independent as
possible within the limits of his immobility and personal hygiene should be emphasized.