rework fractures

[witchbells]

Pt 2 in "nursie makes medical more difficult fun"

This starts with re-naming the fractures we have and adding new ones.

Hairline Fractures For the most part, stay the damn same! Oh, except for some delightful parts;

• Surgical treatment will not require a bonesetter, just one application of bone gel. This is because hairline fractures are more often than not caused by stress rather than sharp, blunt forces that cause most fractures.

• The pain messages will be nerfed or changed to something akin to having a bruise on your character. Hairline fractures are tiny and there have been many reports of people who have gone about their days unknowing until the fracture gets worse, meaning an unattended hairline fracture will progress if left unattended.

Simple Fractures What appeared on advanced scanners as "broken" and fracture" are removed and renamed into one "simple fracture." This is your standard "broken' where a bone is severed in parts and must be set and repaired.

• Renders the limb inoperable.

• Surgery does not change, but moving someone with a single fracture in their skull/ribs/pelvis will not harm them any further.

Comminuted Fractures Fun and new! A comminuted fracture is when the bone is splintered into multiple pieces.

• Moving someone with a comminuted fracture in their skull/ribs/pelvis will fuck up their organs! Use a roller bed.

• Surgical repair will be somewhat more tedious. Namely, you will not need the bonesetter, but you will need to put the bone shards back into place using a hemostat three or four times, and apply bone gel after each.

Open Fractures New and fun! Open fractures are where the bone sticks out of the wound. This type of fracture is only caused by significant force, such as vehicular impact or a hard fall.

• The most painful! Open fractures give you big large pain messages.

• Must also be treated like a regular wound. The biggest threat of an open fracture is infection, clean and stop bleeding with gauze and advanced trauma packs.

• Examining yourself will yield a fun You can see the bone sticking out of your [limb]!

• New surgery!

Make an incision with scalpel, hemostat, and retractor to open up the wound around the bone.

Use the bonesetter to force the bone back into place.

• Will have a small chance of You accidentally damage the soft tissue in [name]'s [limb] while setting the bone! AKA internal bleeding. Fix normally.

Use the hemostat to pick out bone shards.

Apply bonegel.

Cauterize.

 

All in all, it sets out to make the conditions of fractures and the treatment of far more varied. They're all treated differently, appear differently, and are just a little more vivid. and adds some more serious consequences to the game.

[Bedshaped]

I'd like it if splints had more of a role. Like for minor enough breaks you could just use a splint and let it heal naturally with painkillers.

[Chanterelle]

I'm all about more realism! It does sound complicated though.~

[Guest Marlon Phoenix]

I don't know what Comminuted means. We should use baby words and just say "shattered" or "splintered" or some other synonym.

Fractures getting worse over time is an interesting idea. I'm not sure if the complications it will bring already time consuming surgery procedures (especially since broken bones tend to come in pairs) are worth the benefits of more elaborate broken bone mechanics, though.

[UnknownMurder]

I don't know what Comminuted means. We should use baby words and just say "shattered" or "splintered" or some other synonym.

Fractures getting worse over time is an interesting idea. I'm not sure if the complications it will bring already time consuming surgery procedures (especially since broken bones tend to come in pairs) are worth the benefits of more elaborate broken bone mechanics, though.

 

Oh. It already gets worse for each step you take when you try to walk off a fracture.

[witchbells]

I don't know what Comminuted means. We should use baby words and just say "shattered" or "splintered" or some other synonym.

Fractures getting worse over time is an interesting idea. I'm not sure if the complications it will bring already time consuming surgery procedures (especially since broken bones tend to come in pairs) are worth the benefits of more elaborate broken bone mechanics, though.

 

We already have medical players using terms like "exsanguination" and "hemostimulent," I don't think this will be too jarring to any of them.

[Guest Marlon Phoenix]

I'm a career CMO and I have no idea what those mean.

way to make me feel dumb........................

[Fire and Glory]

I too, am a CMO, and I only know exsanguination is related to blood-loss, maybe, I'm not actually looking it up.

I have no idea what hemostimulent might mean and I wouldn't know what a Comminuted is either if I didn't read this thread first.

 

way to make me feel dumb........................

Don't worry Jackboot don't pay any attention to those nerds who actually look up medical terms to feel smart in 2D spessmans.

[witchbells]

bringing this right the fuck back because Cool Shit is Cool and having open fractures would be very Nice

[Fire and Glory]

I would like this.

I especially like how hairline fractures would create a need to get a checkup after getting in a fight, medical issues that are not immediately obvious but create complications would be noice.

[Nikov]

Simple and compound fractures. I've never heard communiutal? What? All I ever learned in first aid courses is "compound". Compound fractures are ones that go through the skin.

[HunterRS]

Simple Fractures are small breaks on one bone, like the forearm or femur

Compound fractures are if you fracture your hand or foot, multiple bones are broken.

Hairline fractures are (I think) small breaks of broken off bone, like if a part of the bone is snapped off but the rest is in the right place still.

My dad is an EMT so I will ask him when I get home to confirm this.

[Ron]

Here are some notes from my anatomy class on classification of bone fractures if you are interested in it.

They are classified by four things, 1. Position of the bone ends after the fracture 2. The completeness of the break 3. The orientation of the bone to the long axis and 4. Whether or not the bone ends penetrate the skin.

Types of fractures (If you want pictures google the name of them)

1. Comminuted is where the bone breaks into many fragments. (3+ pieces)

2. Compression is where the bone is crushed.

3. Depressed is where the broken bone is pressed inwards.

4. Impacted is where the broken bones are forced into each other.

5. Spiral is where the break occurs due to a twisting force on the bone.

6. Greenstick is where the bone breaks incompletely.

Terms to classify the fracture.

1. Nondisplaced is where the bone ends retain their normal position in the body

2. Displaced is the opposite of nondisplaced, and occurs when the bone ends are not aligned properly.

3. Complete is when the bone is broken all the way through (Not necessarily through the skin.)

4. Incomplete is when the fracture does not break the bone all the way through.

5. Linear means the fracture is parallel to the long axis of the bone.

6. Compound means it goes through the skin.

7. Simple means it does not go through the skin.

[witchbells]

Thanks for elaborating on different types of fractures! These terms aren't exactly tossed around casually, and it's good to have the info even if it won't get super complicated in game.

[Bedshaped]

Thanks for the info here. It's all very interesting and will be saved for future ref.

[Nikov]

I think a baseline of first-aid terms should be used at the first-aid level, and the specialist medical terminology used once inside the medbay.

For the (non-medical) purposes of first aid, all we ever discussed were simple and compound. We were told there were more specific details, but the treatment for spiral fracture or a greenstick fracture really didn't change on our level of treatment. Was it simple (inside skin) or compound (outside skin). Chief differences for our purposes of vidja-game first aid would be that a simple fracture could be splinted and moved (carefully), and a compound fracture is pretty much a matter of blood loss and getting a medical evac. Moving unsplinted simple fractures or moving them carelessly could turn them into a compound, we were taught.

Now, once you get to a medical scanner or a professional examines the limb with help intent, and we're not just eyeballing the wound, I imagine the rest of these terms can come up and make some subtle differences in the bonesetting process. Foreign object removal of bone shards, for example. Inserting metal rods to brace a really nasty fracture while it heals. Details for the professionals.