1: Fracture Flashcards
Most affected age range for traumatic fractures
5-14 years (accidents)
Two most commonly fractured bones of the UE with traumatic fractures
Radius and ulna
Type of fracture that most commonly occurs in the lower extremity and affects the tibial shaft and metatarsal bones
Stress/fatigue fracture
Female recruits are at increased risk for ___ and ___ stress fracture
Pelvic and sacral
Risk factors for pelvic stress fracture
Wide pelvis, coxa vara, genu valgum, hormones, nutrition
Occur because of forceful heel strike during prolonged marching or running
Compressive stress fractures
Occur because of muscle pull and can become more serious if displacement occurs.
Distractive stress reactions
Occurs if normal stress is applied to abnormal bone.
▪ Result from a normal stress or force acting on bone that has deficient elastic resistance or has been
weakened by decreased mineralization
Insufficiency fracture
Reduced bone integrity most commonly occurs due to:
▪ The effects of radiation
▪ Postmenopausal osteoporosis
▪ Corticosteroid-induced osteoporosis
▪ Other underlying metabolic bone disease (e.g., hyperparathyroidism, osteomalacia, rickets, and osteodystrophy)
Occurs in bone rendered abnormally fragile by
neoplastic or other disease conditions.
Pathological fracture
The fracture line is at a right angle to the long axis of the bone; usually produced
by shearing force.
Transverse fracture
Occur following a twisting or torsional force fragments displace easily in the
oblique fracture, whereas nonunion rarely occurs in a spiral fracture because ofthe wide area of surface contact.
Oblique or spiral
The bone is broken into more than two fragments and segmental if a fragment of the free bone is present between the main fragments
Comminuted
describes a fracture with multiple fragments at the fracture site and can be associated with different fracture lines
Comminuted
The separation of a wedge-shaped piece of bone
Butterfly
Green stick, Torus (or buckle), and crack or hairline fractures are all types of ___ fractures
Incomplete
____ fractures are more likely to require
surgery to stabilize them.
Unstable
True or false: compressive or shear forces can cause stable fractures to shift, becoming unstable
True
Occurs in the growth centers of children and adolescents, located in the long bones
Epiphyseal fracture
An articular fracture occurs on or near
a ____ and is described by the course
of the fracture line.
Joint
One of the most common
osteoporosis-related fragility fractures; often occurs with only minor trauma
Vertebral compression fracture (VCF)
Only ______ of people who sustain a VCF develop symptoms severe enough to seek medical attention.
20-25%
Bone mass is known to reach its maximum
size and density by reaching age ___ years
30
Men are more likely to experience bone
loss in their mid- to late ___
60s
List the 5 steps in fracture healing
- Hematoma formation
- Cellular proliferation
- Callous formation
- Ossification
- Consolidation and remodeling
What happens in initial 6-12 hours of fracture healing
Bleeding ceases and a clot is formed
What happens in day 1-2 of fracture healing
There is an acute inflammatory reaction and granulation tissue is formed
What happens in weeks 1-3 of fracture healing
Osteogenesis, fibrous union, and callus formation occur.
What happens in week 6 of fracture healing
There is continuity of the external callus
What happens in 4 months - 1 year of fracture healing
There is remodeling of the medullary canal and organized lamellar bone
What factors hinder proper fracture healing
Inadequate blood supply.
▪ Poor general nutritional status.
▪ Poor apposition of the fractured bone ends.
▪ Presence of foreign bodies, infection, or necrotic tissue.
▪ Corticosteroid therapy
In the presence of a fatigue fracture (stress reaction), active movement is typically painful or painless
Painless
Vertebral compression fractures are usually painful or painless
Painless
When VCF are painful, the initial pain may be ___ and ___, but after a few days it may become dull and achy.
Sharp and severe
Fracture associated with height and respiratory dysfunction
Vertebral compression fracture
The fracture may heal in the expected amount of time but in an unsatisfactory
position, with residual bony deformity.
Malunion
The fx may heal, but this may take considerably longer than the expected time.
Delayed union
The fx may fail to heal with resultant formation of either a fibrous union or a false
joint (pseudarthrosis).
Nonunion
The fat globules from the bone marrow (or from the subcutaneous tissue at the fracture site) migrate to the lung parenchyma and can block pulmonary vessels, decreasing alveolar diffusion of oxygen.
Fat embolism
Fracturing which bones puts a patient at risk for developing a fat embolism
Long bones, bony pelvis (contain the most marrow)
Constipation, deep vein thrombosis, pulmonary embolism, and pneumonia can occur due to ___ caused by the fracture
Immobility
Autogenous bone grafting Is most often taken from the ___ or ___
Iliac crest or fibula
____ bone grafting is material from a donor
Allogenic
fractures in children heal in _____ weeks, in adolescents in 6 to 8 weeks,
and in adults in 10 to 18 weeks
4-6 weeks
fractures in children heal in 4 to 6 weeks, in adolescents in ______ ,
and in adults in 10 to 18 weeks
6-8 weeks
fractures in children heal in 4 to 6 weeks, in adolescents in 6 to 8 weeks,
and in adults in ____ weeks
10-18 weeks
Negative predictors for healing
• Medications: Calcium channel blockers and NSAIDs
• Renal or vascular insufficiency
• Smoking
• Alcoholism
• Diabetes mellitus
Symptoms related to fat embolism
▪ Subtle changes in behavior and orientation occur if there are emboli in the cerebral circulation.
▪ Dyspnea and chest pain, diaphoresis, pallor, or cyanosis.
▪ A rash on the _______
▪ A rash on the anterior chest wall, neck, axillae, and shoulders
