11 Fractures Flashcards
What is a fracture ?
often abbreviated to what ?
a break or discontinuity in a bone (or cartilage) resulting from mechanical forces which exceed the bone’s ability to withstand them
often abbreviated to #
Signs of fractures ?
- loss of function
- swelling
- deformity
- bony tenderness
- crepitus
- abnormal movement
- bruising
In what ways can fractures be described and classified?
- By displacement
- By number of fragments
- By associated soft tissue injury; open or closed
- By site: Intra articular or extra articular, shaft or metaphysic
- By maturity: greenstick, buckle fractures, Salter Harris growth plate fractures
- By bone quality: pathological fractures e.g. metastases, osteoporosis, bone cyst
Which bone healing is primary and secondary ?
primary = direct
secondary = indirect
Primary bone healing:
less ..1….
correct anatomical …2…, very stable …3… > minimal ..4… (< 2%)
…5… fixation
- common
- reduction
- fixation
- strain
- rigid surgical
secondary bone healing
most ..1… mechanism
does not require …2…
does not require rigid …3…
strain ..4.. %
…5.. e.g. fracture braces, some surgical techniques
- common
- anatomic reduction
- rigid stability
- 2-10
- non-rigid fixation
- secondary bone healing 4 stages
- healing type ?
- hematoma formation , fibrocartilaginous callus formation, bony callus formation, bone remodelling
- endochondral
how long does each stage of fracture repair last ?
1. inflammatory phase
2. reparative phase
3. remodelling phase
- few days
- several weeks
- months
Pearson’s rule for child upper & lower limb approx healing times ?
upper = 3
lower = 6
Pearson’s rule for adult upper & lower limb approx healing times ?
upper = 6
lower = 12
2 mechanism of injury of fractures ?
direct = direct trauma to fracture site, high/low energy
indirect = no direct trauma to fracture site e.g. twisting injury
Fracture by direct injury includes high / low energy, what’s the difference between them ?
high = significant amount of force, car accidents, falls from height more severe fractures, comminuted
low = involve a relatively smaller amount of force, falls from standing height, twisting injuries
Signs of fractures
- loss of function
- swelling
- deformity
- bony tenderness
- crepitus
- abnormal movement
- bruising
Factors influencing bone healing ?
- local (injury, bone, treatment)
- regional
- systemic
What are local early complications of fractures ?
- nerve injury
- vascular injury
- compartment syndrome
- avascular necrosis
- infection
- surgical
