41. Fracture biology_biomechanics

Question 1

T/Fbone is stronger when loaded rapidly than when loaded slowly

Answer 1

TRUEbone is stronger when loaded rapidly than when loaded slowly (viscoelastic)

Question 2

bone mechanical property of anisotropy

Answer 2

mechanical properties of bone strongly depend on the direction of loadingfor example, long bones are stronger and better resist forces placed along the long axis than those across the axis.

Question 3

stress vs strain

Answer 3

stress (y axis): force per unit area (N/meter ^2)strain (x axis): local deformation (units of length/length) or the change in unit length over original length (usually a percentage)

Question 4

strength vs stiffness of a material

Answer 4

strength: ultimate load a material can withstand before ultimate failurestiffness: RATE at which material deforms when the load is applied; slope of the ascending linear portion of the stress/strain curve; aka elastic modulus

Question 5

stress/strain curve vs load/displacement curve

Answer 5

stress/strain curve—-materialsload/displacement—-structures/fractures

Question 6

yield point

Answer 6

Ypoint at which strain exceeds the materials ability to recoverrender the material permanently deformed

Question 7

plastic vs elastic deformation

Answer 7

elastic deformation–reversible deformation before yield point is reached, material can recover to original formplastic deformation–irreversible deformation past the yield point where strain exceeds the materials ability to recover

Question 8

failure point

Answer 8

Umaterial can no longer withstand strain and fails

Question 9

cortical bone material properties (3)

Answer 9

anisotropic–stronger when loaded longitudinallybrittle–plastic deformation phase is steep/short viscoelastic –more rapid it is loaded, the stiffer it becomespizoelastic–as bone deforms it produces an electrical charge; compression is NEG (osteoblasts), tension is POS (osteoclasts)

Question 10

cancellous bone material properties (

Answer 10

porosity–75-95% make it weaker and more compliantless stiff and lower yield point than cortical boneshort elastic phase, long plastic phase (from collapse of trabeculae)

Question 11

what happens to stress when the surface area is decreased by one half

Answer 11

stress = force/meters squared (N/m^2)when area is decreased by 1/2, stress doubles

Question 12

how is toughness of a material defined

Answer 12

AREA under the stress vs strain curvearea under the curve represent the total energy absorbed during the loading process

Question 13

forces acting on bone

Answer 13

axial–parallel to long axis–made up of tensile (lengthen) and compressive (shorten) forcessheartorsional bending (4 types)

Question 14

4 types of bending (moments) and the anticipated fracture site associated with them

Answer 14

1. pure bending: apply equal and opposite forces at each end of the bone (uniform bending); fracture can occur anywhere; RARE2. cantilever bending: fixed on one end, and load applied transversely on other end; fracture occurs near site of fixation3. 3 point bending: equal load on both ends and opposite load applied somewhere in the middle; fracture occurs at the site of load application4. 4 point bending: equal load on both ends and 2 opposite loads applied in the middle; fracture occurs btwn two inner loads; RARE

Question 15

compressive forces on bone result in what type of fracture configuration

Answer 15

OBLIQUE–due to bone being dramatically weaker in shear than compressionwhen loaded in compression, bone fails along the lines of highest shear (usually at 30-45 degrees the to direction of compressive force

Question 16

tensile forces on the bone result in what type of fracture configuration

Answer 16

TRANSVERSE or perpendicular to the direction of tensile forcerarely occurs as a sole entity

Question 17

bending forces on bone result in what type of fracture configuration

Answer 17

TRANSVERSE during bending, the side opposite the load (convex) is under tension and under the load (concave) is compressionbc bone is weaker in tension, fracture starts on convex or tension surface

Question 18

bending and compression forces on the bone result in what type of fracture configuration

Answer 18

COMBINATIONmay start transverse from bending force on tensile side and propagate , split and deviate creating a butterfly fragment

Question 19

torsional forces on the bone result in what type of fracture configuration

Answer 19

SPIRAL

Question 20

causes of pathologic fractures

Answer 20

1. neoplasia2. osteopenia from immobilization3. osteomyelitis4. iatrogenic bone damage (ie. THR)5. post op implant removalLOW energy fractures–> simple fracture patternsusually at site (stress riser) btwn healthy and dz bone

Question 21

fatigue fractures

Answer 21

repetitive loading causes bone damage at a rate faster than it can be repaireddecreases tensile strength of bone more rapidly than compressive strengthRARE (maybe FCP, avascular necrosis)

Question 22

fracture gap size and strain associated

Answer 22

small fracture gap HIGH STRAINlarge fracture gap LOW STRAINfor the same amount of instability present

Question 23

strain necessary for bone formation

Answer 23

LOW strain environment needed for bone formations< 2 % strain

Question 24

bone healing mechanisms in place to DECREASE strain and aid in bone formation/healing

Answer 24

1. fracture resorption (increasing the denominator)2. callus formation (decreasing the numerator)strain = change in length/original length

Question 25

types of bone healing

Answer 25

1. primary—contact vs gap2. secondary: inflammatory (hematoma), reparative (angiogenesis; GT), remodeling (Wolffs law; piezoelectric properties)

Question 26

stages of secondary bone healing

Answer 26

1. inflammatory (hematoma–no stability)2. reparative (angiogenesis; GT–some stability, tolerates high strain to make fibrous connective tissue soft callus) –interfragmentary strain decreases to form fibrous hard callusfibrous hard callus–>cartilage–>(endochondral ossification) mineralization–>woven bone3. remodeling (Wolffs law; piezoelectric takes –>woven bone–>lamellar bone/Haversian system cortical bone under low strain environment)

Question 27

what are the two physical requirements for primary bone healing to take place

Answer 27

1. interfragmentary strain < 2%2. < 1mm gap

Question 28

difference btwn contact and gap repair for primary bone healing

Answer 28

Both do not form callus; Both are PRIMARY healing; need stable fracture conditionsBUT contact–direct Haversion remodeling occurs (cutting cones, longitudinal lamellar bone); bone union and remodeling occur in ONE phasegap–two stages: layers of bone laid perpendicular and THEN replaced by longitudinal lamellar bone through Haversian remodeling; bone union and remodeling take place in two stages

Question 29

concept of distraction osteogenesis

Answer 29

Gavril Ilizarovmechanically induced bone formation via intramembranous ossification1. within gap is fibrous inter zone (radiolucent, central)2. either side of zone = osteoblasts, vascular that deposit osteoid3. with distraction the fibrous inter zone mineralizes

Question 30

T/FChondroblasts are formed under LOW oxygen tension

Answer 30

TRUEinitial low oxygen tension is a signal for formation of capillary buds and chondroblasts

Question 31

tension side of femur vs tibia

Answer 31

femur= craniolateraltibia=craniolateral

Question 32

tension side of humerus

Answer 32

humerus = craniolateral

Question 33

tension side of radius and ulna

Answer 33

radius= cranialulna = caudal

Question 34

granulation tissue can withstand ___________% deformation before failure

Answer 34

100% strain

Question 35

fibrous tissue can withstand ___________% deformation before failure

Answer 35

10-15 % strain

Question 36

bone can withstand ___________% deformation before failure

Answer 36

2% strain