9. Fractured bones

Question 1

What is special about spongy (cancellous) bone?

Answer 1

Where haematopoiesis occurs: production of blood cells. Organised to provide Maximus strength, not random. Follow lines of stress and can realign in response to stress. Dynamic bone and highly vascular.
More affected in osteoporosis.

Question 2

What are the four cells of bones:

Answer 2

1. Osteoblasts: Deposit bone material, responsible for synthesis and deposition on bones surfaces of protein matriculates of new intracellular material, important for bone building, growth and remodelling
2. Osteoclasts: Reabsorbing cells. Reabsorb bone by direct chemical and enzymatic attack.
3. Osteocytes: Osteoblasts trapped in lacuna, help with bone substance and move along through caniculi to help nourish and strength
4. Stem cells: In loose connective tissue and periosteum. Give rise to osteoblasts under appropriate stimuli. Help in restructuring and structuring of bones.

Question 3

Function of the four sections of a long bone

Answer 3

1. Epiphysis: Shock absorber
2. Epiphyseal plate: Important zone for development, contributes to height and stature. Skeletal dysplasia.
3. Metaphysis: Supports bone marrow, metabolically active region
   4: Diaphysis: Structural. And length.

Question 4

What are the 9 types of fractures

Answer 4

Greenstick, spiral, comminuted, transverse, compound/oblique, vertebral compression, hairline or stress fracture, impacted fracture, avulsion.

Question 5

Greenstick fracture

Answer 5

Children only. Incomplete fracture, one side of bone.
Healing time: 3-6 weeks.
Treatment: Bent back into proper position and in cast for 3 weeks.
Cause: Stress perpendicular to bone.

Question 6

Spiral fracture

Answer 6

Spiral up and down.

Cause: Extreme twisting force

Question 7

Comminuted

Answer 7

Lots of small fractures. Multi-fragmentary.
Complete fracture.
Result of: Severe injury
Treatment: Immobilisation in a cast and pins, screws and plate

Question 8

Transverse

Answer 8

Perpendicular to long axis of bone.

Cause: Pressure applied to right side

Question 9

Compound/oblique

Answer 9

Slanted fractures

Cause: Occurs when force is applied at any other angle other than a right angle.

Question 10

Vertebral compression

Answer 10

Vertebral body compressed due to trauma and/or osteoporosis. May occur at many different angles.
Cause: Trauma and osteoporosis

Question 11

Hairline or stress fracture:

Answer 11

Cause: Overuse, acute event (car crash, fall) that puts pressure on bone
Common in: Athletes
Most affected: Foot and shin bones

Question 12

Impacted fracture:

Answer 12

Incomplete, closed fracture.
Two ends squeezed towards each other, bone has had pressure put on either ends.
Caused by: Fall, pressure, twisting or bending.

Question 13

Avulsion fracture:

Answer 13

Small bone piece torn away.
Cause: Over exertion. Due to extreme force applied to ligament or tendon. Over exertion of muscles or sudden traumatic pulling in an accident.
More common in: Children, epiphyseal plate.

Question 14

Diagnosis:

Answer 14

Bone density scan, X-ray, CT scan

Question 15

Risk factors:

Answer 15

Age, gender, height and weight. Previous history (if broken before), smoking, rheumatoid arthritis, osteoporosis.

Question 16

Signs and symptoms:

Answer 16

Swelling or bruising over bone, pain in the area, visible deformity of area, loss of function such as inability to weight bare on affected area.