Approach to fractures Flashcards
What three cell types compose bone?
Osteoblasts
Osteocytes
Osteoclasts
What are the two distinct mechanisms of bone development?
Intramembranous
Endochondral
What is Wolffs law?
Bone responds to the loads placed on it
What causes bones to break?
If the energy delivered to bone is greater than the
energy that it can absorb, fracture will occur
What is a monotonic fracture?
Supramaximal loading of a bone that ultimately leads to failure
What is a pathological fracture?
A bone that is weakened by a pathological process such as neoplasia, osteoporosis or osteomyelitis
What is a stress fracture?
If the rate of accumulation of fatigue damage surpasses the body’s ability to
remodel it may become weakened to the point of fracture
What is a multiple fracture?
Fracture at >1 level or >1 bone
What is a comminuted fracture?
more than 2 fragments
- minimal, moderate,severe
What is a stable after reduction fracture?
tend to remain in place without force, so may be treatable by coaptation
What is an unstable after reduction fracture?
the fracture collapses as soon as the reducing forces are removed;
these may require operative stabilization
What is gap healing?
Fracture gap fills with primary bone
* No connective tissue or cartilage prior to bone
* Orientation of new bone is transverse to long axis
* Gradually get remodelling in second phase
What is contact healing?
Haversian remodelling begins immediately
* Fractures undergoing 1o bone union are initially weaker than those undergoing callus formation
* 8 months vs 8 weeks for repair
* Implications re implant fatigue and removal
What are the four ways a plate can be used?
Neutralisation
Compression
Buttress
Bridging
What is the purpose of Cerclage wire?
Encircles wire (for mandibular/ maxillary fractures)
