Bone fractures Flashcards
What are 3 types of etiologies for bone fractures?
- Trauma
- Repetitive stress
- Pathological
What are 2 kinds of pathologies that can cause bone fractures?
- Metabolic/generalized disorders (e.g. osteoporosis)
- Structural/localized disorders (e.g. tumour)
What are the 4 steps of bone repair, and how long does each step take?
- Inflammation & hematoma (6-8 hrs)
- Fibrocartilaginous procallus (2-3 weeks)
- Bony callus (months)
- Remodelling (years)
During the hematoma stage of bone repair, what important structure is formed?
Fibrin mesh
What are 2 important players in the procallus stage of bone repair?
- New capillaries infiltrate site
- Fibroblasts
What is the term for the conversion of cartilage into bone by osteoblasts?
Ossification
What kind of bone is deposited by osteoblasts during the bony callus stage of bone repair?
Spongy bone trabeculae
What 2 processes occur during the remodeling stage of bone repair?
- Dead portions of bone removed by osteoclasts
- Spongy bone becomes compact bone
Why is bleeding/hematoma formation a sign of fracture?
Damage to periosteum, blood vessels, and bone marrow
What is the term for a fracture caused by muscle/ligament breaking away a fragment of bone attached to it?
Avulsion
What are 2 terms for a fracture that communicates with the external environment?
Open or compound
What are 2 terms for a fracture that does not communicate with the external environment?
Closed or simple
What are 2 terms used to describe the alignment of bone fragments in a fracture?
Displaced or nondisplaced
What are 2 terms used to describe the extent of a fracture?
Complete or incomplete
What are 3 linear type fractures?
- Transverse: straight across bone
- Longitudinal: Straight down long axis
- Oblique: Diagonal across bone
What is the term for a fracture that rotates around the bone, usually from rotational force?
Spiral
What is the term for a fracture that involves many bony fragments, usually from crushing?
Comminuted
What is the term for a fracture that involves a complete break in at least 2 places, leaving a fragment completely separated?
Segmental
What is the term for a fracture caused by vertical force (usually from falling) which drives the distal fragment into the proximal fragment?
Impacted
What is the term for two oblique (diagonal) fractures meeting to form a triangular bone fragment?
Butterfly
What is the term for a star shaped fracture in flat bones?
Stellate
What is the term for a segment of bone depressed into the cranium?
Depressed
What is the term for a fracture near or inside a joint?
Interarticular
What is the term for a common fracture involving the distal end of the fibula?
Pott
What is the term for a common fracture involving the distal end of the radius, the distal fragment of which is displaced posteriorly?
Colles
What is the term for a fracture common in children that results from immature bone being compressed until it bulges out?
Buckle
What is the term for a fracture common in children where immature bone breaks on one side and bends on the other side?
Greenstick
What is the term for movement of bone fragments back into alignment without surgery?
Closed manipulation
What is the term for surgical alignment of bone fragments?
Open reduction
What is the term for using weight to counteract muscles which are pulling bones out of place?
Traction
What is the term for application of external devices to immobilize the fracture site?
External fixation
What is the term for use of prosthetics (e.g. screws, plates, nails, rods, etc.) to immobilize the fracture site?
Internal fixation
Why may hypercoagulability paradoxically cause hemorrhage in a patient with bone fracture?
All the clotting factors are used up
Why may a foreign body or tumour cause hemorrhage in a patient with bone fracture?
Blood vessel erosion
Why may periosteal stripping lead to surgical site infection in patients with bone fracture?
Periosteum is involved in sequestering infection
Why may cold temperatures or hypovolemia lead to surgical site infection in patients with bone fracture?
Reduced perfusion to site
What condition affects nearly all knee surgery patients?
DVT
What are 2 theories behind the cause of fat emboli syndrome?
- Mechanical: injury to adipose tissue or intramedullary compartment releases fat particles
- Biochemical: fatty acids cause endothelial damage, which leads to platelet aggregation and atheroma formation
Why are glycocalyx molecules on endothelial cells relevant to thromboembolic disorders?
They reduce friction of blood against the endothelium
What are 3 interventions for delayed union in bone repair?
- Bone graft
- Internal/external fixation
- Electrical bone stimulation
What is the term for if a bone fracture has not healed within 4-6 months?
Nonunion
What is the term for if a bone fracture heals in the wrong position?
Malunion
What joint disease can develop as a complication of bone fracture?
Osteoarthritis
