bone fractures

Question 1

displaced fracture

Answer 1

• Complete break in the bone
• Tx: closed reduction - reset bone,
  no surgery, cast
• Tx: open reduction - surgery to
  reset, may need internal
  fixation (screws, pins, plates, etc)

Question 2

Plastic deformity

Answer 2

• Bone bends without any visible break – and
  does not return to original shape
• Incomplete fracture, occurs in pediatric pop.
• Common mechanism - FOOSH
• Tx: cast, high bone remodelling in young
• Tx: closed reduction and cast if over 10yrs old

Question 3

Torus (buckle) fracture

Answer 3

• Bones driven together from end to end –
  buckles under the pressure
• Incomplete fracture, mostly in pediatric pop.
• Common mechanism - FOOSH
• Tx: immobilization - splint or cast

Question 4

Greenstick fracture

Answer 4

• Unique to pediatric pop (<10yrs) – one side of the
  bone breaks while the other side bends
• Mechanism: FOOSH, sport injuries, car accidents
• Tx: closed reduction - reset bone,
  no surgery, cast
• Tx: open reduction - surgery to
  reset, may need internal
  fixation (pins), cast

Question 5

Pathologic fracture

Answer 5

• Fracture caused by cyst, tumor
  (benign or malignant), disease,
  infection in the bone itself
• Mechanism: pressure placed on
  weaker bones causing fractures
• Tx: treat underlying disease,
  bracing, internal fixation,
  bone cement

Question 6

Avulsion fracture

Answer 6

• A piece of bone pulled away from
  the body of the bone
• Mechanism: strong muscular
  contraction or impact
• Tx: casting, if more than 2cm gap,
  open reduction with internal
  fixation

Question 7

Growth plate fracture

Answer 7

• Fracture through the epiphyseal
  plate or growth plate of the bone
• Classified based on Salter-Harris
  system (type I - type V)
• Mechanism: single event (ex.fall),
  or repetitive stress
• Tx: cast immobilization, open
  reduction with internal fixation

Question 8

Closed vs. Open Fracture:

Answer 8

Skin is not broken (simple) vs. bone has come
through the skin (compound).

Question 9

Comminuted Fracture

Answer 9

• Bone broken into 3 or more pieces
• Mechanism: severe trauma
  (ex. car accident)
• Tx: open reduction with internal
  fixation, bone grafting, cast

Question 10

Stress Fracture

Answer 10

• Involves a small break in normal bone
• Mechanism: excessive stress/loading
  exceeding remodelling process
  (ex.overtraining, training surface)
• Does not show up on x-ray right away
• Tx: RICE (rest, ice, compression and elevation), NSAIDS (non-steroidal anti-inflammatory drugs), immobilization,
  internal fixation

Question 11

Spiral Fracture

Answer 11

• Break that goes around the bone
• Mechanism: falls, trauma, sport injuries,
  twisting of bones with great force
• Tx: immobilization (cast), closed
  reduction, open reduction and
  Internal fixation, external fixation,
  bone grafts