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MSK AM > Bone growth and fracture healing > Flashcards

Bone growth and fracture healing Flashcards

1
Q

Where is the site of growth in long bones?

A

Epiphyseal plate

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2
Q

What are the features of cortical bone?

A

Resists bending and torsion
Laid down circumferentially
Less biologically active

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3
Q

What are the features of cancellous (aka spongey) bone?

A

Resists and absorbs compression
Site of longitudinal growth
Very biologically active

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4
Q

Why do bones fail?

A

High energy transfer in normal bones
Repetitive stress in normal bones
Low energy transfer in abnormal bones

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5
Q

What is a fracture?

A

Break in structural continuity of bone

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6
Q

What are the 4 stages of bone regeneration?

A

Inflammation
Soft callus
Hard callus
Bone remodelling

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7
Q

What is stage 1 of bone regeneration?

A

Inflammation- begins immediately after fracture
Haematoma and fibrin clot
Degree of cell death which attracts cells

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8
Q

What cells are attracted during inflammation?

A

Fibroblasts- first cells to appear
Mesenchymal and osteoprogenitor cells
Angiogenesis signal cells

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9
Q

When does stage 2 of bone regeneration begin and end?

A

When pain and swelling subside

Lasts until bony fragments united by cartilage or fibrous tissue

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10
Q

What happens during stage 2 of bone regeneration?

A

Cartilage/fibrous tissue unite and stabilise bone
Increase in vascularity
Angulation can occur

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11
Q

What happens in stage 3 of bone regeneration?

A

Conversion of cartilage to woven bone

Increase in rigidity

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12
Q

What happens in stage 4 of bone regeneration?

A

Conversion of woven bone to lamellar bone

Medullary canal reconstituted

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13
Q

Why are NSAIDs not a good analgesic in stage 1 after a fracture?

A

Decrease inflammatory response, delay ealing process

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14
Q

Why is removal of haematoma not necessarily good?

A

Attracts cells for healing –> removal wipes out cells

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15
Q

What should be done if a haematoma is removed from a fracture site?

A

Apply platelet concentrates

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16
Q

What can be done for bone healing in stage 2?

A

Replace cartilage
Bone graft
Bone substitute

17
Q

What bone grafts can be done?

A

Autogenous cancellous bone graft

Allograft bone

18
Q

What is delayed union?

A

Failure to heal in expected time?

19
Q

What can cause delayed union?

A 
High energy injury
Distraction
Instability
Infection
Steroids
NSAIDs
Immune suppressants
Smoking
Warfarin
Ciprofloxacin
20
Q

What is non union?

A

Failure to heal

21
Q

What can cause non union?

A 
Failure of calcification of fibrocartilage
Instability
Abundant callus formation
Pain and tenderness
Persistent fracture line
Sclerosis

MSK AM (37 decks)

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