bone path final Flashcards
What is an open and a closed fracture?
Closed will not break skin or communicate with the outside world. Open is one that penetrates the skin over the fracture site.
What is a comminuted and a non-comminuted fracture?
Comminuted will have two or more bony fragments that have separated. Non-comminuted is a fracture that penetrates completely through the bone separating the bone into 2 fragments.
What is the difference between avulsion and impaction fractures?
Avulsion- tearing away of a portion of the bone y forceful muscular or ligamentous pulling. Impaction is when a portion of bone is driven into its adjacent segment and is seldon visulaized instead a subtle radiopaque white line is seen in the region of impact.
What are the 2 types of impaction fractures and what are they like?
depressed- an inward buligning of the outer bone surface. Compression- a decreased size of the involved bone owing to trabecular telescoping, occuring primarily in the spine after a forceful hyperflexion injury.
What is an incomplete fracture and what are the different types?
broken on only one side of the bone, leaving a buckling or bending of the bone as the only sign of fracture. Greenstick- primarliy infants and children the bone bends, applying tension to the conves side, producing a transverse fracture with the concave side remaining intact. Torus (buckling)- compression forces the cortex to bulge outward with a torus fracture.
What is the difference between pathologic and stress fractures?
Pathologic- a fracture caused by bone that is weakened by a localized or systemic disease. Stress- a fracture caused by repetitive stress.
What are 2 types of stress fractures?
Fatigue and insufficiency.
What is an occult fracture?
One in which the fracture gives clinical sings of its presence without any radiologic evidence. You clinically suspect a fracture, but cant see it on x-ray.
What should be done with occult fractures?
Follow up radiologic exam within 7-10 days reveals resorption of bone at the fracture site or frank displacement.
What is a pseudo-fracture?
not a true fracture, but represents an insufficiency fracture or is the result of vascular pulsations.
What is a salter-Harris fracture?
An epiphyseal fracture.
What are the different types of salter-Harris fractures?
Type I- One that only goes through the growth plate. Type II- one that goes through the growth plate and the metaphysis. Type III- one that goes through the growth plate and the epiphysis. Type IV- one that goes through the growth plate, metaphysis, and epiphysis. Type V- a compression fracture of the growth plate.
Which type of salter-Harris fracture is the most common?
Type II.
What is a subluxation?
partial loss of contact between the usual articular surface. The joint surfaces are incongruous, but a significant portion remains apposed.
What is dislocation?
a complete loss of contact between the usual articular componenets of a joint.
What is diastasis?
Displacement or frank separation of a slightly movable joint. Like sutures of the skull, pubic symphysis, and distal tibofibular joints. 2 bones pulled apart at fibrous joint.
What is chondral and osteochondral fracture?
A fracture through a joint surface may result from shearing, rotary, or tangential impaciton fractures. The fractures may consist of cartilage only or cartilage and underlying bone.
What is the first stage of fracture healing and what is it like?
Cellular phase- inflammatory response to damaged soft tissues. Osteoblastic bone resorption takes place. This phase is prominent for the first 5 days, but lasts 10 days. Hematoma and granulation tissue are present and will eventually (at 2 weeks) make the callus.
What is the second stage of fracture healing and what is it like?
Vascular phase- new circulatory network is formed. All the new blood flow will cause a vascular swamp and cause passive hyperemia or congestion which promotes the secretion of osteoid matrix by the mesenchymal cells (osteoclastic avtivity). Periosteal cells adjacent to the fracture become activated and reproduce and secrete a matrix about themselves that, in effect, elevates the perisoteum. Lasts 10 days.
What is the primary callus like?
coarsely woven bone and is radiographicaly evident at about 14 days.
What comes after the cellular and vascular fracture healing phases?
reparative or metabolic- a more orderly secretion of callus and the removal and replacement of coarsely woven osteoid by a more mature form of bone.
With the reparative or metabolic phase when will clinical union be achieved?
When the callus is sufficiently developed to allow weight bearing or similar stress.
What is the final phase of fracture repair?
Remodeling or mechanical phase- Restoration of medullary cavity and marrow, Clinical healing before anatomical healing.
How long can the remodling phase last?
May last for years.
What is apposition?
The ends of fractures close to each other.
Review types of fractures on page 5 and 6 of the fracture handout.
OK.
What is a colles facture?
fracture of the distal radius 20-35 mm proximal to the articular surface.
What type of fracutre will accompany a colles fracture 60% of the time?
ulnar styloid process.
What is the usual cause of a colles fracture?
Falling on an outstretched, extended hand.
Who is more likely to get colles fractures? Why?
Women 6 times more likely due to osteoporosis.
