bone path final Q7 Flashcards

1
Q

What is an open and a closed fracture?

A

Closed will not break skin or communicate with the outside world. Open is one that penetrates the skin over the fracture site.Closed will not break skin or communicate with the outside world. Open is one that penetrates the skin over the fracture site.Closed will not break skin or communicate with the outside world. Open is one that penetrates the skin over the fracture site.Closed will not break skin or communicate with the outside world. Open is one that penetrates the skin over the fracture site.Closed will not break skin or communicate with the outside world. Open is one that penetrates the skin over the fracture site.

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2
Q

What is a comminuted and a non-comminuted fracture?

A

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.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.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.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.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.

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3
Q

What is the difference between avulsion and impaction fractures?

A

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.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.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.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.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.

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4
Q

What are the 2 types of impaction fractures and what are they like?

A

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.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.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.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.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.

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5
Q

What is an incomplete fracture and what are the different types?

A

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.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.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.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.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.

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6
Q

What is the difference between pathologic and stress fractures?

A

Pathologic- a fracture caused by bone that is weakened by a localized or systemic disease. Stress- a fracture caused by repetitive stress.Pathologic- a fracture caused by bone that is weakened by a localized or systemic disease. Stress- a fracture caused by repetitive stress.Pathologic- a fracture caused by bone that is weakened by a localized or systemic disease. Stress- a fracture caused by repetitive stress.Pathologic- a fracture caused by bone that is weakened by a localized or systemic disease. Stress- a fracture caused by repetitive stress.Pathologic- a fracture caused by bone that is weakened by a localized or systemic disease. Stress- a fracture caused by repetitive stress.

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7
Q

What are 2 types of stress fractures?

A

Fatigue and insufficiency.

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8
Q

What is an occult fracture?

A

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.

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9
Q

What should be done with occult fractures?

A

Follow up radiologic exam within 7-10 days reveals resorption of bone at the fracture site or frank displacement.

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10
Q

What is a pseudo-fracture?

A

not a true fracture, but represents an insufficiency fracture or is the result of vascular pulsations.

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11
Q

What is a salter-Harris fracture?

A

An epiphyseal fracture.

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12
Q

What are the different types of salter-Harris fractures?

A

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.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.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.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.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.

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13
Q

Which type of salter-Harris fracture is the most common?

A

Type II.

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14
Q

What is a subluxation?

A

partial loss of contact between the usual articular surface. The joint surfaces are incongruous, but a significant portion remains apposed.

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15
Q

What is dislocation?

A

a complete loss of contact between the usual articular componenets of a joint.

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16
Q

What is diastasis?

A

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.

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17
Q

What is chondral and osteochondral fracture?

A

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.

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18
Q

What is the first stage of fracture healing and what is it like?

A

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.

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19
Q

What is the second stage of fracture healing and what is it like?

A

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.

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20
Q

What is the primary callus like?

A

coarsely woven bone and is radiographicaly evident at about 14 days.

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21
Q

What comes after the cellular and vascular fracture healing phases?

A

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.

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22
Q

With the reparative or metabolic phase when will clinical union be achieved?

A

When the callus is sufficiently developed to allow weight bearing or similar stress.

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23
Q

What is the final phase of fracture repair?

A

Remodeling or mechanical phase- Restoration of medullary cavity and marrow, Clinical healing before anatomical healing.

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24
Q

How long can the remodling phase last?

A

May last for years.

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25
Q

What is apposition?

A

The ends of fractures close to each other.

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26
Q

Review types of fractures on page 5 and 6 of the fracture handout.

A

OK.

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27
Q

What is a colles facture?

A

fracture of the distal radius 20-35 mm proximal to the articular surface.

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28
Q

What type of fracutre will accompany a colles fracture 60% of the time?

A

ulnar styloid process.

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29
Q

What is the usual cause of a colles fracture?

A

Falling on an outstretched, extended hand.

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30
Q

Who is more likely to get colles fractures? Why?

A

Women 6 times more likely due to osteoporosis.

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31
Q

What is a gamekeepers thumb?

A

A tear or complete rupture of the ulnar collateral ligament at the first metacarpophalangeal joint leading to a dislocation of the thumb.

32
Q

What areas of the spinal are the most commonly fractured?

A

C1-2, C5-6, T12-L2.

33
Q

What % of spinal fractures and dislocations involve the cord?

A

10-14%.

34
Q

What % of fractures in the cervical spine and TL junction and toracic spine produce neurological damage?

A

Cervical- 40%, TL- 4%, Thoracic- 10%.

35
Q

What is the most common line of force in spinal injuries?

A

Flexion.

36
Q

Problems with the atlanto-dental interval suggest what?

A

Transverse ligament problems.

37
Q

What are the 2 general types of hip trauma at the proximal femur?

A

Intracpasular and extracapsular trauma.

38
Q

What type of fracture causes more problems the intracapsular or extracapsular fractures of the proximal femur?

A

Intracapsular.

39
Q

What is a torus fracture?

A

Buckled trabeculae with a cortical bulge.

40
Q

What is a severe fracture caused by a trivial trauma in a osteoporosis person called?

A

Sudeck’s atrophy.

41
Q

What is clayshovelers fx?

A

Avulsion of a lower cervical segment of an SP.

42
Q

What is a teardrop fx?

A

A displaced, triangular fragment from the anterioinferior body corner.

43
Q

What is a jefferson’s fx?

A

fractured anterior and posterior arch of the atlas.

44
Q

What is a hangmans fx?

A

Bipedicular fx of axis.

45
Q

What is a chance Fx?

A

horizontal fracture through a single body and posterior arch.

46
Q

What is a bucket handle fx?

A

superior and inferior pubic ramus fx with a fx or separation of the contralateral si joint.

47
Q

What is a duverneys fx?

A

Iliac wing fx.

48
Q

What is a sprung pelvis?

A

separation of the pubic symphisis and both SI joints.

49
Q

What is a straddle fx?

A

bilateral superior pubic rami and ischiopubic fx.

50
Q

What is segond’s fx?

A

avulsion of the lateral tibia at the insertion of the tensor fascia lata.

51
Q

What is cottons fx?

A

trimalleolar fx.

52
Q

What is a maissoneuve’s fx?

A

proximal fibula fx owing to an inversion and external rotation injury of the ankle.

53
Q

What is a toddler’s FX?

A

distal diaphyseal or metaphyseal spiral fx of the tibia in an infant.

54
Q

What is a boot top fx?

A

distal diaphyseal or metaphyseal sprial fx of the tibia and fibula in an adult.

55
Q

What is an aviator fx?

A

fx through the neck of the talus.

56
Q

What is a bedroom fx?

A

phalangeal fx from striking an object.

57
Q

What is a dancers fx?

A

aka jones. Avulsion fx of the styloid of the 5th metatarsal base.

58
Q

What is a lisfranc’s?

A

dorsal dislocation of the metatarsal bases with associated fx.

59
Q

What is flail chest?

A

2 fractures of the same rib.

60
Q

What is golfers fx?

A

lateral rib fx following an a strike to the ground with a golf club.

61
Q

What is a bankart lesion?

A

avulsion of the triceps insertion with a small fragment from the inferior glenoid rim.

62
Q

What is a hill-sachs defect?

A

aka hatchet. An impaction fx at the posterosuperior surface of the humeral head from the inferior glenoid rim following recurrent anterior shoulder dislocation.

63
Q

What is galeazzi fx?

A

fx of the junction of the distal and middle third of the radial shaft and dislocation of the inferior radioulnar joint.

64
Q

What is monteggia’s fx?

A

fx of the proximal ulnar shaft with dislocation of the radial head.

65
Q

What is a nightstick fx?

A

fx of the ulnar shaft when the arm is raised to protect the head from a blow.

66
Q

What is colles fx?

A

fx of the radius within 20-35 mm of the joint and posterior angulation of the distal fragment.

67
Q

What is chauffeurs fx?

A

fx of the radial styloid.

68
Q

What is bartons fx?

A

posterior rim fx of the distal radius.

69
Q

What is smiths fx?

A

fx of the radius within 20-35 mm of joint and anterior angulation of the distal fragment.

70
Q

What is a bennett’s fx?

A

intra-articular fx through the base of the first metacarpal, with dorsal and radial displacement of the shaft.

71
Q

What is a boxer’s fx?

A

second or third metacarpal neck fx with anterior displacement of the head.

72
Q

What is gamekeepers fx?

A

disruption of the ulnar collateral ligament at the first metacarpophalangeal joint.

73
Q

What is rolando fx?

A

comminuted intra-articular fx at the base of the first metacarpal.

74
Q

What is FBI sign?

A

fat, blood, interface usually seen in the knee as a sign of intra-articular fx.

75
Q

What is a malgaigne’s fx?

A

a double injury to one hemipelvis. A ipsilateral double vertical fx of the superior ramus and the ischiopubic ramus, with a fx or dislocation of the si joint.