Chapter 4 Fracture Flashcards

1
Q

It is defined as complete or incomplete interruption, a break in the continuity of a bone.

A

Fracture

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2
Q

List are types of Complete fracture. Except:

Simple

Impacted

Fissured-fracture

Comminuted

Compound

Compression

Spiral

Complicated

A

Fissured-fracture

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3
Q

What are the types of Incomplete fracture?

A
  • Greenstick
  • Fissured
  • Perforated
  • Depressed
  • Stress
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4
Q

What are other types of Fracture?

A
  • Avulsion
  • Spontaneous
  • Colles’ or Dinner fork
  • Pott’s
  • Dupuytren’s
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5
Q

___________ - fracture where the broken bone actually injured or punctured a near-by organ.

A

Complicated

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6
Q

_________ - fracture has the bone splitting without displacement.

A

Fissured

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7
Q

_________ - very small, hairline type of crack that occurs through repeated stress over time.

A

Stress

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8
Q

__________ - fracture where there is a hole in the bone, often caused by a bullet.

A

Perforated

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9
Q

________ - a portion of bone attached to a ligament or tendon, fractures, due to a violent pull on that ligament or tendon.

A

Avulsion

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10
Q

______ - a violent avulsion causes a fracture of the distal fibula and an avulsion fracture of the medial malleolus, by the deltoid ligament.

A

Pott’s

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11
Q

______________ - Falling in an outstretched arm usually causes an impacted and comminuted fracture on the distal radius and an avulsion fracture of the ulnar styloid process.

A

Colles’ or Dinner fork

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12
Q

___________ - the person falls from a height and lands on their feet. The tibia and fibula may be fractured and the interosseous ligament is ruptured.

A

Dupuytren’s

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13
Q

What are the material that can be used for casting?

A

plaster

fiberglass

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14
Q

Three causes of Fracture:

A
  • Trauma (indirect, direct, and spontaneous)
  • Overuse or repeated wear
  • Pathologies ( Osteoporosis, tumors, local infections or bone cyst )
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15
Q

___________ - a twisting injury causing an oblique fracture, with little tissue damage.

A

Indirect trauma

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16
Q

___________ - object impacting bone resulting in a transverse fracture with local tissue damage.

A

Direct trauma

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17
Q

___________ - fracture caused by a bone pathology.

A

Spontaneous

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18
Q

List are observations to identify Fracture and its treatment. Except:

a. Discoloration - if excessive then surgery is necessary.
b. Is client using slings/cast?
c. Edema and inflammation are usually present but check bilaterally
d. Is client using crutches?
e. Evaluate client posture

A

Except: a

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19
Q

In palpating fracture it is important to check for:

A
  • Check for heat and inflammation, distal to injury site
  • Trigger points in muscles adjacent to injury site
  • Check tissue around cast for tissue health
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20
Q

Fractures are classified into several types according to:

A
  • Nature of break
  • Location of the bone
  • Angle of the broken ends
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21
Q

Fracture where in the skin is still intact. This is called:

A

Closed or simple fracture

22
Q

If the ends of the bone broken through the skin or into one of the body cavities. It is called:

A

Open or compound fracture

23
Q

Testing fracture without cast: True or False

Testing surrounding muscles and joints involved in fracture is advisable .

Test range of motion proximal only to injury site.

A

False

24
Q

Testing fracture with cast. Which statement is false?

  1. Avoid testing affected muscles, tissues and joints, up to one week after cast is removed.
  2. Use caution when testing ROM of affected joints, do not disrupt any healing.
  3. All passive forced ROM is necessary
  4. Passive Relax, Active Free, Active Resisted are all indicated
  5. Note any muscle weakness or joint restrictions present
A

3

25
Q

In fracture: Reduction with no immobilization. True or False:

Passive forced ROM and Active Resisted ROM is needed until complete healing has occurred.

A

False

26
Q

What are the signs and symptoms of fracture with cast on?

A
  • Pain
  • inflammation
  • loss of function
  • muscle spasm
  • Complication-nerve severed, vascular damage, fascial restriction
27
Q

Give atleast four aims or goals in treating fracture with cast on:

A
  • Avoid interfering with healing process
  • Reduce inflammation
  • Decrease sympathetic nerve firing
  • Decrease hypertonicity
  • Decrease pain
  • Maintain pain-free ROM
28
Q

In treatment of fracture without cast, How many days before the client may do stretching or strengthening affected muscles and joints?

A

7 days

29
Q

The following are aims or goals in the treatment of fracture without a cast. Except:

a. Increase circulation
b. Increase Parasympathetic nervous system firing.
c. Increase hypertonicity
d. Decrease adhesions
e. Wait for tone to return to muscles before increasing ROM. Address compensatory changes

A

Except: c

Correct: Decrease hypertonicity

30
Q

The following are contraindications of fracture with or without cast. Except:

a. Joint testing after union has occurred
b. Avoid temperature extremes to any hypotonic muscles
c. Avoid hot hydro locally, if pins present
d. No traction of affected joint before consolidation

A

Except: a

31
Q

how many are the stages of healing?

A

Five stages

32
Q

What stage of healing where in there is an inflammatory reaction and proliferation of the osteoblasts at the periosteum.?

A

Second stage

33
Q

_________ - Hematoma forms around the ends of the fracture bone within 72 hours of initial trauma.

A

First stage

34
Q

What stage of healing wherein remodelling of the irregular outer surface and reshaping of the marrow space inside the bone take place through alternating osteoclastic and osteoblastic activity?

A

Fifth stage

35
Q

Stage of healing wherein consolidation occurs as the immature woven bone is changed into matured lamellar bone.

A

Fourth stage

36
Q

Stage of healing where in a soft callus or splint is formed from the mass of proliferating osteoblasts.

A

Third Stage

37
Q

Early complications of fracture are the following. Except:

a. Compartment syndrome
b. Nerve compression
c. myositis ossificans
d. Vascular damage
e. Bone and soft tissue infectons

A

Except: b

38
Q

Late complications of fracture are the following. Except:

a. Delayed union
b. non unionc. malunion
d. cast dermatitis
e. volkmann’s ischemic contracture

A

Except: d

39
Q

True about the use of hydrotherapy in fracture. Except:

Note contraindication

Check with M.D. to make sure you can use hydrotherapy

Proximal to injury, use deep moist heat

Use cool over cast

Can progress to mild contrast to increase circulation

Use cool on injury, once healing has progressed

A

Use cool on injury, once healing has progressed

40
Q

Condition wherein there is an increase in pressure within the compartment of the lower leg.

A

Compartment syndrome

41
Q

It is a cold application such as an ice pack or gel pack, applied to the limb distal to the cast.

A

Hydrotherapy

42
Q

True about fracture with cast in acute and sub-acute stage. Except:

a. Elevate affected limb for drainage (apply appropriate hydro for stage of injury)
b. Diaphragmatic breathing
c. Treat compensating areas (relaxation massage)
d. Heat on restrictions/adhesions

A

Except: d

43
Q

True or false:

In subacute can use effleurage, Petrissage proximal to injury. In subacute can release trigger points that refer into the injury site.

A

True

44
Q

In massage with cast off. true or false :

  • Depends on tissue health and proper healing process
  • If surgery, the deep manipulations are needed for 6 months after consolidation
A

False

45
Q

True statement regarding massage with cast off. Except:

a. Treat affected areas first
b. Can use manipulation to decrease adhesions present, treat trigger points
c. If muscle is hypotonic, can use light tapotement to restore tone.
d. ROM (Active Resisted ROM to increase strength)
e. Stretch affected muscles (7 days after cast is removed) back to normal rangef. Joint mobs to proximal/distal joints(carefully after union/do not traction until afterg. consolidation) can progress to affected joints

A

Except: a

Correct: Treat unaffected areas first

46
Q

Remedial Exercise on fracture with cast on After 4 days can do gentle__________ , progress to Active Free ROM to uninvolved joints. Pain free _________ contractions to affected muscle.

A
  • Passive Relax ROM
  • isometric
47
Q

Exercise develop for two areas: the compensating structures and the muscle under the cast. It is called:

A

Remedial Exercise

48
Q

When cast off remedial exercise begin with Passive Relax and _________ ROM in pain free range, progress to proper length and strength muscle and joints using __________ and active resisted ROM.

A
  • Active Assisted
  • Active Forced
49
Q

Remedial exercise in cast off address the following: Except:

a. Postural re-education
b. Address imbalances
c. Concentric muscle contractions

A

Except: c

Correct: Isometric muscle contractions

50
Q

What is the time of union consolidation for spiral fracture of upper limb and lower limb?

A
  • upper limb 3 weeks to 6 weeks
  • Lower limb +6 weeks12 weeks
51
Q

What is the time of union consolidation for transverse fracture of upper limb and lower limb?

A
  • upper limb 6 weeks to 12 weeks
  • Lower limb12 weeks to 24+ weeks
52
Q

True or false:

Use Vitamin E oil for skin, after cast has been removed.

A

True