Chapter 4 Fracture Flashcards
It is defined as complete or incomplete interruption, a break in the continuity of a bone.
Fracture
List are types of Complete fracture. Except:
Simple
Impacted
Fissured-fracture
Comminuted
Compound
Compression
Spiral
Complicated
Fissured-fracture
What are the types of Incomplete fracture?
- Greenstick
- Fissured
- Perforated
- Depressed
- Stress
What are other types of Fracture?
- Avulsion
- Spontaneous
- Colles’ or Dinner fork
- Pott’s
- Dupuytren’s
___________ - fracture where the broken bone actually injured or punctured a near-by organ.
Complicated
_________ - fracture has the bone splitting without displacement.
Fissured
_________ - very small, hairline type of crack that occurs through repeated stress over time.
Stress
__________ - fracture where there is a hole in the bone, often caused by a bullet.
Perforated
________ - a portion of bone attached to a ligament or tendon, fractures, due to a violent pull on that ligament or tendon.
Avulsion
______ - a violent avulsion causes a fracture of the distal fibula and an avulsion fracture of the medial malleolus, by the deltoid ligament.
Pott’s
______________ - 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.
Colles’ or Dinner fork
___________ - the person falls from a height and lands on their feet. The tibia and fibula may be fractured and the interosseous ligament is ruptured.
Dupuytren’s
What are the material that can be used for casting?
plaster
fiberglass
Three causes of Fracture:
- Trauma (indirect, direct, and spontaneous)
- Overuse or repeated wear
- Pathologies ( Osteoporosis, tumors, local infections or bone cyst )
___________ - a twisting injury causing an oblique fracture, with little tissue damage.
Indirect trauma
___________ - object impacting bone resulting in a transverse fracture with local tissue damage.
Direct trauma
___________ - fracture caused by a bone pathology.
Spontaneous
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
Except: a
In palpating fracture it is important to check for:
- Check for heat and inflammation, distal to injury site
- Trigger points in muscles adjacent to injury site
- Check tissue around cast for tissue health
Fractures are classified into several types according to:
- Nature of break
- Location of the bone
- Angle of the broken ends
Fracture where in the skin is still intact. This is called:
Closed or simple fracture
If the ends of the bone broken through the skin or into one of the body cavities. It is called:
Open or compound fracture
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.
False
Testing fracture with cast. Which statement is false?
- Avoid testing affected muscles, tissues and joints, up to one week after cast is removed.
- Use caution when testing ROM of affected joints, do not disrupt any healing.
- All passive forced ROM is necessary
- Passive Relax, Active Free, Active Resisted are all indicated
- Note any muscle weakness or joint restrictions present
3
In fracture: Reduction with no immobilization. True or False:
Passive forced ROM and Active Resisted ROM is needed until complete healing has occurred.
False
What are the signs and symptoms of fracture with cast on?
- Pain
- inflammation
- loss of function
- muscle spasm
- Complication-nerve severed, vascular damage, fascial restriction
Give atleast four aims or goals in treating fracture with cast on:
- Avoid interfering with healing process
- Reduce inflammation
- Decrease sympathetic nerve firing
- Decrease hypertonicity
- Decrease pain
- Maintain pain-free ROM
In treatment of fracture without cast, How many days before the client may do stretching or strengthening affected muscles and joints?
7 days
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
Except: c
Correct: Decrease hypertonicity
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
Except: a
how many are the stages of healing?
Five stages
What stage of healing where in there is an inflammatory reaction and proliferation of the osteoblasts at the periosteum.?
Second stage
_________ - Hematoma forms around the ends of the fracture bone within 72 hours of initial trauma.
First stage
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?
Fifth stage
Stage of healing wherein consolidation occurs as the immature woven bone is changed into matured lamellar bone.
Fourth stage
Stage of healing where in a soft callus or splint is formed from the mass of proliferating osteoblasts.
Third Stage
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
Except: b
Late complications of fracture are the following. Except:
a. Delayed union
b. non unionc. malunion
d. cast dermatitis
e. volkmann’s ischemic contracture
Except: d
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
Use cool on injury, once healing has progressed
Condition wherein there is an increase in pressure within the compartment of the lower leg.
Compartment syndrome
It is a cold application such as an ice pack or gel pack, applied to the limb distal to the cast.
Hydrotherapy
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
Except: d
True or false:
In subacute can use effleurage, Petrissage proximal to injury. In subacute can release trigger points that refer into the injury site.
True
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
False
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
Except: a
Correct: Treat unaffected areas first
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.
- Passive Relax ROM
- isometric
Exercise develop for two areas: the compensating structures and the muscle under the cast. It is called:
Remedial Exercise
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.
- Active Assisted
- Active Forced
Remedial exercise in cast off address the following: Except:
a. Postural re-education
b. Address imbalances
c. Concentric muscle contractions
Except: c
Correct: Isometric muscle contractions
What is the time of union consolidation for spiral fracture of upper limb and lower limb?
- upper limb 3 weeks to 6 weeks
- Lower limb +6 weeks12 weeks
What is the time of union consolidation for transverse fracture of upper limb and lower limb?
- upper limb 6 weeks to 12 weeks
- Lower limb12 weeks to 24+ weeks
True or false:
Use Vitamin E oil for skin, after cast has been removed.
True
