Exam 4 - Fractures

Question 1

what is a fracture

Answer 1

any break in the continuity of bone that occurs when more stress is placed on the bone than it is able to absorb

Question 2

causes of fractures

Answer 2

• traumatic (fall)
• fatigue (prolonged, repeated stress)
• pathologic (weakened bone)

Question 3

open fracture

Answer 3

• compound
• fractured bone penetrates skin

Question 4

closed fracture

Answer 4

• simple
• does not break through the skin

Question 5

clinical manifestations of fractures

Answer 5

• pain
• edema
• deformity

Question 6

what are the three phases of bone healing

Answer 6

1. inflammatory
2. reparative
3. remodeling

Question 7

complications of fractures

Answer 7

• delayed healing
• bone growth impairment
• compartment syndrome
• fat embolism syndrome

Question 8

delayed healing

Answer 8

1. delayed union - bone pain and tenderness increase
2. malunion - improper alignment
3. nonunion - no healing 4-6 months post-fracture (poor blood supply, repetitive stress)

Question 9

impaired bone growth

Answer 9

• pediatric consideration
• fracture through epiphyseal plate
• can delay future bone growth

Question 10

compartment syndrome

Answer 10

• crush injuries and cast
• results from increased pressure within limited anatomic space
• tourniquet effect
• edema, loss/weakened pulses, PAIN

Question 11

fat embolism syndrome

Answer 11

• fat molecules in the lung following long bone fracture or major trauma

Question 12

what is osteomyelitis

Answer 12

an acute or chronic pyogenic infection of bone

Question 13

what is the usual cause for osteomyelitis

Answer 13

bacteria

Question 14

risk factors for osteomyelitis

Answer 14

• recent trauma
• diabetes
• hemodialysis
• IV drug use
• splenectomy

Question 15

direct route of contamination for osteomyelitis

Answer 15

• open wound
• surgery/insertion of meta plates or screws

Question 16

indirect route of contamination for osteomyelitis

Answer 16

• from bloodstream (most common)
• bacteremia

Question 17

Osteomyelitis pathogenesis

Answer 17

• pressure increases within the bone
• causes local arteries to collapse
• leads to impaired healing and difficult to treat

Question 18

local clinical manifestations of osteomyelitis

Answer 18

• tenderness, warmth, redness
• wound drainage
• restricted movement
• spontaneous fracture

Question 19

systemic clinical manifestations of osteomyelitis

Answer 19

• fever
• positive blood culture
• leukocytosis

Question 20

Osteomyelitis pharmacotherapy

Answer 20

• obtain culture
• empiric antibiotic therapy: nafcillin, cefazolin, vancomycin
• bacteria-specific therapy