Exam 4: Skeletal System - Fractures Flashcards
fracture
refers to a broken bone
occurs internally without penetrating through skin
simple or closed fracture
penetration through skin and expose damaged bone to outside environment
- this makes bone vulnerable to infection and may introduce serious complications with healing
compound or open fractures
rare infection of bone that can occur as result of compound fracture or from systemic infection
osteomyelitis
2 ways to get osteomyelitis
- through compound fracture not responding to antibiotics
2. someone who already has sepsis - not broken but very vascular and bacteria gets in
greenstick fracture
- most common in children: not full bone structure finished
- incomplete break
- bending of bone - since still flexibility in bone as kids
epiphyseal fracture
- breakage in growth plate
epiphyseal plate - needs specialized treatment to avoid disruption of growth
- if broke when young you can see diff in length of legs
spiral fracture
- result of torsional stress
- red flag for abuse : someone could have had arm twisted
- can be accidental
transverse fracture
- breakage at a right angle to the length of the bone
- can be from sharp direct blow or prolonged stress
- due to a direct hit or if fall and hit perpendicular object
compression fracture
- crushing of vertebrae
- can occur from hard fall
- can be related to osteoporosis
- can heal on own but may need surgery depending on severity
comminuted fracture
- breakage results in shattering into 3 or more pieces
- requires surgery and pins
putting it together like a puzzle - car accident or falling
colles fracture
- distal radius fracture
- results in putting arm down to “break fall”
most common in winter
Pott’s fracture
- ankle fracture
- bimalleolar : lateral and medial
- occurs in sports involving running and jumping
- swelling pain, nasty looking
avulsion fracture
- muscle/tendon tension fractures insertion point on bone
- excessive force due to over-contraction of muscle
- most commonly a sports injury
- patella not where it should be
rip portion of off the bone
what are the stages to fracture healing
- hematoma and inflammation
- soft callus
- hard callus
- remodeling
stage 1: hematoma and inflammation
- immediately to 1 week
- hematoma forms at fracture site
- macrophages, neutrophils, platelets migrate to site and stimulate inflammation
- platelets and WBC secrete cytokines, interleukins, PDGF, TGF
- BMP and tissue growth factors stimulate proliferation and differentiation of progenitor cells to chondroblasts and osteoblasts
- progenitor cells in endosteal and periosteal regions
endosteal vs periosteal
endosteal: inside the bone
periosteal: between bone and connective tissue wrapping around it
- heal bone from both the inside and outside
stage 2: soft callus
- 2nd week to 1 month
- endochondral bone formation begins
- sets down stronger fibrocartilage to connect broken ends
- formation of bridging callus (soft callus)
- osteoblasts begin to put down woven bone
formation of cartilage is dependent on ______
gap distance and immobilization of broken ends
stage 3: hard callus
- several months
- fibrocartilage replaced by woven bone
- type II collagen replaced by type I collagen
- formed 3-4 weeks after fracture; may continue several months until secure connection established
stage 4: remodeling
- up to a year or more
- woven bone replaced by compact bone
- bone collar may remain
bad damage - large area of bone collar - thicker than bone around it
application: fracture healing
stress fractures
what type of bone formation is this?
will healing time inc or dec?
intramembraneous ossification
will heal faster - does not have to do cartilage part
stress fracture
small fractures, not a big gap, two ends not completely aart - thin fracture line on bone
- commonly in legs and feet
- do not need intervening cartilage
application: spinal fusion and laminectomy
- common in lumbar region
- laminectomy only if pressure on spine or nerves
bone grafts: - shard of bone between two vertebrae helps heal - sets distance so you do not compress it
