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PTRS 746 Exam 1 > Extremity Fracture > Flashcards

Extremity Fracture Flashcards

1
Q

Content: 3 phases of bone healing (with time frame)

A
  1. Inflammatory phase, 1-2 wkls
  2. Reparative phase, months
  3. Remodeling phase, mo-yrs
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2
Q

Q: What occurs during the inflammatory phase?

A

Increased vascularity and formation of fracture hematoma

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3
Q

Q: What is the cellular response during the inflammatory phase? (4)

A
  1. Neutrophils 2. Macrophages 3. Phagocytes 4. Osteoclasts
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4
Q

Q: What occurs during the reparative phase?

A

Cell differentiation - chondroblasts are mineralized by osteoblasts to form a soft callus

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5
Q

Q: What can be seen radiographically during the reparative phase?

A

Fracture line diminishes

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6
Q

Q: What is the risk during the reparative phase?

A

Delayed union or non-union

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7
Q

Q: What occurs during the remodeling phase?

A

Reformation of the medullary canal

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8
Q

Diagram: Fill in the following table

A
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9
Q

Content: 4 factors of bone healing

A
  1. Age
  2. Location and configuration
  3. Extent of initial displacement
  4. Blood supply
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10
Q

Q: Remodeling is _____ ________ in children and _____________ _____________ after early adulthood.

A

Very, rapid, relatively, constant

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11
Q

Q: What is the femoral shaft healing time for the following ages? Birth, 8 yo, 12 yo, 20 yo

A

3 wks, 8 wks, 12 wks, 20 wks

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12
Q

Q: Fractures surrounded by __________ heal faster

A

Muscle

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13
Q

T/F: Cortical bone heals faster than cancellous bone

A

False, flip it

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14
Q

T/F: Long oblique and spiral fractures heal faster than transverse fractures

A

True

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15
Q

Q: Non-displaced fractures with ________ periosteal sleave heal _______ as fast as displaced fractures.

A

Intact, twice

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16
Q

Q: Greater initial displacement = ?

A

More extensive

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17
Q

Q: Periosteal sleeve disruption = ?

A

Prolonged healing time

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18
Q

Q: What is the healing prognosis is all fracture fragments have blood supply?

A

Excellent

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19
Q

Q: If only some fragments have blood supply, what is the course of action?

A

Rigid immoblization to allow for vascularized fragments to serve as “hosts” to unvascularized fragments

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20
Q

Content: Initial complications due to local injuries to… (5)

A
  1. Skin
  2. Vascular
  3. Neurologic
  4. Muscular
  5. Visceral
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21
Q

Content: Early complications - local (3)

A
  1. Infection, gangrene, septic arthritis
  2. Compartment syndrome
  3. Osteomyelitis, avascular necrosis
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22
Q

Content: Early complications - remote (3)

A
  1. Thrombus/embolus formation
  2. Pneumonia
  3. Tetanus
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23
Q

Content: Late complications - joint (2)

A
  1. Persistent pain or stiffness
  2. Post-traumatic DJD
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24
Q

Content: Late complications - bony (5)

A
  1. Abnormal healing
  2. Growth disturbance
  3. Persistent ostemyelitis
  4. Osteoporosis
  5. Complex regional pain syndrome (CRPS)
25
Q

Content: Late complications - muscular (2)

A
  1. Myositis ossificans
  2. tendon rupture
26
Q

Defn: Increased pressure with fasical compartment (esp. anterior LE) due to edema or hematoma within closed space

A

Acute Compartment syndrome

27
Q

Q: What are the 3 signs of acute compartment syndrome?

A
  1. Painful
  2. Edematous, tight
  3. Absent or significantly diminished pulse
28
Q

Q: How is chronic compartment syndrome different than acute?

A

Chronic is due to muscular expansion or decreased size of anatomical compartment

29
Q

Content: Heterotropic ossification (3)

A
  1. Soft tissue ossification, usually periarticular
  2. most commonly involves hip or knee
  3. unknown etiology
30
Q

Content: 5 risk factors for heterotropic ossification

A
  1. Neurologic involvement
  2. Open wounds/burns
  3. Sepsis
  4. Prolonged critical illness
  5. Aggressive ROM
31
Q

Content: 6 ways fractures are described

A
  1. Anatomic location
  2. Fracture location
  3. Direction
  4. Alignment
  5. Articular involvement
  6. Open/Closed
32
Q

Diagram: Identify the type of fracture

A

Transverse

33
Q

Diagram: Identify the type of fracture

A

Oblique

34
Q

Diagram: Identify the type of fracture

A

Spiral

35
Q

Diagram: Identify the type of fracture

A

Longitudinal

36
Q

Diagram: Identify the type of fracture

A

Comminuted

37
Q

Diagram: Identify the type of fracture

A

Impacted

38
Q

Diagram: Identify the type of fracture

A

Depressed

39
Q

Diagram: Identify the type of fracture

A

Avulsion

40
Q

T/F: Avulsion fractures are more common in children, esp. at growth plates.

A

True

41
Q

Content: Fracture mechanics - cortical bone (2)

A
  1. Tolerant to compression and shear forces
  2. Fractures due ot tension - bending, twisting, pulling
42
Q

Q: Who is cortical bone more flexible in?

A

Children

43
Q

Q: A cortical bone fracture caused by an angulatory tension force (in children) is called a?

A

Greenstick fracture

44
Q

Q: What type of forces are cancellous bone susceptible to?

A

Compression forces

45
Q

Diagram: Salter-harris classificaiton of growth plate injuries

A
46
Q

Content: Salter Harris Classification - Type 1 (Description, Tx, Px)

A

D: run directly along the growth plates, vital portions of growth plate remain attached to the epiphysis

Tx: Rarely reduced, immobilization to fully heal

Px: Excellent if blood supply is intact

47
Q

Content: Salter Harris Classification - Type 2 (Description, Tx, Px)

A

D: Runs along the grwoth plate and includes a triangular metaphyseal fragment

Tx: Reduction and immobilization

Px: Good

48
Q

Q: Which type of Salter-Harris classification is most common?

A

Type 2

49
Q

Content: Salter Harris Classification - Type 3 (Description, Tx, Px)

A

D: Run along part of growth plate and turn perpendicularly into the joint

Tx: Surgery to restore joint surface

Px: Good if blood supply to separated portion is intact

50
Q

Content: Salter Harris Classification - Type 4 (Description, Tx, Px)

A

D: Run from epiphysis across the growth plate and into the metaphysis

Tx: Surgery to restore joint surface and align growth plate

Px: May cause premature focal fusion and joint deformity

51
Q

Content: Salter Harris Classification - Type 5 (Description, Px)

A

D: Compression of growth plate results in a growth disturbance

Px: Poor

52
Q

Q: What type of Salter-Harris Classification is not often recognized at the time of injury?

A

Type 5

53
Q

Q: What Salter-Harris classification is an injury to perichondrial ring may cause physis to tether to bone, hindering growth?

A

Type 6

54
Q

Q: What are the two main types of fracture management?

A

Reduction and immobilization

55
Q

Content: 2 types of fracture reduction

A
  1. Open
  2. Closed
56
Q

Content: 4 types of immobilization

A
  1. Casting
  2. Splinting
  3. External fixation
  4. Internal fixation
57
Q

Q: What 4 things should be considered for a PT fracture intervention?

A
  1. MOI
  2. Age
  3. Functional needs/demands
  4. Type of immobilizaiton/orthopedic plan of care
58
Q

Q: What 5 things does a PT fracture intervention entail?

A
  1. Preserve/Improve ROM
  2. Increase mobility
  3. ADL training
  4. Education
  5. Wound care
59
Q

Q: What can cause an avulsion fracture?

A

Musculature is stronger than the developing bone can handle

PTRS 746 Exam 1 (9 decks)

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