Extremity Fractures Flashcards
Healing Factors (4)
- Age
- Location & Configuration
- Extent of Displacement
- Blood Supply
Initial Fracture Complications
- Local Injuries to skin, blood vessels, nerves, muscles and visceral structures (internal organs)
Early Fracture Complications - Local (3)
- Infection, gangrene, septic arthritis
- Compartment syndrome
- Osteomyelitis, AVN
Early Fracture Complications - Remote (3)
- Thrombus, embolus formation
- Pneumonia
- Tetanus
Late Fracture Complications - Joint (2)
- Persistent pain or stiffness
- Post-traumatic DJD
Late Fracture Complications - Bone (5)
- Abnormal healing
- Growth disturbances
- Persistent osteomyelitis
- Osteoporosis
- Complex regional pain syndrome (CRPS)
Late Fracture Complications - Muscular (2)
- Myositis ossificans
- Tendon rupture
Compartment Syndrome
Caused by swelling or other causes of decreased space within the fascial compartment resulting in reduced blood flow.
Acute Compartment Syndrome (3)
- Caused by edema or hematoma
- Signs include pain, edema (shiny, tight skin), blue color in distal limb, absent or diminished pulse
- EMERGENCY
Chronic Compartment Syndrome
- Usually due to increased muscle size or decrease in size of the anatomical compartment
- Not considered a medical emergency
Heterotropic Ossification
- Bone deposits in soft tissue areas
- Common sites are around knees and hips
Heterotropic Ossification Risk Factors (5)
- Neurological Injuries (SCI)
- Open wounds
- Sepsis
- Prolonged critical illness
- ** Aggressive ROM
Fracture Classification Areas (6)
- Anatomic location
- Fracture location on the bone (proximal, distal)
- Direction (transverse, longitudinal)
- Alignment (varus, valgus, displaced)
- Articular involvement
- Open/Closed
Transverse Fracture
Horizontal fracture across the bone
Oblique Fracture
- Diagonal fracture
- Usually caused by sharp angled blow
Spiral Fracture
- AKA torsion fracture
- Fracture “wraps” or spirals around the bone
- Commonly due to sports injury or child abuse
Longitudinal Fracture
- Fracture occurs vertically
Comminuted Fracture
- Fracture occurs in multiple directions, results in fragments
- Commonly caused by trauma and aging
- Often treated with ORIF or external fixation
Impacted Fracture
- Occurs when two bone surfaces are jammed together
- Often seen in hips of children
Depressed Fracture
- Fracture that causes bones to cave inwards
- Most commonly seen in the skull
- Commonly due to blunt force trauma
Avulsion Fracture
- Piece of bone is pulled off, usually due to repeated pulling on the bone by muscles
- More common in children, especially at growth plate
Salter Harris Fractures
- Fracture of the growth plate, can result in growth deficits
- Types I-VI
Salter Harris Type 1
- Fracture occurs along the growth plate on either side but does not cross growth plate
- Immobilized until fracture fully heals
- Excellent prognosis w/ good blood supply
Salter Harris Type 2
- Fracture occurs along the growth plate and extends up into metaphysis creating a triangular shaped fragment
- Requires reduction/immobilization
- Good prognosis