Fracture classification and assessment (Lewis) Flashcards
What are the basic forces to which a bone is subjected
Tension Compression Shear Bending Torsion
Tension
Produces elongation
Places with ligaments and tendons
Apophyses
Compression
Short, oblique fx
bone is strongest in this mode of loading
Shear
eccentric loading of bone surface
bone is weakest in this mode of fracture
Torsion
Rotational forces applied to long axis of bone
Spiral Fx
Greenstick fracture
young animals
Bending forces
opposing cortices involved
Fissure fracture
involves only one cortex
2 examples of incomplete fractures
Greenstick
Fissure
5 complete fractures
Transverse oblique spiral comminuted segmental
Transverse fracture
Fx is perpendicular to the bone’s long axis
bending forces
Oblique fx
line runs diagonally to the bone’s long axis
cortices are in the same plane
Spiral fx
line runs diagonally to the bone’s long axis
opposing fx corticies are in different planes
Comminuted
at least 3 fragments
fx lines intersect
Segmental fx
at least 3 fragments
fx lines do not intersect
Diaphyseal
mostly cortical bone
lots of mineral
few osteoblasts
slow healing
Metaphyseal
mostly cancellous bone
good muscle attachments
good blood supply/healing
Physeal
Salter-harris
What is required for a articular fracture
Anatomic reduction
rigid stabilization
Displacement
location of the distal segment relative to the proximal segment
Type 1 fracture
clean soft tissue laceration <1cm
Type 2 fracture
soft tissue laceration <1cm
mild trauma
no flaps or avulsion
Type 3a fx
soft tissue available for wound coverage despite vast laceration
flaps or high E trauma
Type 3b fx
extensive soft tissue injury loss
periosteum stripped
bone exposed
Type 3c fx
arterial supply to distal limb damaged
zone of growth plate that physical fractures purportedly transverse
zone of hypertrophy
Salter harris 1
straight across
Salter harris 2
above
physis and metaphysis
S.H. 3
lower
physis and epiphysis
S.H. 4
Through
Epiphysis, physis, and metaphysis
S.H. 5
Crush
If you give a fracture assessment score of 10, is the risk high or low
little risk
Buttress fragment would have an assessment score of
1
compression fragment would have a score of
10
Single limb injury would have a score of
10
multiple limb injury would have a score of
1
What size of animal would have the highest risk assessment socre
10
For a fracture, what does a high score mean
rapid healing with less dependence on implants
What are the treatments for low score fractures
buttress plate
bridging osteosynthesis
interlocking nails
Midscale fracture score treatments
neutralization plate
type 2 ESF
Interlocking Nail
IM pin/Type 1 ESF
high score fracture treatments
external coaptation
compression plate
Type 1 or 2 ESF
IM pin/cerclage
