Fracture description and radiographic assessment of fracture healing Flashcards
Describe articular fractures
fracture involves the joint surface
all require rigid internal fixation to maintain articular surface to try and prevent severe OA
what is the diaphysis
Diaphysis is the shaft of the bone- the cortex is thick and bone strong
what is the metaphysis
Metaphysis is the transition from the physis or growth plate to the diaphysis
generally the bone is softer here
what is the epiphysis
the ends of the bons - are covered with articular cartilage making up the joint
what system do we use to treat physeal fractures
Salter Harris system - there are 5 fracture types described
Describe the aims of management of Salter Harris fractures
aim to maintain normal bone growth of the bone resulting in a limb of normal length without angular limb deformities
what are closed fractures
the skin is intact
what are open fractures
the skin overlying the fracture is broken
Describe a type 1 open fractures
small wound <1cm
little contamination
treat as a closed fracture
Describe a type 2 open fracture
extensive wound >1cm
communicating with the fracture
Describe a type 3 open fracture
very extensive soft tissue damage and fractured bones are seen protruding through the skin
Describe comminuted fracture
consists of at least 3 fragments
what may you need to use to fix a comminuted fracture
if not re-constructable- use buttress plate or external fixator to bridge the area of comminution
Describe a avulsion fracture
when a distractive force results in the fracture and also tends to bring about a loss of reduction
Describe how to repair avulsion fractures
need to overcome the distractive forces can use a lag screw or tension band to do this
this converts the distractive forces into compressive ones
what do pathological fractures originate from
from weakening of the bone by a pathological process e.g. neoplasia
List 5 factors that affect bone healing
age of patient
comorbidities
nature of fracture
stability and appropriateness of the repair
post-op management
what is primary bone healing
when there is bone to bone healing
what is secondary bone healing
where there is intervening callus formation
What does primary bone healing need
intimate contact of the bone ends under compression
needs application of bone plate and extensive dissection and manipulation of soft tissue
describe how secondary bone healing works
does not require accurate reduction of the fracture
could just use an external fixator
