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Musculoskeletal > Fracture Healing > Flashcards

Fracture Healing Flashcards

1
Q

What are the functions of bone?

A 
Support, protection and movement
Mineral storage (calcium and phosphate)
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2
Q

What type of bone makes up the majority of the skeleton?

A

Cortical bone

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3
Q

Describe the features of cortical bone?

A

Slower turnover rate and metabolic activity

High Young’s modulus and resistance to torsion and bending

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4
Q

Describe the features of cancellous bone?

A

Higher turnover rate
Undergoes greater remodelling
Lower Young’s modulus and is correspondingly more elastic

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5
Q

What components make up the matrix portion of. bone?

A

Collagen
Non-collagenous proteins
Mucopolysaccharides
Calcium Phosphorous

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6
Q

What cells are present in bone?

A

Osteoprogenitor cells
Osteocytes
Osteoblasts
Osteoclasts

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7
Q

What is the name for the shaft of the bone?

A

Diaphysis

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8
Q

What is the name for the end of the bone?

A

Epiphysis

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9
Q

What is the name for the mid region of the bone between the end and the shaft?

A

Metaphysic

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10
Q

What is the other name for the growth plate of a bone?

A

Physis

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11
Q

What is the function of the physis?

A

Responsible for skeletal growth and allows remodelling of angular deformities after fracture

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12
Q

What is the result of damage to the physeal blood supply?

A

Growth arrest which can be partial or complete

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13
Q

Indirect healing is an artificial situation. T/F?

A

False - direct healing is an artificial situation

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14
Q

What is indirect fracture healing?

A

Formation of bone via a process of differential tissue formation until skeletal continuity is restored

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15
Q

How long after fracture does a haematoma form?

A

6-8 hours

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16
Q

For how long in fracture healing does the soft callus persist?

A

3 weeks

17
Q

What are the steps in indirect fracture healing?

A

Formation of fracture haematoma
Fibrocartilaginous callus formation
Bony callus formation
Remodelling

18
Q

For how long in fracture healing does the bony callus persist?

A

3-4 months

19
Q

Which cells lay down woven bone in the process of bony callus formation in fracture healing?

A

Osteoblasts

20
Q

Describe the formation of the soft callus in fracture healing?

A

New capillaries organise the fracture haematoma into granulation tissue which is a pro callus. fibroblasts and osteogenic cells then invade the pro callus and make collagen fibres which connect the ends together. Chondrocytes then begin to produce fibrin cartilage and the soft callus forms.

21
Q

What is direct fracture healing?

A

An artificial surgical situation in which there is direct formation of bone withthout the process of callus formation to restore skeletal continuity.

22
Q

Describe the process of direct fracture healing

A

No callus forms and there is direct formation of bone via osteoclastic absorption and osteoblastic formation (cutting cones)
Cutting cones cross the fracture site and lay down new osteones directly

23
Q

What vessels supply the inner two thirds of a bone?

A

Endosteal vessels

24
Q

What vessels supply the outer third of a bone?

A

Periosteal vessels

25
Q

Fractures at what sites are particularly prone to problems with union or necrosis because of potential problems with blood supply?

A

Proximal pole of scaphoid
Talar neck
Intracapsular hip
Surgical neck of humerus

26
Q

What patient factors can inhibit fracture healing?

A 
Increasing age
Diabetes
Anaemia
Malnutrition
Peripheral vascular disease
Hypothyroidism
Smoking 
Alcohol
27
Q

Which medications can inhibit fracture healing?

A

NSAIDs
Steroids
Bisphosphonates

28
Q

How to NSAIDs inhibit fracture healing?

A

reduce local vascularity at fracture site

29
Q

COX-2 specific NSAIDs inhibit fracture healing more than non-specific NSAIDs. T/F?

A

True

Musculoskeletal (11 decks)

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