Fracture Healing And Management Flashcards
What is a fracture
A breach in the continuity of bone
Why do fractures occur
Non-physiological loads are applied to normal bone
Physiological loads are applied to abnormal bone
Why might a fracture occur in abnormal bone
Due to a tumour
Due to a metabolic bone disease such as osteoporosis, pager’s disease or osteogenesis imperfecta
How would you describe a fracture to another medical professional
Describe the site, pattern, displacement or angular ion, joints involved and skin involved
What are the 3 parts of bone
Proximal 1/3
Middle 1/3
Distal 1/3
What type of fracture is this
Transverse fracture
What type of fracture is this
Oblique fracture
What type of fracture is this
Spiral fracture
What type of fracture is this
Comminuted
What type of fracture is this
Segmental
What type of fracture is this
Avulsed
What type of fracture is this
Impacted fracture
What type of fracture is this
Green stick fracture
What is an open fracture
A breach in the skin that communicated with the bone
Why does an open fracture require urgent treatment
So no infection can get inside the bone
What are the stages of fracture healing
Haematoma
Inflammation
Repair
Remodelling
What is involved in the haematoma stage of fracture healing
Bleeding
Decreased blood flow
Periosteal stripping
Osteocyte death
What is involved in the inflammation stage of fracture healing
Fibrin clot organisation
Neovascularisation
Cellular invasion - haematopietic cells, osteoclasts and mesenchymal stem cells
What is involved in the repair stage of the fracture healing
Callus formation
Progressive matrix mineralisation
High vascularity
What is involved in the remodelling stage of fracture healing
Woven bone structure replaced by lamellar bone
Increased bone strength
Vascularity returns to normal
Healing without unique scar
What are the principles of fracture management
Reduce the fracture
Immobilise the part
Rehabilitate the patient
What are the different types of fracture fixation
Slings
Casts
Splints
Intra-medullary devices
External fixations
What are the factors which can influence fracture healing
Patient
- age
- nutrition
- smoking
- drugs
Tissue
- bone type
- bone site
- vascularity
- bone pathology
Treatment
- apposition of fracture
- stability
- micromotion
What can be the consequences of early fractures
Local
- vessel damage
- nerve damage
- compartment syndrome
- infection
General
- hypovolaemic shock
- ARDS
- VTE
- Fat embolism
What are the consequences of a late fracture
Local
- malunion
- non-union
- avascular necrosis
- ischaemic contractures
- joint stiffness
- myosotis ossificans
- complex regional pain syndrome
- osteoarthritis
General
- poor mobility
- functional disability
- social isolation
- pressure sores
- disuse osteoporosis
- loss of income or job
