Fracture management Flashcards
what are the symptoms/signs of a possible fracture?
- history of a fall/direct blow/twisting injury/accident
- localized pain aggravated by movement
- muscle guarding with passive
- decreased function of part
- swelling
- sharp, localized tenderness at site
how do we describe a fracture?
- mechanism of injury: traumatic, pathological, stress
- anatomical site: bone and location in bone
- configuration displacement: 3 planes of angulation, ttranslation, shortening
- articular involvement/epiphyseal injuries: fracture involving joint, dislocation, ligamentous avulsion
- soft tissue injury
what is a bending (angulatory) force effect on bone?
long bone bends causing failure on convex side of bend
what is a bending (angulatory) force type of fracture?
transverse
oblique
greenstick in kids
what is a twisting (torsional) force effect on bone?
spiral tension failure in long bone
what is a twisting (torsional) force type of fracture?
spiral
what is a straight pulling (traction) force effect on bone?
tension failure from pull of ligament or muscle
what is a straight pulling (traction) force type of fracture?
avulsion
what is a crushing (compression) force effect on bone?
usualy in cancellous bone
what is a crushing (compression) force type of fracture?
compression
torus (buckle) in kids
what is a repetitive microtrauma force effect on bone?
small crack in bone unaccustomed to repetitive/rhythmic stress
what is a repetitive microtrauma force type of fracutre?
fatigue
or stress
what is a normal force on abnormal bone effect on bone?
such as with osteoporosis, boney tumor or other diseasesd bone
what is a normal force on abnormal bone type of fracture?
pathological
what are the kinds of fractures?
- closed
- open: comes out through skin
- transverse
- spiral
- comminuted: multiple parts
- impacted: bone driven into itself
- greenstick
- oblique
list the fracture types in order of severity from least to greatest
simple>displaced>comminuted>intra-articular>compound
What is the Salter-Harris classification of epiphyseal complex fractures for Type I?
fracture through the physis (widened)
What is the Salter-Harris classification of epiphyseal complex fractures for Type II?
fracture partway through the physis extending up into metaphysis
What is the Salter-Harris classification of epiphyseal complex fractures for Type III?
fracture partway through the physis extending down into the epiphysis
What is the Salter-Harris classification of epiphyseal complex fractures for Type IV?
fracture through metaphysis, physis and epihysis can lead to angulation deformities when healing
What is the Salter-Harris classification of epiphyseal complex fractures for Type V?
crush injury to physis
what is closed reduction
manioulation mechanical (traction)
what is open reduction
surgery w screws
what is fracture retention for closed methods?
sustained traction
cast/splint
functional bracing
what is fracture retention for open methods?
internal fixation
external fixation
arthroplasty
explain the parameters for non-op treatment
rehab, WB start later
risk of joint stiffness,malunion, non union are present
fracture healing is rapid
risk of infection low
explain the paramters for operative treatment
rehab, WB start sooner risk of sitffness and malunion low risk of non-union present fracture healing slower risk of infectinon present
explain fracture management in immobilization stage
- educate patient
- decrease effects of inflammation
- decrease effects of immobilization
- if patient confied to bed, maintina strength and ROM in major muscles
explain fracture management in post-immob stage
- educate patient
- provide protection until radiologically healed
- initiate active exercises
- increase joint and soft tissue mob
- increase strength and endurance
- improve cardio fitnesss
