Fractures

Question 1

Types of fracture patterns

Answer 1

Linear fracture - break is parallel to the bone
Oblique fracture - fracture has a curved or sloped pattern
Transverse - break is at a right angle to the bone
Spiral fracture - one part of the bone is twisted at breakpoint

Question 2

Types of fractures

Answer 2

Displaced fracture - bone breaks into two or more pieces and moves out of alignment

Non displaced fracture - bone breaks but does not move out of alignment

closed fracture - skin is not broken

open fracture - the bone has broken through the skin

Question 3

Stages of fracture healing

Answer 3

Bleeding

• initial bleeding at the site of injury
• fibrin blood clot forms

Acute inflammatory/haematoma

• 24 hours after injury a haematoma forms creating a model for callus formation
• granulation tissue is formed

Bone regrowth phase
- new cartilage and fibrous tissue form around the fracture site

Callus formation stage

• a soft callus is formed on the bone ends and eventually join together
• soft callus changes to hard callus
• collagen changes from type 2 to type 1

Consolidation phase

• hard callus is absorbed and lamellar bone is deposited
• debris is cleared up and gaps are filled

Question 4

Dynamic hip screw

Answer 4

Fixation for NOF fractures that occur outside the capsule

• large screw through the neck of femur and held together by a lateral femoral plate
• compresses the fracture allowing for healing

Question 5

Dynamic hip screw Benefits and complications

Answer 5

Benefits

• no bone needs to be replaced or moved
• faster surgery than a hip replacement
• lasts a lifetime
• better hip function outcome

Complications

• infection
• haematomas
• non union or malunion
• avascular necrosis

Question 6

Fracture healing timeline

Answer 6

Hematoma - mins to hours
Proliferation - hrs to 2 weeks
Callus formation 2-6 weeks
Consolidation - 6 - 12 weeks