Fractures Flashcards
Fractures may result from…
- single, highly stressful, traumatic incident (traumatic #)
- repetitive stress of normal degree persisting to point of mechanical fatigue (stress #)
- normal stress acting on an abnormally weakened bone (pathological #)
What are the fracture types?
- closed/open (simple/compound)
- complete/incomplete
- complicated
Describe a closed fracture.
Bone doesn’t communicate externally
Describe an open fracture.
Fractured bone or penetrating object communicates externally. Greater amount of soft tissue damage and issue of pathogens/infection.
Describe a complicated fracture.
Blood vessels, nerves or organs suffer significant damage.
Describe a complete fracture.
Bone is completely broken into 2 separate parts.
- Transverse
- Oblique
- Spiral
- Segmental
- Avulsion
What is a comminuted fracture?
Bone is broken into more than two fragments.
Describe an incomplete fracture.
Bone is divided but the periosteum remains in continuity. E.g. greenstick #, compression #, stress #
What is a pathological fracture?
Due to a disease:
- osteoporosis
- Paget’s
- infection
- tumour
What is a physeal fracture?
Damage through the growth plate that has long term consequences. Can cause progressive deformity. Harris-Salter classification system used.
What are the symptoms of a fracture?
- swelling, ecchymosis and deformity
- localized persistent pain
- marked or total loss of function
- localized bone tenderness
- crepitus
- may be sudden or insidious onset depending on #
How are fractures diagnosed?
- examination and palpation of tender point and surrounding tissue
- neurovascular assessment
- radiographs (new # may not show immediately)
- CT, spiral CT, MRI
- bone scans
- ultrasound or vibration
What does fracture management involve?
Fracture reduction, immobilisation and rehabilitation
How is a fracture immobilized?
- internal or external fixture
- splints/casts/strapping and walking aids
- screws, k-wires, plates
How are fracture rehabilitated?
With joint mobilization and exercises.
How are fractures reduced?
With an open (surgical) or closed procedure.
What further treatment may complicated fractures require?
- antibiotic treatment
- debridement
- irrigation
- dressings
How long does a fracture take to heal?
A fracture without complications will heal in 6-16 weeks.
Callus visible: 2-3 weeks
Union: 8-12 weeks
Consolidation: 12-16 weeks
What osseous complications can arise from fractures?
- osteomyelitis
- delayed union, non-union or mal-union
- avascular necrosis
- joint problems
- shortening of the bone
- osteoarthritis
What soft tissue complications can arise from fractures?
- nerve or vascular damage
- compartment syndrome
- CRPS
What is a pilon ankle fracture?
of metaphysical area of distal tibia (and sometimes fibula) extending to articular surface.
How are pilon ankle fractures classified?
RUEDI-ALLGOWER
- malleolar # with large posterior plafond fragments
- spiral extension #
- central compression # w/ or w/o fibula #
What is the Lauge Hansen Classification System?
A way of classifying ankle fractures by their MOI.
- Supination/adduction Injuries
- Supination/external rotation injuries
- Pronation/Abduction injuries
- Pronation/External Rotation injuries
What is the Weber Classification System?
A classifications system for ankle joint fractures.
What type of fractures can affect the talus?
- chip/avulsion
- talar neck
- taller body
- talar dome
- posterolateral process
- lateral process
- talar head
What can complicated talar fractures?
Avascular necrosis as there is no nutrient artery within the talus.
What are the complications of calcaneal fractures?
Possible permanent disability, residual pain and delayed return to normal function.
What are the most common forefoot fractures?
Digital #’s.
What happens if digital fractures are inadequately treated?
- haelomata
- contracted digits
- transverse plane deformities
- metatarsalgia
What is the cause of a stress fracture?
Generally overuse or pathological concerns.
What are the symptoms of stress fracture?
insidious onset, painful over time, decreases with rest
What bones in the foot are most commonly affected by stress fracture?
Navicular and metatarsals
