Fractures Flashcards
Define a fracture
Discontinuity in a bone (or cartilage) resulting from mechanical forces which exceed the bones ability to withstand them
What are the causes of fractures?
-Acute trauma/mechanical load
-Fragility fracture, mechanical forces not normally causing fractures (low level traumas)
-Insufficiency fracture, normal repetitive stress on abnormal bone
-Stress fracture, Abnormal loading on normal bone
-Pathological fracture, Bone may have a lesion that weakens a bone (eg bone cyst)
Name the types of fractures and briefly explain
-Transverse- across the bone
-Oblique- diagonal
-Spiral- twists the bone
-Comminuted- bone breaks into multiple pieces
-Avulsion- small fragment off end of bone
-Impacted- broken ends of bone are jammed together by the force
-Fissure- hairline or crack extending through surface of bone
-Greenstick- bone bends or cracks along edge
What is the difference between adult and children’s bones?
-Babies have more bones
-Children’s bones are continuously growing
-Kids bones are more flexible
-Children heal faster than adults and can remodel/reshape their bones
-Kids ligaments are stronger than some of their bones (more likely to have avulsion fracture)
What are the displacement of fractures and briefly explain
-Displaced - middle on bone downwards
-Angulated - breaks at an angle
-Shortened - breaks and ends move up towards each other
-Rotated - bone twists so end is facing opposite side
What are the types of fractures based on?
-The breaking pattern
-Displacement of fragments
-Incomplete or complete
-Stable or unstable
-Soft tissue damage
-Articular involvement (intra + extra)
-Presence of wounds
How many stages of fracture repair is there?
4
What is the first stage of fracture repair and explain
Haematoma Formation
-Immediately after fracture, space fills with blood
-Forms a haemotoma to provide structural support and prevents further bleeding
How long does Haematoma Formation last for?
Hours- days
What is the second stage of fracture repair and briefly explain?
Callus formation
Internal =
-Macrophages clean up debris
-Osteoclats breakdown dead tissue
-Fibroplasts produce collagen and fibrous network
-Chondroblasts produce cartliage
-Osteoblasts start to produce new bone
External =
-Osteoblasts and chondroblasts activate to produce bone cartilage (stabilising fracture site)
How long does Callus Formation last for?
Days- weeks
What is stage 3 of fracture repair and briefly explain it
Callus Ossification
-Internal and external callus cartilage model under goes endochondral ossification to form woven/spongy bone = stronger callus
How long does callus ossification last for?
One- four months
What is stage 4 of fracture repair and briefly explain
Bone remodelling
Repair =
-Only complete once the woven /spongy bone has been replaced with compact bone
Remodel =
-Internal callus become stronger
-External callus is reduced via osteoclasts activity
-During remodelling, the healed fracture and surrounding callus responds to activity, functional demands and growth.
-Bone that is no longer needed is removed and fractured site is smoothed and remodelled
-May not be perfect remodelling
What is fracture management?
-Joint movement and function must be preserved whilst pain at fracture site is minimised to achieve better healing
-Loading of bone from muscle activity to help heal
