Fractures Flashcards
Preclinical Disability
-progressive and detectable but unrecognized decline in physical function in older adults
-decreased task efficiency
Phenotypes
-describes how an individual’s characteristics are a result of their genotype interacting with the environment
Musculoskeletal system and aging
-Skeletal muscle of older people is more easily damaged with the loading
-Aging collagen increased cross-links between molecules, increasing the mechanical stability and tissue stiffness
-Tendons exhibit a lower metabolic activity that compromises healing
-joint increased stiffness and decreased flexibility and proprioception
Bone Remodeling influences
-mechanical stress
-Calcium and phosphate
-hormonal levels
4 types of Fractures
Traumatic, stress, insufficiency, pathologic
Traumatic Fractures
-sudden impact
-Transverse, oblique, spiral
-mostly radius and ulna
-most affected 5-14
Stress Fractures
-partial break
-rhythmic repeated microtrauma
-most in tibial shaft and metatarsal
- Compressive: forceful heel strike during prolonged marching
- Distractive: muscle pull on bone
RF
-increase intensity of training
-females: pelvic and sacral fractures
Insufficiency Fracture
-normal stress applied to abnormal bone
-decreased elastic resistance or decreased mineralization
-minor trauma
Pathologic Fracture
-abnormally fragile bone by disease
Classification of Fractures
Transverse: right angle line, shearing
Oblique/Spiral: twisting force
Comminuted: broken into fragments
Segmented: broken with a segment of free bone is left
Butterfly: separation of a wedge
Greenstick: splintering of bone
Torus: bone bulges out from stress
Hairline/crack: skinny crack
Vertebral Compression Fracture
-most common osteoporosis related fracture
-minor
-pain worse with spinal extension
-height loss and respiration dysfunction
Fracture Healing
- Hematoma (6-12h): Blood clot forms and inflammation
- Proliferation (1-2d): granulation tissue and fibrocartilage
- Callous Formation (1-3w):
Soft callous - Ossification (6w): Soft callous replaced by bony callous
- Remodeling (4m-1y): restoration of medullary canal
Factors to Hinder Fracture Healing
-inadequate blood supply
-poor nutritional status
-poos apposition
-infection
-corticosteroid
Clinical Manifestations of Fractures
-point tenderness
-pain with weight bearing
-swelling and bruising
-loss of mobility
Complications of fractures
-malunion
-delayed union
-nonunion: fibrous union or false joint
