Fractures Flashcards
What is a fracture?
A fracture is a broken bone
– it can either be completely broken or cracked
What causes fractures?
Direct:
– Break occurs at point of impact
Indirect:
– Force is transmitted along bone
– Injury occurs at some point distant to impact
– E.g. femur, hip, or pelvic fracture due to knees
hitting dash
What are the mechanisms of injury (cause of fracture)?
- Twisting
- Avulsion
- Stress
- Pathological
Twisting
Distal limb remains fixed but proximal part rotates
❑ E.g. football or skiing accidents
Avulsion
❑ Muscle and tendon unit with attached fragment of bone ripped
off bone shaft
❑ E.g. commonly children (growth spurts), adult athletes or
dancers
Stress
❑ Occur in legs/feet secondary to prolonged running or walking
Pathological
❑ Result of fracture with minimal force
❑ E.g. in patients with cancer or osteoporosis
What are the type of fractures?
- transverse
- spiral
- comminuted
- oblique
- impacted
- greenstick (in paediatric patients)
Transverse?
Right angle to long axis (horizontal fracture line)
Often caused by direct injury
Spiral?
Fracture site coils through bone (like a spring)
Occurs with torsion
Comminuted?
Bone shatters into 3 or more pieces
Such as in high energy impact,
crush injury or osteoporosis
Oblique?
Occurs at angle to long axis
Impacted?
Compression (ends jammed together)
Frequently no loss of function
Greenstick?
Pliable bone splinters on 1 side but
without complete break
Closed fracture?
the fractured
bone does not break
or pierce the skin
Open (compound) fracture?
the fractured
bone tears or pierces the skin
- check for wounds around injury site
- wounds increase the risk of infection,
as they expose the bone as well as
underlying tissues)
What is a stable fracture?
the ends of the injury remain in place
(the bone itself may not be completely broken)
What is an unstable fracture?
the ends of the fractured bones can easily
be displaced (this could damage
blood vessels, nerves or organs)
fracture in the upper extremity
rarely life-threatening, but may result in long-term impairment
Fracture in the lower extremity
associated with more severe injuries -
possibility of significant blood loss e.g.
femur fracture, pelvic injuries
What are the specific fractures?
- pelvic
- patella
- calcaneal
- mid shaft of femur
- neck of femur
Pelvic
– Direct or indirect force, likely to break in 2 places
- Fragments can damage blood vessels, urinary
bladder, rectum and nerves - Must use pelvic splint and treat as potentially critical
Patella
Due to direct impact
Calcaneal
Results from falls (foot landing), consider lumbar
sacral compression
Mid shaft of femur
high speed deceleration with impact.
- can cause hypovolaemia so use traction splint!
Neck of femur
r - Leg tends to shorten and rotate outward
(external rotation)
- Minimal blood loss due to joint capsule
