Fractures Flashcards
What is a pathology?
The study of disease and injury
What are some reasons/mechanisms for fractures?
(3)
Stress
Pathologies
Trauma (direct or indirect)
Who is most likely to have fractures due to stress?
Why?
Athletes
Because they perform repetitive movement
How can pathologies cause fractures?
When the bone is weakened by an underlying disease or condition, making it more susceptible to fracture even with minimal force
How can stress cause fractures?
Repetitive movement, overuse
How can trauma cause fractures?
Ir can result from a sudden force or impact applied to the bone, exceeding its strength
What are the types of force?
(Unloaded is no force)
(Torsion is like a Chinese burn)
When is combined loading likely to happen?
In a road traffic accident (RTC)
What are the main types of fractures?
(4)
Open
Closed
Displaced
Non-displaced
Are displaced and non-displaced an open or closed fracture?
They can be either, but displaced is more likely to be open
What is an incomplete fracture?
Where the bone doesn’t fully break
What are examples of incomplete fractures?
Fissure
Green stick
Bowing
Torus/buckle
What is a fissure?
It results from minor injury, incomplete cortical break without bending
Which types of fractures are most common in paediatrics?
(3)
Green stick
Bowing
Torus
What is a green stick fracture?
Similar to a fissure, but the bone is bent- compression and bending
What is a bowing fracture?
Bending without visible break- bending
What is a torus/buckle fracture?
Bending with compression and outward bulging of the cortex- compression
What are examples of complete fractures?
(5)
Transverse
Oblique
Spiral
Comminuted
Avulsion
What is a transverse fracture?
Straight across the bone- tension
What is an oblique fracture?
At an angle to the bone-compression
What is a spiral fracture?
A corkscrew shaped fracture around the bone- torsion
What is an Avulsion fracture?
Avulsion of a fragment of bone away from the main body of the bone
Which type of fractures are these?
What types of incomplete fractures are these?
What types of complete fractures are these?
What is a comminuted fracture?
The bone has been shattered into multiple pieces- high energy forces
Where is a comminuted fracture likely to occur?
A road traffic collision (RTC)
What is an example of a paediatric fracture?
Physeal/growth plate fracture
What are the types of physeal/growth plate fractures?
(5)
Type 1
Type 2
Type 3
Type 4
Type 5
What type of physeal/growth plate fractures are these?
What happens if there’s movement at the fracture site?
(2)
Relative stability
Secondary/indirect healing
What happens if there’s no movement at the fracture site?
(2)
Absolute stability and compression
Primary/direct healing
What happens following movement at the fracture site?
(2)
Non-operative fracture treatment
Operative treatments happen only where some motion occurs at the fracture site, such as external fixation or internal fixation of comminuted fractures
When does no movement at the fracture site tend to occur?
(2)
No movement doesn’t usually occur naturally, but rather following open reduction and internal fixation surgery
There’s no callus formation
What are the stages of indirect bone healing?
(4)
Haematoma/inflammation
Soft callus
Bony callus
Bone remodelling
What happens during the haematoma/inflammation stage in indirect bone healing?
(3)
Blood vessels rupture and produce a haematoma that fills the fracture gap
The clotted blood creates a fibrin scaffold that guides the influx of inflammatory cells and the ingrowth of fibroblasts and new capillaries
This activates osteoprogenitor (osteogenic) cells in the periosteum, medullary cavity and surrounding soft tissues and stimulation. Of osteoclastic and osteoblastic activity
What happens during the soft callus stage in indirect bone healing?
A mass of predominantly uncalcified tissue, soft callus, bridges the ends of the fractured bones
What happens during the bony callus stage of indirect bone healing?
(2)
There’s a deposition of woven/fibrous bone by osteoblasts
In some cases, the activated osteogenic cells in the soft tissues and bone surrounding the fracture line also differentiate into chondrocytes (cartilage cells) to make fibrocartilage and hyaline cartilage
What happens in the bone remodelling stage of indirect bone healing?
(2)
Te cartilage undergoes ossification
As the callus matures and is subject to weight-bearing forces, portions that are not physically stressed and resorbed. This remodelling reduces the size of the callus until the shape and outline of the fractured bone are re-established
