Fractures Flashcards
What are the 4 stages to fracture repair?
- Hematoma formation & inflammation
- Fibrocartilaginous callus formation
- Bony callus formation / Consolidation
- Bone remodelling
How does fixation affect fracture healing time?
- Adequate fixation prevents impairment of the blood supply, which may be caused by movements of the fragments
- Maintains the reduction so prevents deformity and loss of function
How does age affect fracture healing time?
- Children = quicker and consolidation may occur at b/n 4-6 weeks
- Adults = makes little difference depending on other factors
How does smoking affect fracture healing time?
Increased rate of delayed union and non-union
How does diet affect fracture healing time?
Bone and soft tissue healing requires large amount of calories, proteins and minerals
How does infection affect fracture healing time?
Colonisation of bacteria = Necrosis & Oedema = Slow healing or Cellular death
How does ultrasound affect fracture healing time?
Low intensity US may accelerate fracture healing
How long does union of the proximal 1/3 humerus take?
7-10 days
How long does union of the distal 1/3 radius take?
4-6 weeks
How long does union of the proximal 1/3 femur take?
4-6 weeks
How long does union of the distal 1/3 tibia take?
6-8 weeks
How long does consolidation of the proximal 1/3 humerus take?
3-4 weeks
How long does consolidation of the distal 1/3 radius take?
8-10 weeks
How long does consolidation of the proximal 1/3 femur take?
8-12 weeks
How long does consolidation of the distal 1/3 tibia take?
16-20 weeks
What are (15) complications of fracture?
- Pulmonary embolism and deep vein thrombosis
- Hypovolemic shock or loss of blood
- Fat embolism –> acute respiratory distress syndrome
- Skin plaster sores
- Muscle damage and atrophy
- Compartment syndrome
- Avascular necrosis
- Problems with union
- Growth disturbance
- Intra-articular fractures
- Visceral injuries
- Adhesions
- Injury to large vessels
- Nerve injury
- Oedema
What are some clinical features of fractures?
- Pain
- Deformity
- Oedema
- Muscle spasm
- Abnormal movement
- Crepitus
- Loss of function
- Hypovolaemic shock
- Limitation of joint movement
- Muscle atrophy
How do we know when a fracture is healed?
- Absence of pain on weight-bearing, lifting or movement
- No tenderness on palpation at the fracture site
- Blurring or disappearance of the # line on x-ray
- Full or near full functional ability
How long does cancellous (spongy) bone take to heal?
Approx. 3-12 weeks
How long does is take compact bone to heal?
Approx. 12-18 weeks
What does it mean for healing time if a fractured bone has poor blood supply?
Healing takes longer
