Fractures

Question 1

Is complete or incomplete fracture more common in peds?

Answer 1

Incomplete aka greenstick.

Question 2

What type of fracture is a colles, and in what direction is the proximal segment displaced?

Answer 2

Transverse radial fracture. Proximal displaced palmar direction, distal radius has dorsal tile.

Question 3

The Weber fx classifation system concerns distal fib/tib fx with tearing on the syndesmosis fibres. List A, B and C class fx.

Answer 3

A: distal fibular fx

B: distal fibular fx with some tearing of the syndesmosis fibres

B: distal fib and tib fx, tearing of syndesmosis with widening of the mortisse.

Question 4

What must you be weary of when looking for fx on radiograph?

Answer 4

• Accessory bones
• Sesamoids
• Epiphysis

Question 5

Bipartite patella occurs ___.

Answer 5

when the patella doesn’t fuse and is two separate bones.

Question 6

Generally speaking, what is the immediate concern with fx and dislocations?

Answer 6

FX
-hemmorage

Dislocation
-Artery (asymptomatic) and nerve injury

Question 7

Describe the three stages of secondary bone healing (no fixation; cast/immob).

Answer 7

1. Inflammatory
   - hematoma, osteoclastic
2. Reparative
   - chondro/fibroblasts, callus matrix
3. Remodeling
   - resorption, organized matrix

-callous formation

Question 8

What is primary bone healing?

Answer 8

Direct contact between bone fragments with compression.

• ORIF
• hard to see callous

Question 9

What are the time frames for bone healing?

Answer 9

Induction and inflammation
-0 to 5 weeks

Soft callus
-3 to 5 weeks

Hard callus (remodeling) 
-5 to 10 weeks

Question 10

What are the 3 types of abnormal repair?

Answer 10

Delayed Union
-longer than expected

Mal-Union
-poor functional positon

Non-Union
-pseudoarthrosis?

Question 11

How long does it take to see a stress fx on radiograph?

Answer 11

2-4 weeks for callous.