Fractures Flashcards
What is a fracture?
a break in the continuity of a bone
What is a simple fracture?
aka. closed.
- bone is broken without an external wound; the skin is intact
What is a compound fracture?
aka open
- bone is broken and there is an external wound leading to the site of the fractured bone, or fragments of bone protrude through the skin;
- ends of the bone have broken through the skin or into one of the body cavities;
- more prone to infection
what is a complicated fracture?
bone is broken and has injured some internal organ. ie. rib pierces lung
What is a comminuted fracture?
bone is splintered into pieces
what is an impacted fracture?
bone is broken and one end of the fractured bone segment is wedged into the interior of the other bone
What is a complete fracture?
the bone is broken into 2 or more pieces (ie. transverse, oblique spiral, comminuted, avulsion and osteochondral)
What is an incomplete fracture?
- the line of fracture does not include the whole cross section of bone
- bone is bent or cracked and the periosteum remains intact (ie. compression, greenstick, perforation and stress fractures)
What is a greenstick fracture?
the bone is partially bent and partially broken. occurs usually in children especially those with rickets
What is a depressed fracture?
a piece of skull is broken and driven inwards
What is an epiphyseal separation?
separation between shaft and bone and epiphysis (growing end).
-occurs in young patients
What are Salter Harris classifictions?
- classification system used to describe fractures affecting the epiphyseal plate or growth plate
- only applies while bone is still growing
- Five types
What is a type I salter harris classification?
transverse fracture through the growth plate
What is a type II salter harris classification?
fracture through the growth plate and metaphysis
What is a type III salter harris classification?
fracture through the growth plate and the epiphysis
What is a type IV salter harris classification?
fracture through the growth plate, epiphysis and metaphysis
What is a type V salter harris classification?
compression fracture through the growth plate
What are the complete fractures?
transverse, comminuted, avulsion, osteochondral
What are the incomplete fractures?
compression, greenstick, perforation, and stress fractures
What is a Colles fracture?
- wrist fracture
- transverse fracture of the radius proximal to the wrist allows the fragment to rotate and displace dorasally
- “dinner fork” deformity
- most common fracture in elderly
- FOOSH
What are some complications of a Colles fracture?
malunion and RSD/CRPS (complex regional pain syndrome) or shoulder-hand syndrome (edmea and capsular tightening affect the wrist and shoulder); CTS
What is a Galeazzi fracture?
- break of the radial shaft and a dislocation of the inferior radioulnar joint (rotational break)
- FOOSH with some rotational component
- casting approx 6 weeks
- ulnar nerve lesion may occur with this injury
- “scooping ice cream”
What is a Pott’s fracture?
- ankle fracture affects 1 or both malleoli
- distal fibula breaks close to the lateral malleolus
- deltoid ligament may also rupture or avulse the medial malleolus
What is a Dupuytren’s fracture?
- fibula fractures higher up, the medial malleolus avulses and the talus is pushed superiorly between the tibia and fibula
- MOI=eversion with some external rotation
- leg is casted for 6-12 weeks
- malunion and joint stiffness are possible complications
What are causes of Dupuytren’s fracture?
- direct violence
- indirect violence
- muscular contraction
- overuse
- pathologies
What pathologies can cause fractures?
osteoporosis, tumors, local infections or bone cysts which can cause a brittleness or weakness of the bone.
What does indirect force mean in terms of a fracture?
the bone is fractured by a force applied at a distance from the site of fracture and transmitted to the fractured bone; torquing or twisting force causes a spiral fracture, often with little soft tissue damage. ie. fracture of the clavicle.
A patellar fracture secondary to a massive quadriceps contraction is an example of what?
A fracture caused by a muscular contraction.
What are some complications of fractures?
- can develop early or late
- client may note increase in pain levels, edema, bruising, paresthesia or temperature local to the fracture
What are the early complications of fractures?
torn muscles and tendons, ligament damage, compartment syndromes, nerve injuries, vascular injuries, joint hemarthrosis, bone and soft tissue infections, DVT’s and problems caused by poorly fitting casts.
What are the late complications of fractures?
delayed union and non-union, malunion, myositis ossificans, nerve compression, nerve entrapment, bone necrosis, Volkmann’s ischemic contracture, joint stiffness and disuse atrophy
What is the symptom picture for fracture?
- immediately after the fracture and before reduction, unnatural mobility and deformity are present at the fracture site
- shock
- pain with acute/severe tenderness over fracture site
- bleeding
- inflammation
- edema, both local (early) and diffuse (follows)
- local erythema, followed by bruising, both local and/or diffuse
- muscle spasm/splinting
- loss of motion/function (active and passive)
- possible local, unnatural, hypermobility, often with crepitus (end of bone rubbing together)
- possible deformity, as in shortening of limb or trunk segment
- fatigue, generalized weakness.
