Fractures

Question 1

what is a fracture?
how is it classified?

two kinds?

Answer 1

break in continuity of bone
classified: cause, location, pattern, type

simple (closed)-
compound (open) -skin is broken

Question 2

what is the most common bone lesion?

Answer 2

fracture

Question 3

what are the kinds based on type?

Answer 3

greenstick
pathologic
comminuted

Question 4

what is a greenstick fracture>

Answer 4

1 broken and 1 bent surface
moreso occurs in children

one surface of bone is broken and the other is bent so separated into two separate fragments or pieces (can’t actually break it) same force for an adult would break it

Question 5

what is a pathologic fracture?

Answer 5

d/t bone disorder (osteoporosis)

Question 6

what is comminuted fracture?

Answer 6

multiple breaks at one site

still broken at one site but with multiple pieces broken

Question 7

what are the different fractures based on pattern?

Answer 7

oblique and longitudinal

Question 8

what is an oblique fracture?

Answer 8

break at 45 degree
d/t twisting force
also known as a spiral break

Question 9

what is a longitudinal fracture?

Answer 9

longitudinal break line

angel of the break down to the bone itself

Question 10

what are the types based on appearance?

Answer 10

burst
chip
displaced

Question 11

what is a burst fracture?

Answer 11

bone breaks into multiple pieces
usually at the end of bone (joints)

in articulation, may have two 2 bones articulated. the direction of force you can apply to the joint and amount of force you can apply in an unexpected force it will break.

Question 12

what is a chip ?

Answer 12

small fragment near joint

kinda like segmented?

Question 13

what is displaced?

Answer 13

both separates at the fracture line

Question 14

what are other fractures?

Answer 14

impacted fracture, colles fracture (wrist-distal radius) fracture of the wrist and mulitple bones articulating at the wrist and more than one of them breaks (fall on wrist); potts fracture (ankle-distal fibula) fracture in the ankle; compression fraction of the vertebrae

Question 15

et/path?

Answer 15

force overload on bone

more force than it can withstand

Question 16

manifestations?

Answer 16

pain
deformity (external)
l/o function
hemorrhage (soft tissue)
soft tissue injury (skin)

Question 17

tx?

Answer 17

reduction (re-align bones)
immbolization (healing)
preserve and restore function

Question 18

what are the 4 stages of healing?

Answer 18

hematoma formation
soft callus formation
bony callus
remodelling

Question 19

what occurs in the hematoma formation?

Answer 19

blood clot forms. requires about 48-72 hours
hematoma surrounds the break and keeps the bone together in a form of alignment

provides a medium for cellular activity-inflm cells, osteoblasts through molecular signalling

capillary buds appear at the points where the vessels were severed and gives rise to new blood vessels

fibrin mesh (yellow) b/w break to seal the fracture site, source of inflm cells, and a medium for new blood vessels to develop

Question 20

what occurs in the soft callus formation?

Answer 20

hematoma is replaced by fibrocartilage

there is an overlap between 1st and 2nd stage

with hemorrhaging and fracture you have dec blood to the distal bone because blood is localized to the damage and necrotic bone occurs

the fibroblasts deposit and appearance of new blood vessels

need granulation tissue because healing

bone is still not weight bearing

Question 21

what occurs in the bony callus stage?

Answer 21

bone begins to form

spongy born forms in ossification process. before compact bone

bone trabeculae form
fibroblasts because forming fibrous connective tissue
osteogenic cells proliferate

Question 22

what occurs in the remodelling stage?

Answer 22

ossification and remodelling (different form(

forms new bone and is weight bearing

dead tissue and all the cells need to go away and remodelling reshapes the bone and need to remove al the extraneous material

achieves bone shape (rarely the same as before)

now weight bearing