Fractures- Ayers Flashcards
Discuss difference between Non-articular vs. Intra-articular fractures
Non-articular fractures do not involve the joint surface.
Intra-articular fx involve the joint surface (articular surface) and can lead to post-traumatic arthritis.
Name the different fracture (fx) patterns.
- Spiral
- Oblique
- Transverse
Name different types of Diaphyseal Fractures
Type A:
-Simple fracture with 2 fragments
Type B:
-Butterfly fracture with a free wedge of bone
Type C:
- Comminuted fracture
- Complex
- Contact lost between the bone fragments.
Fracture healing, Infection and amputation rate are a function of what?
Degree of Soft tissue injury
Note: We must also evaluate degree of Periosteal stripping in the OR.
Describe Type I Open Fracture
- Inside out injury (fractured bone penetrating through skin).
- Minimal soft tissue damage
- Periosteum is minimally damaged
Describe Type II Open fracture
- Inside out or Outside in mechanism
- Moderate soft tissue damage
- Some necrotic muscle
- Some Periosteal stripping
Describe a Type IIIA Open Fracture
- Outside in injury
- Extensive muscle devitalization
- Bone coverage with existing soft tissue is not a problem.
Describe a Type IIIB Open fracture
- Outside in injury
- Extensive muscle devitalization
- Requires a local or free flap for bone coverage and soft tissue closure.
- Periosteal stripping
Describe a Type IIIC Open fracture
- High energy
- Major vascular injury requiring repair
- High risk for infection and/or amputation
What is Comminution?
The amount of bone fragments from the fracture.
Will most fractures heal without intervention?
Yes.
Exceptions: (Confirm this)
- Ribs and Clavicles
- Nonunion model difficult to create.
Note: Intervention is aimed at putting bone is best realignment to achieve the best functional outcome.
Fractures that heal non-operatively occur via what?
Callus:
-Which is highly vascularized bone growth that appears around the fracture site.
Name the 2 factors required for bone healing.
- Good blood supply
- Good mechanical stability
Name the 3 blood supplies of Long bones
- Nutrient artery (intermedullary)
- Periosteal vessels
- Metaphyseal vessels
Name 2 mechanisms of Bone formation
- Endochondral
2. Direct bone formation (Cutting Cones)