Fractures/ Fracture Healing Flashcards
What are 2 types of excessive loading that cause fractures?
- One time events
- Repetitive loading cycles
What are 8 sets of descriptive terms for fractures?
- If skin is broken
- Anatomic site/ extent of fracture
- Complete/ Incomplete
- Fracture segment alignment
- Direction of the fracture line
- Special features
- Associated abnormalities
- Special types of fractures
What are the terms for skin broken or not broken fractures?
Open vs Closed.
What are risks of open fractures?
- Osteomyelitis
- Infection
What are 2 examples of fracture sites with specific names?
- Intertrochanteric
- Supracondylar
How are shafts of long bones divided in terms of naming the fracture?
- Proximal/ middle/ distal thirds
What are the descriptions of fractures near joints?
- Intra-articular (inside joint)
- Extra-articular (Near joint on proximal or distal bone)
What type of fracture can be splinted or casted?
An incomplete fracture in which the cortex is partiall intact.
What is a complete fracture?
All cortices are disrupted around the circumference of the bone.
How are complete fractures stabilized?
- Fixators
- Screws
- Plates
If there are more than 2 complete fractures, how is it described?
Comminuted.
How are fracture segment alignments described?
- Distal relative to proximal
What are 5 types of displacement?
- Medial/ lateral
- Anterior/ posterior
- Superior/ inferior
- Rotated
- Overriding/ distracted
What are terms used to describe the amount of displacement?
- % of shaft, cortex
- Fully
How is angulation described?
- Direction of distal segment.
How is an apex described?
- The point of the two segments of the fracture.
How is the direction of the fracture line described?
- In reference to the long axis of the bone.
Ex) transverse, oblique, longitudinal, spiral
What type of force may cause a transverse fracture?
- Bending
How are transverse and longitudinal fractures aligned to the long axis of the bone?
- Parallel (longitudinal)
- Perpendicular (transverse)
What type of force can cause an oblique fracture?
- Compression on bending and torsion.
What type of force causes a spiral fracture?
- Torsion
What differentiates a spiral fracture from an oblique fracture?
- Sharp edges around vertical segment
What type of force causes an impaction fracture?
- Compressive
What type of bone tends to heal quickly from impaction fractures?
- Cancellous bone
ex) vertebral body, metaphysis
How well do impaction fractures tend to heal generally?
- Quickly
relatively stable fractures
What is a Hill-sachs lesion?
Humerus dislocated and impacted on glenoid causing deformation in the humeral head.
What causes an avulsion fracture?
- Tensile loads from ligaments and tendons fracture bone at the site of the attachment.
How are avulsion fractures described?
- Location, and fracture line.
What are 3 common sites of avulsion fractures?
- Deltoid ligament/ malleolus
- Rectus femoris/ AIIS
- Achilles/ Calcaneus
What are associated abnormalities with fractures?
- Subluxations
- Dislocations
How longs does it take for a stress fracture to become visible on plain film, and what is visible?
- 2 weeks for bony callus to become visible./
What is a pathologic fracture?
- Fracture due to weakened bony architecture.
What cause periprosthetic fractures?
- Bony adaptations around joint replacements
What can cause a bone graft fracture?
Bone grafts.
Why are fractures different in children?
- Bones are more pliable,and structures are incomplete
- Growth plates
What is an incomplete fracture extremely common in children?
Greenstick
What is a torus fracture?
A common incomplete fracture in children, where one side of a bone buckles in on itself.
What is a plastic bowing fracture?
- Common incomplete fracture in children with a failure at the microscopic level leading to plastic deformation.
- No distinct fracture line
What type of fracturesare plastic bowing fractures often coupled with?
- Greenstick
What is a type I Salter-Harris (SH) fracture?
Fracture transversely through cartilage.
What is a type II SH fracture?
Fracture through cartilage and towards into metaphysis.
What is a type III SH fracture?
Fracture through cartilage and into epiphysis.
What is another name for a type III SH fracture?
Secondary Ossification Fracture.
What is a type IV SH fracture?
Through cartilage, and into the metaphysis and epiphysis.
What is a type V SH fracture?
- Compression/ Crush fracture.
What is a type VI SH fracture?
Crush on one side of bone/ cartilage.
What is a type VII SH fracture?
- Epiphyseal fracture only.
- Secondary ossification center
What is another name for a type VII SH fracture?
Intra-articular fracture.
What is a type VIII SH fracture?
Through metaphysis only.