Fractures & healing

Question 1

What is a fracture?

Answer 1

A soft tissue injury, complicated by a breach in the continuity of bone

Question 2

When do fractures occur? 2 ways!

Answer 2

1. When non-physiological loads are applied to normal bone

2. When physiological loads are applied to abnormal bone

Question 3

Name the 6 types of fracture that can occur and briefly describe them.

Answer 3

SIMPLE
clean break, little or no disturbance to surrounding skin

COMPOUND/OPEN
broken bone piercing and protruding through skin

GREENSTICK
incomplete fracture, bone is bent - occurs mostly in children

COMMINUTED
multifragmentary, more than 2 pieces

IMPACTED
ends driven into each other, common in children

COMPLICATED
broken bone damages surrounding structures or organs

Question 4

Name the three phases of fracture healing.

Answer 4

Inflammatory phase
Reparative phase
Remodelling phase

Question 5

What happens in the inflammatory phase of fracture healing?

Answer 5

Haematoma develops within hours

Inflammatory cells infiltrate the area within days

Question 6

Which inflammatory cells infiltrate the haematoma of a broken bone, during the inflammatory phase of fracture healing?

Answer 6

Macrophages
Monocytes
Lymphocytes
Fibroblasts

Question 7

What happens in the reparative phase of fracture healing?

Answer 7

2 weeks after, a fibrocartilaginous callus forms where the haematoma was

New blood vessels form

The callus hardens into bone over 6-12 weeks

This is woven bone

Question 8

What happens in the remodelling phase of fracture healing?

Answer 8

Woven bone replaced by stronger lamellar bone (cortical & cancellous)

Takes months to years

Question 9

What are the principles of fracture management?

Answer 9

Reduce
Immobilise
Rehabilitate