Fx's and Fx Recovery Flashcards
What is a fracture?
a structural break in the continuity of bone, epiphyseal plate, or cartilaginous joint surface
True/False: Some soft tissue injury accompanies a fracture
true
What are the risk factors for fracture?
osteoporosis, sudden impact, Hx of falls
What are the fracture sites?
diaphyseal - shaft,
metaphyseal - growth plate,
epiphyseal - rounded end,
intra-articular - surface within
What are the orientation of fracture lines in reference to the longitudinal axis?
transverse, longitudinal, oblique, spiral
What are the position of Fx fragments (described by how the distal fragment displaces in relation to the proximal fragment)?
nondisplaced, medial displacement, lateral displacement, distracted, overriding with posterior and superior displacement, distracted and rotated laterally
What type of fracture results in failure of a long bone due to twisting/torsional force?
spiral
What type(s) of fractures occur in long bones causing it to bend and fail on the convex side of the bend?
transverse/oblique/greenstick
What type of fracture occurs when the bone fractures in more than two fragments?
comminuted
What are the two extents to which identify fractures?
complete and incomplete
What are the two identifiers of fractures regarding the relationship to the environment?
closed, open
What are the complications that can additionally identify fractures?
local, systemic, related to injury
What type of fracture tears away from the larger mass of bone through the straight pull of a ligament or tendon?
avulsion
What type of fracture occurs due to crushing or compressive force?
compression fracture
Which type of bone do compression fractures occur most commonly in?
cancellous bone
What type of fracture is a small crack in bone unaccustomed to the repetitive/rhythmic stress/microtrauma?
stress fracture/fatigue fx
What type of fracture occurs when abnormal bone is subject to a normal force?
pathological fracture
What are the clinical presentations of fracture?
history of trauma, localized pain aggravated by movement or WBing, muscle guarding with passive movement, decreased function of the involved body part, swelling, possible deformity, abnormal movement, sharp/localized tenderness with palpation
Describe the inflammatory phase of cortical bone healing.
internal bleeding is followed by normal clotting
Describe the reparative phase of cortical bone healing.
hematoma,
osteogenic cells proliferate from periosteum and endosteum to form a thick callus which envelops the Fx,
as the callus starts to mature, the osteogenic cells differentiate into osteoblasts and chondroblasts
What do the chondroblasts form? What do the osteoblasts form?
cartilage near Fx site, primary woven bone
Describe the remodeling phase of cortical bone healing.
stage of clinical union: Fx is firm enough that it no longer moves - when temp callus surrounds it, the callus gradually hardens as the cartilage ossifies, movement of the related joints is allowed with caution, no movement of the fx site or pain should be felt by pt or therapist
stage of radiological union: temp callus replaced by mature lamellar bone, callus is reabsorbed and bone returns to normal
Describe cancellous bone healing.
occurs mainly thru formation of an internal callus (endosteal), has rich blood supply and large area of boney contact so union is more rapid than in cortical bone
What type of forces is cancellous bone more susceptible to?
compression
True/False: Fracture to an epiphyseal plate can cause growth and boney deformities depending on the type of injury, age of child, blood supply, method of reduction, and closed v open
true
What is the fracture healing times for children? adolescents? adults?
4-6 weeks, 6-8 weeks, 10-18 weeks
What are the complications of Fxs?
swelling within a compartment -> nerve and circulatory compromise; problems with fixation devices (i.e. displacement of screws, breakage of wires); fat embolism that migrates to lungs and blocks pulmonary vessels; infection; refracture; delayed or malunion
What are the common impairments post-immobilization?
decreased ROM, joint play, and muscle flexibility; muscle atrophy w/ weakness and poor muscle endurance; if soft tissue damage - elastic scar restricts tissue mobility in the region
What are the common interventions post-immobilization?
joint mobilization, PNF stretching, functional activities, muscle performance: strengthening and endurance; scar tissue mobilization
