Fx's and Fx Recovery

Question 1

What is a fracture?

Answer 1

a structural break in the continuity of bone, epiphyseal plate, or cartilaginous joint surface

Question 2

True/False: Some soft tissue injury accompanies a fracture

Answer 2

true

Question 3

What are the risk factors for fracture?

Answer 3

osteoporosis, sudden impact, Hx of falls

Question 4

What are the fracture sites?

Answer 4

diaphyseal - shaft,
metaphyseal - growth plate,
epiphyseal - rounded end,
intra-articular - surface within

Question 5

What are the orientation of fracture lines in reference to the longitudinal axis?

Answer 5

transverse, longitudinal, oblique, spiral

Question 6

What are the position of Fx fragments (described by how the distal fragment displaces in relation to the proximal fragment)?

Answer 6

nondisplaced, medial displacement, lateral displacement, distracted, overriding with posterior and superior displacement, distracted and rotated laterally

Question 7

What type of fracture results in failure of a long bone due to twisting/torsional force?

Answer 7

spiral

Question 8

What type(s) of fractures occur in long bones causing it to bend and fail on the convex side of the bend?

Answer 8

transverse/oblique/greenstick

Question 9

What type of fracture occurs when the bone fractures in more than two fragments?

Answer 9

comminuted

Question 10

What are the two extents to which identify fractures?

Answer 10

complete and incomplete

Question 11

What are the two identifiers of fractures regarding the relationship to the environment?

Answer 11

closed, open

Question 12

What are the complications that can additionally identify fractures?

Answer 12

local, systemic, related to injury

Question 13

What type of fracture tears away from the larger mass of bone through the straight pull of a ligament or tendon?

Answer 13

avulsion

Question 14

What type of fracture occurs due to crushing or compressive force?

Answer 14

compression fracture

Question 15

Which type of bone do compression fractures occur most commonly in?

Answer 15

cancellous bone

Question 16

What type of fracture is a small crack in bone unaccustomed to the repetitive/rhythmic stress/microtrauma?

Answer 16

stress fracture/fatigue fx

Question 17

What type of fracture occurs when abnormal bone is subject to a normal force?

Answer 17

pathological fracture

Question 18

What are the clinical presentations of fracture?

Answer 18

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

Question 19

Describe the inflammatory phase of cortical bone healing.

Answer 19

internal bleeding is followed by normal clotting

Question 20

Describe the reparative phase of cortical bone healing.

Answer 20

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

Question 21

What do the chondroblasts form? What do the osteoblasts form?

Answer 21

cartilage near Fx site, primary woven bone

Question 22

Describe the remodeling phase of cortical bone healing.

Answer 22

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

Question 23

Describe cancellous bone healing.

Answer 23

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

Question 24

What type of forces is cancellous bone more susceptible to?

Answer 24

compression

Question 25

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

Answer 25

true

Question 26

What is the fracture healing times for children? adolescents? adults?

Answer 26

4-6 weeks, 6-8 weeks, 10-18 weeks

Question 27

What are the complications of Fxs?

Answer 27

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

Question 28

What are the common impairments post-immobilization?

Answer 28

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

Question 29

What are the common interventions post-immobilization?

Answer 29

joint mobilization, PNF stretching, functional activities, muscle performance: strengthening and endurance; scar tissue mobilization