General orthopaedics Flashcards
state the stages of fracture healing 4
hematoma formation- day 1-5
Fibrocartilaginous Callus Formation (Days 5 to 11)
Bony Callus Formation (Days 11 to 28)
Bone Remodelling (Day 18 onwards, lasting months to years)
define direct and indirect fracture healing
direct-bone fragments fixed together by compression
-no callus formation
-bony ends joined and healed by osteoclasts and osteoblasts
indirect healing
-non-operative fracture healing
-small amountof motion and weightbearing at the fracture
-causes a soft calluse to form and secondary bone formation
describe hematoma formation in bone healing
bld vsls supplying bone and periosteom are ruptured during fracture
hematoma forms
pro-inflam cytokines released tnf-alpha, IL,1,6,11,23
describe the fibrocartilgationus callus formation part of bone healing
release of VEGF leads to angiogenesis at the site
fibrin rich granulation tissue develops
fibroblasts chondroblasts and osteoblasts are recruited and create firbocartilgtionous network
describe the bony callus formation of bone healing
cartilgainous callus undergoes endochondral ossification
RANK-L is expressed causes further differentiation of chronoblasts/clasts and osteoblasts/clasts
cartilgationus callus is resorbeed and begins to calcigy
at end of phase hard calcified callus of immature bone forms
describe the bone remoddeling part of bone healing
continued migration of osteoclasts/blasts hard callus undergoes repeated remodeling
-centre of callus is replaced by compact bone and ultimately results in regeneration of normal bone structure
state the 3 types of nerve injuries 3
neuropraxia
axonotmesis
neutrotmesis
define neuropraxia
mildest form of nerve injury
focal segmental demyelination at site of injury without axon disruption
what does neuropraxia result in
blockage of nerve conduction and transient weakness or paresthesia
define axonotmesis
injruy to axon but does not completely sever the surrounding endoneurial sheath so regeneration can take place
define neurotmesis
complete anatomical disruption of both the axon and all of the surrounding CT
-no chance of spontaneous recovery
-early surgical treatment is necessary
main differntials for patient preseing with a hot swollen acutely painful joint
septic arthtis
haemarthoris (traumatic injury/bleeding disordeR)
crystal arthopaties
rheumatologies
-RA
-spondylarhotpaties
define the term seronegative conditions
are rheumatoid factor negative
define osteocalsts and osteoblasts
Osteoclasts are responsible for aged bone resorption and osteoblasts are responsible for new bone formation
common causes of abrnomal gait
Arthritis of the leg or foot joints
Conversion disorder (a mental disorder)
Foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin sore, swelling, or spasms)
Broken bone
Injections into muscles that causes soreness in the leg or buttocks
Infection
Injury
Legs that are of different lengths
Inflammation or swelling of the muscles (myositis)
Shin splints
Shoe problems
Inflammation or swelling of the tendons (tendinitis)
Torsion of the testis
Brain, spinal cord, and peripheral nerves diseases
Vision problems