General Principles of Fracture Care (From Required Medscape Readings) Flashcards
What is the difference between primary/direct and secondary/indirect healing?
Primary healing occurs when the bone fragments are in close approximation and can heal without the formation of a bone callus. Secondary healing occurs when the bone fragments are farther apart and must form a callus/bone bridge to heal.
The four phases of bone healing are __________________.
- First 7 days: Fracture and inflammatory phase
- 7 to 21 days: Granulation tissue/soft callus formation
- 4 to 16 weeks: Hard callus formation, including woven bone creation
- Months to years: Remodeling, including lamellar bone creation
What medications can make bone healing take longer?
- NSAIDs
* Corticosteroids
These things should be included in taking a history from a patient with a suspected fracture: ________________.
- History of prior fractures
- Mechanism of injury
- Loss of consciousness
- Dominant handedness (if it’s the upper extremity)
- Medications
- Surgical history
What is often done in the examination of open fractures?
Take a picture so that future clinicians can see the wound without having to take the dressing off again.
Describe some of the ways fractures are described.
- Displacement
- Angulation
- Rotation
- Shortening
- Fragmentation
- Soft tissue involvement
Neurovascular integrity must be assessed in the physical exam of someone with a fracture. What should you do if you can’t feel pulses in the distal part of a fractured extremity?
Immediately realign the limb
_________________ occurs when tissue pressure exceeds perfusion pressure in a closed anatomic space.
Compartment syndrome
What is a Salter Harris fracture?
fracture or growth plate fracture is a fracture that involves the epiphyseal plate or growth plate of a bone
What is a colles fracture?
extra-articular fractures of the distal radius
what is a boxers fracture?
A boxer’s fracture involves a break in the neck of the metacarpal. This was described originally in the fracture of the metacarpal bone of the little (fifth) finger because this is the most common one to break when punching an immovable object.
What is a Maisonneuve fracture?
Maisonneuve fracture is the combination of a spiral fracture of the proximal fibula and unstable ankle injury which could manifest radiographically by widening of the ankle joint due to distal tibiofibular syndesmosis and/or deltoid ligament disruption, or fracture of the medial malleolus. It is caused by pronation external-rotation mechanism. It requires surgical fixation. 5
What nerve innervates the medial dorsal portion of skin on the hand?
Dorsal ulnar cutaneous nerve
What nerve injury would lead to the loss of a patient being able to make the OK sign?
anterior interossius nerve of median origin
