HLTH 2501: trauma Flashcards
complete fracture
occurs when the bone is broken to form two or more separate pieces
incomplete fracture
occurs when the bone is only partially broken
greenstick fracture
is a incomplete fracture that is common in the softer bones of children; the shaft of the bone is bent, tearing on the cortical bone (outer layer)
open fracture
aka compound fracture; occurs when the skin is broken, as the bone fragments may be angled to protrude through the skin; there is lots of damage to soft tissues, including the blood vessels and nerves, as well as a higher risk of infection
fracture lines
simple fractures, segmental fracture, comminuted fracture, and compression fracture
simple fracture
is a single break in the bone in which the bone ends maintain their alignment and position
segmental fracture
occurs when several large bone fragments separate from the main body of a fractured bone
comminuted fracture
occurs when there are multiple fracture lines and bone fragments
compression fracture
common in the vertebrae and occur when a bone is crushed or collapses into small pieces
impacted fracutre
occurs when one end of the bone is force of telescoped into the adjacent bone
pathologic fracture
results from a weakness in the bone structure because of conditions such as a tumor or osteoporosis
stress fractures
result from repeated excessive stress, commonly in the tibia, femur, or second and third metatarsals
depressed fractures
occur in the skull when the broken section is forced inward on the brain
transverse fracture
is a fracture across the bone
linear fracture
is a break along the axis of the bone
oblique fracture
is a break at an angle to the diaphysis of the bone
spiral fracture
is a break that angles around the bone, usually caused by a twisting injury
colles fracture
is a break in the distal radius at the wrist; commonly occurs when someone tries to break a fall; ulna may also be damaged
pott fracture
refers to a fracture of the lower fibula because of excessive stress on the ankle, such as occurs when stepping down with force; tibia may also be damaged
what else happens when a bone breaks?
bleeding occurs from the vessels in the bone; inflammation develops around the bone; hematoma or clot forms in the medulla canal; necrosis occurs at the ends of broken bones
how do fractures heal?
hematoma serves as the basis for a fibrin network, in which granulation tissue grows; capillaries extend into here, and phagocytes clean up as fibroblasts lay down new collagen fibres and chondroblasts form new cartilage; osteoblasts will also work to generate new bone
procallus
aka fibrocartilaginous callus; holds two bones together and is a preliminary bridge to repair bone
bony callus
is formed by osteoblasts and is the replaced bone; eventually this is remodeled by osteoblasts and osteoclasts, and more compact bone will be laid down
five stages of bone healing
hematoma, granulation tissue, procallus (fibrocartilage), bony callus, and remodelling
factors affecting the healing process in bone
amount of local damage done to bone and soft tissue, inflammation, how far apart the gaps of the bones are, foreign material or infection at the site, and systemic factors like anemia or circulatory problems
who heals fastest from bone breaks?
children, then adults, then the elderly
complications that may affect healing in patients with severe injuries
muscle spasms, infections, ischemia, compartment syndrome, fat emboli, nerve damage, failure to heal, and fractures in or near the joint
muscle spasms and healing
may occur as local pain and irritation cause strong contractions at the fracture site and may pull the bone fragments further out of position
results of muscle spasms for healing
fragments can be out of position, causing angulation, rotation, or overriding of bone pieces; soft tissue damage, bleeding, and inflammation may also occur
ischemia and healing
can occur in a cast as edema increases after injury; due to compression, the area may become pale, cold, or numb if the cast is too tight
compartment syndrome
may develop after fractures when there is excessive inflammation like crushing injuries; increased pressure of fluid within the fascia compresses the nerves and vessels, causing severe pain and ischemia or necrosis; may be aggravated by a cast
fat emboli
are a risk when fatty marrow escapes from the bone marrow into a vein; can travel to the lungs and cause obstruction, inflammation, and respiratory distress syndrome
first indicators of fat embolus
behavioral changes, confusion, and disorientation if cerebral; respiratory distress and hypoxia may also occur
when are fat emboli’s common
in fractures of the pelvis or long bones such as the femur; as well when the fracture site has not been well immobilized during transportation after the injury
why may nerve damage occur with fractures?
the periosteum may tear
failure to heal word
nonunion
why may failure to heal occur
is the bone is not stabilized with the ends closely approximated and aligned
long-term residual effects of fractures
osteoarthritis or stunted growth
signs of a fracture
swelling, tenderness, altered sensation, inability to move, crepitus, and pain which may lead to shock (pallor, diaphoresis, hypotension, tachycardia, nausea, and vomiting)
crepitus
a grating, creaking, cracking, or popping sound that may be heard with fractures
tests for fractures
X-rays
treatment for fractures
immediate splinting and immobilization, reductions, or traction
reduction
can be performed to restore the bones to their normal positions; can be closed or open
closed reduction
is accomplished by exerting pressure and traction
open reduction
requires surgery and the use of pins, plates, rods, or screws to fix the fragments in position
traction
involves the application of force or weight pulling on a limb that is opposed by body weight; the force maintains the alignment of the bones, prevents spasms, and immobilizes the limb
dislocation
is the separation of two bones at a joint with loss of contact between the articulating surfaces; usually one bone is out of position and one remains normal
subluxation
if the bone is only partially displaced, with partial loss of contact between the surfaces
what might a dislocation be caused by?
trauma such as a fall, an underlying disorder like rheumatoid arthritis or other damage like torn ligaments
damage of a dislocation
there is damage to the soft tissue, the ligaments, nerves, and blood vessels as the bone is pulled away from the joint
treatment for dislocation
return the original bone to its normal position, immobilization during healing, and therapy to maintain joint mobility
sprain
is a tear in a ligament and near a tendon
avulsion
is where the ligaments or tendons are completely separated from their bony attachments
signs of sprains
tenderness, pain, swelling, and discoloration due to hematoma formation
what develops at the site after a sprain?
inflammation and then granulation tissue; collagen will also form to create links with the remaining tendon or ligament
what is the average healing time for a sprain?
6 weeks
what may additional stress on a sprain cause?
the development of excessive fibrous tissue in the tendon, and thus shortening, less strength, and decreased flexibility at the joint
risk factors for injury in fitness
inadequate equipment, training, or warm up techniques, as well as more aggressive approaches to sport and failure to allow minor injuries to heal
tennis elbow
when inflammation develops at the function of the forearm muscle with teh humerus
muscle tears
are tears along the muscle itself or at points of attachment; occur as a result of direct trauma or overstressing of the muscle; three types (1st, 2nd, 3rd degree)
first degree muscle tear
usually involves a small percentage of the muscle; pain is mild and does not affect ROM and strength much
second degree muscle tear
a larger tear that involves much of the muscle, but isn’t a complete tear; pain is severe and the muscle can loss much strength and ROM
third degree muscle tear
is a complete tear across the width of the muscle; the muscle cannot contract, there will be internal bleeding, and surgery may be required
immediate treatment after a muscle tear
activity should stop, cold should be applied to stop bleeding, and the limb should be elevated
scar tissue and muscle tears
scar tissue always forms and will reduce the flexibility and strength of the muscle
result of repeated injuries
fibrous scar tissue replaces normal structures, hindering mobility and osteoarthritis may develop
common causes of tendonitis
common swinging motions of the rotator cuff like golfing, tennis, hockey or painting walls
repetitive strain injury
refers to disorders affecting muscles, tendons, and nerves that develop over a period of time; often is associated with repetitive forceful or precision movements
repetitive strain injury damage
it interferes with circulation to the area and damages soft tissues
risk factors to repetitive strain injury
upper body areas, high stress levels, 30-50 age range, and work-related activities
signs of repetitive strain injury
pain, weakness, numbness, causing disability and interference with sleep
what is tendonitis
an inflammation of injury of the tendon and sheath
carpal tunnel syndrome
the median nerve is compressed at the wrist between tendons and the transverse carpal ligaments
strain vs sprain
a sprain is injury to the ligaments and capsule of a joint and a strain is injury to the muscles or tendons
where does the hematoma form?
in the medullary canal
examples of repetitive strain injury
tendonitis or carpal tunnel syndrome
treatment for repetitive strain injury
rest, cold or heat, NSAIDs, PT and sometimes OT
