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Intro Traumatic Fractures Flashcards

1
Q

Anatomic sites and extent of fracture of long bone:

A
  • Proximal end (intra-articular/extra-articular)
  • proximal 1/3
  • Middle 1/3
  • Distal 1/3
  • Distal end (intra-articular/extra-articular)
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2
Q

Complete fracture -

A

All cortices disrupted

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3
Q

Incomplete fracture mostly in -

A

Mostly in short bones & children

Generally stable without subsequent stresses

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4
Q

Comminuted fracture -

A

> 2 fragments

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5
Q

Alignment of fractures described by ___ segment in relation to ___

A

distal segment in relation to proximal

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6
Q

Direction of fracture lines -

A
  • In reference to longitudinal axis
  • Transverse (perpendicular to long axis of bone)
  • longitudinal (incomplete fracture along long axis of long bone)
  • oblique (angulation)
  • spiral (spiral orientation along long axis of long bone)
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7
Q

Impaction -

A
  • compression with axial load (bone buckles on itself)

- Depression & compression

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8
Q

Avulsion -

A
  • tensile loading of fragment & main body of bone
  • Muscle contraction (with lengthening at same time) or passive loading
    EX: Inversion of ankle sprain (Around insertion of tendon, pulls off fragment)
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9
Q

Pediatric fractures of immature bones heals (slowly/rapidly)

A

Heals rapidly

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10
Q

If pediatric fracture involves growth plate, what can that mean?

A

Potential disruption of growth concerning

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11
Q

Greenstick fracture -

A
  • Fracture on side of tensile loading

- Angular displacement common

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12
Q

Torus fracture -

A

Impaction fracture on side of compressive loading

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13
Q

Plastic bowing -

A
  • Longitudinal compression forces exerted, capacity for elastic recoil exceeded
  • Likely a component of all pediatric fractures
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14
Q

Pediatric Physeal (growth plate) Fractures Type 1:

A

Growth plate only

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15
Q

Pediatric Physeal (growth plate) Fractures Type 2:

A

Physis and metaphysis

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16
Q

Pediatric Physeal (growth plate) Fractures Type 3:

A

Physis and epiphysis

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17
Q

Pediatric Physeal (growth plate) Fractures Type 4:

A

Epiphysis, physis, & metaphysis

18
Q

Pediatric Physeal (growth plate) Fractures Type 5:

A

Crush injury of physis

19
Q

Pediatric Physeal (growth plate) Fractures SALTR:

A 
Distal end
S – slip
A –  above physis
L – lower 
T – through 
R – ruined (crush injury)
20
Q

Pediatric Physeal (growth plate) Fractures Type 6 (Rang’s):

A

involves perichondral ring (more superficial layer) or associated periosteum of physis

21
Q

Pediatric Physeal (growth plate) Fractures Type 7-9 (Ogden’s):

A

do not directly involve physis, though may disrupt blood supply
VII: Osteochondral fracture of epiphysis
VIII: Fracture of metaphysis
IX: avulsion of periosteum

22
Q

Which phase is more extensive in healing of pediatric physeal fractures?

A

Remodeling

23
Q

Remodeling & potential for subsequent deformity of pediatric physeal fractures dependent on what 3 things?

A
  1. Skeletal age (Time to remodel vs. time for deformity to develop)
  2. Distance of fracture from growth plate
  3. Severity of displacement of fragments
24
Q

Concerns of deformity of pediatric physeal fractures?

A
  1. Limb length
  2. Angulation
    - Altered joint reaction forces
    - Biomechanical stresses
25
Q

Fracture screening using tuning fork looking for what?

A

Pain provocation or sound conduction

26
Q

Fracture screening using tuning fork better for identifying what type of fracture?

A

Transverse

27
Q

Fracture screening using tuning fork less accurate for what type of fractures?

A

Stress fractures

28
Q

Closed reduction -

A
  • Without surgical intervention
  • Fragments reduced with manipulation/ traction/ combo
  • Soft tissue hinge promotes reduction under tension
29
Q

open reduction -

A

Surgical access for fixation or alignment

30
Q

Goals of fixation -

A
  1. Avoid subsequent soft tissue injury
  2. Maintain bone length
  3. Maintain alignment
31
Q

Types of fixation -

A
  1. Internal (screws inside – maintain alignment of fracture site)
  2. External (e.g. splint, plaster cast)
32
Q

Common immobilization/ protection timelines for bone healing:
Adults =
Children =

A 
Adults = 6-8 weeks
Children = 4-6 weeks
33
Q

Early excessive loading of a bone fracture is a risk for what?

A

risk for pseudoarthrosis (false joint)

34
Q

T/F Insufficient loading of bone fracture may be detrimental

35
Q

What radiographic indicator of fracture healing?

A

callous formation when expected

36
Q

Factors affecting healing and prognosis of bone injuries:

A
  1. Age
  2. Degree of local trauma
  3. Extent of bone loss
  4. Immobilization - Appropriate protection vs. appropriate stressing
  5. Type of bone (cortical v. trabecular)
  6. Size of bone (diameter)
  7. Concomitant Health Conditions (Infection, Local Malignancy & radiation therapy, Other local bone pathology, AVN (avascular necrosis))
  8. Hormones
  9. Approximation (bone not in alignment)
  10. Blood supply
37
Q

life threatening complications of fractures?

A

Hemorrhage
PE
Tetanus

38
Q

Fracture Complication in associated tissues?

A

Nerve injury
Infection
Arterial Injury

39
Q

Fracture complications of bone at fracture site?

A

Delayed union
Pseudoarthrosis
Avascular necrosis

40
Q

Fracture late-effect complications?

A

Limb length discrepancy

MSK (18 decks)

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