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S3- Musculoskeletal > Introduction to Fractures > Flashcards

Introduction to Fractures Flashcards

1
Q

FRACTURE DESCRIPTION

A

FRACTURE DESCRIPTION

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2
Q

What are some ways we can describe a fracture?

A
  • Open vs Closed
  • Anatomical Site and Extent
  • Type: Complete vs Incomplete
  • Alignment of fragments
  • Direction of fracture lines
  • Special features
  • Associated abnormalities (dislocation, subluxation, soft tissue injury)
  • Special Types (stress fracture, pathological fracture, etc.)
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3
Q
  • What is an open fracture?

- What is a closed fracture?

A
  • Open fracture= breaks through skin

- Closed fracture= bone broken, skin intact

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4
Q

Anatomical Site and Extent:

  • Long bones divided into ______, ______ and _________ thirds.
  • Ends further divided into _____ vs ______ articular.
A
  • proximal, middle, distal

- intra-articular (inside joint) and extra-articular (outside joint)

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5
Q

Type (Complete vs Incomplete):

  • In a complete fracture, all _______ are disrupted.
  • In an incomplete fracture, these mostly occur in ______ bones and _______. They are generally ________ without subsequent stresses.
  • What is a comminuted fracture?
A
  • cortices
  • short bones and children, stable
  • Comminuted fracture= >2 fragments
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6
Q

Alignment:

  • Alignment is the description of the _______ segment in relation to the ________ segment in relation to the normal anatomical position.
  • What are some ways to describe alignment?
A
  • distal, proximal

- Displaced, Angulated, Shortened, Rotated

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7
Q

Direction of Fracture Lines:

  • In reference to ___________ axis
  • What are some ways to describe the direction of fracture line?
  • Comminution is described by its ________.
A
  • longitudinal
  • Transverse, Longitudinal, Oblique, Spiral
  • Degree (minimal, moderate, severe)
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8
Q

Special Features:

  • Impaction: ________ with ______ load
  • Avulsion: _______ loading of fragment and main body of bone.
A
  • compression with axial load

- tensile

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9
Q

PEDIATRIC FRACTURES

A

PEDIATRIC FRACTURES

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10
Q

Immature bone heals _______, the potential disruption of _______ is most concerning.

A
  • rapidly

- growth

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11
Q

What are 3 special pediatric fractures?

A
  • Greenstick
  • Torus
  • Plastic Bowing
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12
Q

With a Greenstick Fracture, we have a fracture on the side of ______________. _______ displacement is common.

A
  • tensile loading

- angular

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13
Q

With a Torus Fracture, we have a fracture on the side on _____________________.

A

compressive loading

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14
Q

Plastic Bowing involves the capacity for ________ recoil being exceeded. It is likely a component of all pediatric fractures.

A

elastic

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15
Q
  • Tensile Loading side fractured = __________

- Compressive Loading side fractured = _________

A
  • Greenstick

- Torus

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16
Q

Describe the first 5 Types of Pediatric Physeal (growth plate) Fractures.

A
  • Type 1= growth plate only
  • Type 2= physis and metaphysis
  • Type 3= physis and epiphysis
  • Type 4= epiphysis, physis, and metaphysis
  • Type 5= crush injury of physis
17
Q

What is a good way to remember the Types of Pediatrc Physeal Fractures?

A 
SALTR
S= slippage
A= above physis
L= lower physis
T= through
R= ruined
18
Q

Type 6 (______) Pediatric Physeal Fracture involves ___________ ring of associated periosteum of physis.

A
  • Rang’s

- perichondral

19
Q

Type 7-9 (______) Pediatric Physeal Fractures do not directly involve the ______, though may disrupt ______ supply.

A
  • Ogden’s
  • physis
  • blood supply
20
Q

With pediatric physeal fractures healing, the _______ phase is more extensive.

A

remodeling

21
Q

What are some concerns with physeal fracture healing?

A
  • Limb length

- Angulation (altered joint reaction forces, biomechanical stresses)

22
Q

FRACTURE SCREENING

A

FRACTURE SCREENING

23
Q

General things to look at when screening for fractures?

A
  • Hx/Patient Interview
  • American College of Radiology Appropriateness Criteria
  • Evidence-Based Fracture Rules (Canadian C-Spine, NEXUS Low-Risk Rules, Ottawa Knee/Anke/Foot Rules)
  • Physical Examination Procedures
24
Q

What instrument is also used for pain provocation or sound conduction in screening for fractures? It is less accurate for stress fractures and hass a questionable sensitivity.

A

Tuning Fork

25
Q

REDUCTION AND FIXATION

A

REDUCTION AND FIXATION

26
Q
  • What is reduction?

- What is fixation?

A
  • Reduction= Fractured surfaces placed back together.

- Fixation= stabilization of fracture for healing.

27
Q
  • A closed reduction is done __________ surgical intervention. Fragments are reduced with manipulation/traction/combo.
  • A open reduction is done ________ for access for fixation or alignment.
A
  • without

- surgically

28
Q

What are the goals of fixation?

A
  • Avoid subsequent soft tissue injury
  • Maintain bone length
  • Maintain alignment
29
Q

What are the types of fixation?

A
  • Internal (hardware)

- External (cast, splint)

30
Q

GENERAL FRACTURE HEALING

A

GENERAL FRACTURE HEALING

31
Q

Common immobilization timeframes for adults and children?

A
  • Adults= 6-8 weeks

- Children= 4-6 weeks

32
Q

Early excessive loading causes a risk for ______________.

A

pseudoarthrosis

33
Q

Fracture ealing time frames can also be dependent on the ________/_____ affected.

A

-location/bone

34
Q

What are some factors that affect healing rates and prognosis?

A
  • Age
  • Degree of local trauma
  • Extent of bone loss
  • Immobilization (appropriate protection vs appropriate stressing)
  • Type of bone (cortical vs trabecular)
  • Size of bone
  • Concomitant Health Conditions (infection, local malignancy and readiation therapy, other local bone pathology, AVN)
  • Hormones
  • Approximation
  • Blood supply
35
Q

Complications of Fractures can have what life threatening conditions?

A
  • Hemorrhage
  • Fat Embolism
  • Pulmonary Embolism
  • Gas Gangrene
  • Tetanus

S3- Musculoskeletal (27 decks)

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