Lecture 5: Fractures and splint Flashcards

1
Q

What is the definition of a fracture?

A

IS A DISRUPTION OR CHANGE IN THE CONTINUITY OF THE BONE

THE BREAK CAN OCCUR AT ANY POINT ALONG A BONE AND IN MANY

DIFFERENT TYPES OF PATTERNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 classification of fractures

A

closed
open
dispalced
non displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Explain a closed fracture

A

Occurs when forces on bone exceed the
bone’s ability to withstand forces applied
• May be complete or incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain an open frracature

A

• Complete break in bone where bone ends
separate and break through skin
• Increased chance of wound and bone
infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of classification has a greater risk of infection

A

open fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

explain a non displaced fracture and give an example

A

Dispalcaced= normal allignment

ex: Hairline fracture
•Simple crack of the bone
•Maybe difficult to distinguish
from a sprain or simple contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

explain a displaced fracture and give example

A

pull out of normal allignment
Produces actual deformity,
or distortion, of the limb by
shortening, rotating or angulating it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 10 signs and symptoms of a fracature

A

1) deformities
2) point tenderness on palpation
3) guarding (muscle attempt to protect)
4) pain
5) swelling (rapid vs generalized)
6) bruising
7) crepitus (crushing sound)
8) false motion/free movement
9) exposed fragments
10) locked joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Will a fracture always have a deformity?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

True or false: the amount of energy affects the type of fracture>

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the different forces applied to a bone that can cause a fracture?

A
tension/compression
bending
shearing
torsion
combination loading
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tension forces mostly affect which tissues

A

muscles, ligaments, tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 3 types of fractures for foreamr

A

forearm
colles fracture (bone of radius tilts us) FALL ON PALM
smiths fracture FALL ON WRIST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

TRUE OR FALSE: fractures are always obvious>

A

False, sometimes you must do an X ray to ses a stress fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why are open fractures dangerous

A

Higher risk of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is important to ask when considering a fracutre>

fracture eval

A

What happened/pain scale
Where does it hurt
Did you hear any strange noises (cracking, snapping or popping)
Any strange senstations (tingling.numbness)
Previous injuries

(pain, moi, age/sex,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the tests you can perform when suspecting a fracture?

A

Tap Test
Tuning fork
Compression test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Explain the tap test and what consists of a positive test

A

TAP ON THE BONY PROTUBERANCES DISTAL AND PROXIMAL TO THE
SUSPECTED FRACTURE.

• POSITIVE TEST: PAIN THAT RADIATES TO THE FRACTURE SITE CAUSED BY THE VIBRATIONS OF THE TAPPING.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain the tuning fork test

A

APPLY VIBRATING TUNING FORK ON BONE DISTAL AND PROXIMAL TO THE SUSPECTED FRACTURE.

• POSITIVE TEST: PAIN THAT RADIATES TO THE FRACTURE SITE CAUSED BY THE VIBRATIONS OF THE FORK.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

explain the compression test

A

COmpression and spreading can cause pain to am area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the ottawa ankle rule?

A

set of guidelines to help a physician decide if a patient with foot or ankle pain should have an xray done

22
Q

Where are some areas of foot pain that the ottawa ankle rule would refer to a xray?

A

malleolar and midfoot zone
medial malleolus
navicular ]
base of 5th metatarsal

23
Q

What are you looking for when suspecting a fracture?

A
SHARP
swelling
heat
altered function
redness
pain
24
Q

What to do when you find a fractue?

A
RICE
rest
ice
cold
elevate
25
Q

What are the 10 principles of splinting

A

1) supprt injured
2) expose injury
3) cover open wounds/control bleeding
4) PRE check distal pulse PMSC
5) Apply splint
6) Stabilize (aabove below fracture, above below joint)7
7) Secure splint (triangular baandage, do not go over fracture site, expose fingers and toes)
8) recheck PMSC
9) apply cold if tolerate
10) elevate

26
Q

Name types of splints and when is the best time to use them

A
Speed splint (can go through xray)
quick splint (moldable for wrist)
Vacuum splint
traction splint for femer
WHATEVER YOU HAVE AVAILABLE
27
Q

How should you prepare your splint before

A

Have it built, lined with towels, triangular bandages together and tied

28
Q

What are the 5 P’s of fractures?

A
Pain(severe/sharp)
Pulses (distal/present)
Parasthesia (any weird tingling feelings)
Paralysis (partially or fully)
Pallor (cyanotic)
29
Q

What are fracture complications ?

A

1) non union
2) infection from open wounds
3) neural entrapment
4) blood vessel entrapment
5) shock
6) embolism

30
Q

What is the process of normal healing vs lack of fusion

A

Normal: Blood clot formed, replaced by callous, normal healing and fusion occurs

lack of fusion: Fusion does not occur properly

31
Q

explain fat embolism and when does it occur

A

Fat emboli (particles of fat) passes through blood stream and lodges into blood vessel

32
Q

Which fractures have the most blood loss

A

Pelvic and femer…

call 911

33
Q

What are the types of fractures

A
transverse
linear
oblique (displaced/non displaced)
spiral 
greenstick 
comminuted
impacted 
avulsion 
compression fracture
34
Q

Know the difference between open/closed fracture and displaced/non displaced

A

.

35
Q

explain a depressed skull fracture and cause

A

most often in flat bones/skull
how: striking head on hard immovable object or getting hit with hard object
results in; gross pathology of soft areas

36
Q

explain a greenstick fracture and cause

A

incomplete break in the bone
(occurs in immature bone)
usually occurs on outer bend due to a hard blow

37
Q

explain impacted fracture and cause

A

compression force
(falling on something)
REQUIRES TRACTION

38
Q

explain a longitudinal fracture and cause

A

bone splits along its length

impacts force on long axis (compression)

39
Q

explain a spiral fracture and cause

A

S shaped separtion
common in skiing, football
firmly planted foot with body rotation oppositve direction (TORSION FORCE)

40
Q

explain an oblique fracture

A

occurs when one end of the bone is fixed while other end receives torsion/twisting

41
Q

explain a serrated fracture what is is caused by and what can it cause

A

2 BONY FRAGMENTS HAVE A SAWTOOTH, SHARP-EDGED FX LINE

• USUALLY CAUSED BY DIRECT BLOW

• CAN CAUSE EXTENSIVE INTERNAL DAMAGE and SEVERANCE OF VITAL BLOOD VESSELS
AND NERVES

42
Q

explain transverse fracture and cause

A

occurs in a straight line (More of less right agles to the bone)
direct outside blow

43
Q

explain comminuted fracture and cause

A

break in bone where it shatters (3 or more pieces)

hard blow or awkward fall

44
Q

explain ablow out fracture and cause

A

occurs to the wall of the eye as result of hard blow to the eye

45
Q

avulsion fracture and cause

A

seperation of bone fragment from cortex at an attachment of a ligament or tendon
sudden powerful twist

46
Q

explain a stress fracture

A

small incomplete break caused by (overuse,bad balance, weakness, malnutrition)
they are stresses greather than the body can compensate

47
Q

what is an epiphyseal plate fracture>?

A

break in bone at growth plate

due to sports participation at younger ages

48
Q

will an epiphyseal fracture show up on xrat?

A

no it is clear

49
Q

what are the 5 subtypes of epiphyseal fractures (SALTER)

A

1) straight across
2) above oblique (most common)
3) lower or below (through growth plate and epi)
4) two or through (through all elements)
5) ER: erase or crush

50
Q

What are the 3 types of elbow fractures and what are they caused. by?

A

type 1: through with no split

2) through with 1 split
3) through with 2 splits a

caused by: fall where force travels up to the elbow