Lecture 5: Fractures and splint Flashcards by Tanya Thibault

What is the definition of a fracture?

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

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What are the 4 classification of fractures

closed
open
dispalced
non displaced

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Explain a closed fracture

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

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Explain an open frracature

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

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What type of classification has a greater risk of infection

open fracture

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explain a non displaced fracture and give an example

Dispalcaced= normal allignment

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

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explain a displaced fracture and give example

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

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What are the 10 signs and symptoms of a fracature

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

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Will a fracture always have a deformity?

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

TRUE

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

tension/compression
bending
shearing
torsion
combination loading

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Tension forces mostly affect which tissues

muscles, ligaments, tendons

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What are the 3 types of fractures for foreamr

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

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TRUE OR FALSE: fractures are always obvious>

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

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Why are open fractures dangerous

Higher risk of infection

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What is important to ask when considering a fracutre>

fracture eval

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,

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

Tap Test
Tuning fork
Compression test

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Explain the tap test and what consists of a positive test

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.

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Explain the tuning fork test

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.

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explain the compression test

COmpression and spreading can cause pain to am area

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What is the ottawa ankle rule?

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

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

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

What are you looking for when suspecting a fracture?

SHARP
swelling
heat
altered function
redness
pain

What to do when you find a fractue?

RICE
rest
ice
cold
elevate

What are the 10 principles of splinting

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

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

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

How should you prepare your splint before

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

What are the 5 P's of fractures?

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

What are fracture complications ?

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

What is the process of normal healing vs lack of fusion

Normal: Blood clot formed, replaced by callous, normal healing and fusion occurs lack of fusion: Fusion does not occur properly

explain fat embolism and when does it occur

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

Which fractures have the most blood loss

Pelvic and femer... | call 911

What are the types of fractures

``` transverse linear oblique (displaced/non displaced) spiral greenstick comminuted impacted avulsion compression fracture ```

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

explain a depressed skull fracture and cause

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

explain a greenstick fracture and cause

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

explain impacted fracture and cause

compression force (falling on something) REQUIRES TRACTION

explain a longitudinal fracture and cause

bone splits along its length | impacts force on long axis (compression)

explain a spiral fracture and cause

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

explain an oblique fracture

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

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

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

explain transverse fracture and cause

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

explain comminuted fracture and cause

break in bone where it shatters (3 or more pieces) | hard blow or awkward fall

explain ablow out fracture and cause

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

avulsion fracture and cause

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

explain a stress fracture

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

what is an epiphyseal plate fracture>?

break in bone at growth plate | due to sports participation at younger ages

will an epiphyseal fracture show up on xrat?

no it is clear

what are the 5 subtypes of epiphyseal fractures (SALTER)

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

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

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