MOD 5.1 Fracture Management Flashcards
What are the symptoms and signs of a possible fracture?
- history of direct trauma
- localized pain aggravated by movement
- muscle guarding with passive movement
- decreased function
- swelling or deformity
- sharp, localized tenderness at site
What are the benefits of progressive fracture treatment?
- improved quality of life
- more effective rehab
- faster return to work
What are the 5 main things we want to know about a fracture?
- mechanism
- anatomical site
- configuration displacement
- articular involvement
- soft tissue injury
What is configuration of displacement?
- three planes of angulation
- translation
- shortening
What effect does a bending force have on a bone and which type of fracture is caused?
long bone bends causing failure on convex side, results in transverse or oblique fracture
greenstick in children
What effect does a twisting force have on a bone and what fracture is caused?
serial tension failure of long bone resulting in spiral fracture
What effect does a straight pulling force on a bone and which fracture is caused?
tension failure from pull of ligament or muscle
avulsion fracture
What effect does a crushing force have on a bone and what type of fracture is caused?
compression fracture or torus
What effect does a repetitive microtauma force have on a bone and what fracture is caused?
small crack in bone and fatigue or stress fracture
What effect does a normal force have on a abnormal bone and what fracture is caused?
pathological fracture
What is a type 1 salter Harris fracture?
fracture through the physis of a bone
What is a type 2 salter Harris fracture?
fracture partway through the physics extending up into the metaphysis
What is a type 3 salter Harris fracture?
fracture partway through the physis extending down into the epiphysis
What is a type 4 salter Harris fracture?
fracture through the metaphysis, physis, and epiphysis can lead to angulation deformities when healing
What is a type 5 salter Harris fracture?
crush injury to the physis
Why are salter Harris classifications important?
can lead to bone from stopping growing and can lead to limb length difference
What are the goals of fracture treatment?
- get fractures to heal in position
- restore patient to optimal functional state
- prevent fracture and soft tissue complications
What is closed reduction
- using manipulation or mechanical traction to move bones into place
What is open reduction?
surgery to reduce fracture
What are the contraindications of closed reduction?
- fractures with severe soft tissue damage, joint involvement
- inherently unstable fractures
- multiple fractures
- fractured in confused or uncooperative patients
What are closed reduction method retention?
- sustained traction
- cast/splint
- functional bracing
What are open reduction retention methods?
- internal fixation
- external fixation
- arthroplasty
When is open reducation internal fixation indicated? (ORIF)
- when closed reduction fails
- when large articular fragment needs accurate positioning
- for avulsion fractures
- when operation is needed for associated injuries
Which treatment of a fracture allows for sooner rehab an weight bearing?
operative
Which form of treatment allows for faster healing?
non-operative
When does the hard callus form after a bone fracture?
3-6 weeks
When is a fracture healed in adults?
UE: 6-8 weeks
LE: 12-16 weeks
When is a fracture healed in a child?
UE: 3-4 weeks
LE: 6-8 weeks
When is a fracture healed radiologicially?
- bridging callus formation
- remodeling
What factors affect fracture healing?
- energy of injury
- blood supply
- the patient’s nutrition, fitness, smoking
- method of treatment
- site of fracture
- magnitude of injury including soft tissue
