MS: Fractures Flashcards
what is the percentage of injuries in U.S are MS?
50%
Why do females have double the rate of injury during ovulation?
increased estrogen levels
Female vs. Male strentgh training info
males gain two times faster but lose two times faster
What type of connective tissue makes up MS system?
bone, cartilage, ligaments, tendons, fascia
What is the diaphysis of the bone?
mid shaft
What is the metaphysis of the bone?
flared portion at distal end
What is the physis of the bone?
growth plate, important in young kids
x-ray can show if plate is fused which means maturing is complete
What is the epiphysis of the bone?
adjacent to physis and and most distal
what part of the bone is covered by articular cartilage?
epiphysis
What are osteoblasts?
cells the make bone
What are osteoclasts?
break down boneand release the minerals, resulting in a transfer of calcium from bone fluid to the blood
what are osteocytes?
maintain the bone
What is a fracture?
a breakdown or defect in bone continuity
What is a trasnverse fracture?
a clean break, easiest to heal
what is a spiral fracture?
when torque or rotating force is applied to axis of bone
more surface area for site of fracture
What is an oblique fracture?
A fracture in which the line of break runs obliquely to the axis of the bone.
what is a comminated fracture?
A fracture in which a bone is broken, splintered, or crushed into a number of pieces.
always a trauma associated with this
What is a segmental fracture?
a bone break in which several large bone fragments separate from the main body of a fractured bone. The ends of the fragments may pierce the skin, as in an open fracture, or may be contained within the skin, as in a closed fracture.
What is an avulsion fracture?
A fracture occurring when a joint capsule, ligament, tendon, or muscle is pulled from a bone, taking with it a fragment of the bone to which it was attached.
What is an impacted fracture?
A bone fracture in which one of the fragments is driven into another fragment.
What is a greenstick fracture?
A fracture in which one side of the bone is broken and the other side is bent
common in kids potentially child abuse b/c bone is young and doesn’t break clean
What is a compression fracture?
impaction of bone
seen in vertebrae due to vertebral body collapsing, common in osteoporosis due to minerlization
What is a pathological fracture?
fx through bone weakened by disease or or tumor
ex) lung, breasts and colon cancer
What is an intra-articular fracutre?
fx line crossed articular cartilage and enters joint
the joint is now architecturally changed
What is a non-displaced vs displaced fracture?
NP: bone is still in alignment (easier to treat)
D: a traumatic bone break in which two ends of a fractured bone are separated and out of their normal positions.
What is an angulated fracture?
fragments are maligned
What is a boyonetted displacement?
distal fragment longitudinally overlaps the proximal fragment
What is a distracted displacement?
distal fragment seperated from proximal fragment by a gap
Why is a road burn still considered an open fracture?
b/c the skin is opened near the trauma
What is a Salter Harris classification?
fracture to the epiphysial plate
usually in girls u16 boys u 21
could lead to bone growth discrepency
What is an exotosis fracture?
is the formation of new bone on the surface of a bone, because of excess calcium forming.
What is Wolff’s law?
long term stress to bone due to microtraumas
bone growth due to pressure
what is a stress fracture?
is a fatigue-induced fracture of the bone caused by repeated stress over time.
What are risk factors for a fracture?
smoking, diabetes, poor blood pressure, nutrition
Physical examination for fracure?
common signs of inflammation: redness, tenderness, possible deformity
eval the skin, stability of jts, functions of nerves/vessels distal to site of injury
tend to open lacerations as it is open fracture
What is the order for diagnostic tests?
- Xray
2. MRI - gold standard for stress fracture due to visible vascularity and bone density
What bones are common for undetected stress fx?
navicular, ribs and schapoid due to poor blood supply
usually pt will experience strong pain 1-4 weeks after injury
What is first step in fracture healing?
hematoma- a fibrin mesh forms as a base for healing
What is procallus formation?
second step in fracture healing where fibroblasts, capillary beds and osteoblasts move into wound
What is callus replacement?
osteoblasts replace callus with trabecular or lamellar bone
What are possible adverse outcomes to healing?
delayed union- healing slower than normal (infection? etc.)
nonunion- failure of healing (lack of blood flow?)
malunion- healing with unacceptable deformity (massive trauma?)
limb function may be affected- contracture, swelling
What is prognosis for PT and fractures?
6 weeks in cast roughly 6 weeks of PT
Prognosis for healing?
children- 4-6 weeks
adolescents- 6-8 weeks
adults- 10-18 weeks
Negative predictors for healing?
renal or vascular insufficiency- electrolyte or homeostasis imbalance
smoking, alcohlosim, diabetes (even if properly managed)
can increase healing by 50%
PT implications acute post cast?
swelling reduction, restore mvmt
skin integrity+ mobility—–PRICE
PT implications subacute?
after 2 weeks restore mvmt, add strength
PT implications chronic?
functional activities
