November 6, 2015 - Fractures

Question 1

Stages of Bone Healing

Answer 1

1. Bleeding
2. Inflammation
3. Proliferation
4. Remodelling

Question 2

Osteoblasts

Answer 2

Form bone

Question 3

Osteoclasts

Answer 3

Resorb bone

Question 4

Osteocytes

Answer 4

Maintain bone

Question 5

Avascular Necrosis

Answer 5

Bones with poor blood supply also at risk for avascular necrossi and non-union.

For example, the femoral head/neck, scaphoid, and talus. This is because much of these bones are encased in cartilige which does not allow vessels to pass through.

Question 6

Factors that Promote Bone Healing

Answer 6

Youth

Calcium

Vitamin D

Moderate stress

Electric stimulation

Ultrasound

Anabolic hormones

Question 7

Factors that Delay Bone Healing

Answer 7

Poor blood supply

Old age

Lack of Calcium

Lack of Vitamin D

Tobacco dependence

NSAIDs

Corticosteroids

Excessive bone gap

Question 8

Stress Fracture

Answer 8

Microfracture resulting from repetitive sub-threshold loading that ultimately exceeds the bone’s intrinsic ability to repair itself.

Often impact sports.

Question 9

Periostitis

Answer 9

Inflammation of the connective tissue covering the bone surface; the periosteum. This is highly pain sensitive as it has significant nerve and vascular supply.

Most common in tibia = shin splints (anterior tibia)

Question 10

Immediate Assessment of Bone Injury

Answer 10

You need to ask whether the fracture you are dealing with is potentially life-threatening or limb-threatening.

Question 11

Ottawa Ankle Rules

Answer 11

The guideline to aid in deciding when to use x-ray for injuries to the ankle.

Widely used.

Question 12

Nonunion

Answer 12

A permanent failure of healing following a broken bone. This is a serious complication of a fracture.

Often due to avascular necrosis, the two ends are not fixed (next to each other), or infection.

Question 13

Malunion

Answer 13

Occurs when a fractured bone doesn’t heal properly. It may heal twisted, shorter, or bent.