Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Semester 3 > orthopedic pathology (fractures) > Flashcards

orthopedic pathology (fractures) Flashcards

1
Q

fracture

A

break/defect in bone

“broken bone”

bery common

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

fracture accompanied by soft tissue injury

A

The physical force that is required to break a bone practically always produces some soft tissue injury

Difficult to determine the extent of soft tissue injury

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

causes

A

Trauma or sudden force

Direct – a bone breaks at the point of impact

Indirect – bone breaks some distance from the force (closed chain?)

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

other cause

A

Overuse or repeated wear
Stress fracture

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

pathologies as acause

A

Pathologies

Osteoporosis,
osteopenia (?)
tumours,
local infection
or bone cysts

Can cause weakening of bone

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

symptoms fracture

A

Unnatural mobility

Muscle splinting

Visible deformity

Pain (SHARP)

Bleeding

Swelling, bruising

Decreased function

Internal organ damage
Shock

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

daignosis

A

Imaging
X-ray
CT
MRI
Ultrasound (not as common)

Physical examination:
Fracture Screen:
Four step test

Torsion test (resisted isometric contraction)

Palpation (bony prominences)

Percussion/tuning fork (based on sound pattern/pain w/ fork distal to site?)

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

treatment

A

immobilization
(cast/splint)

surgical reduction
(screws, wires, metal plates)

Meds
NSAIDS (advil, naproxen, etc)

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

healing

A

Depends on:
The amount of damage incurred

Amount of movement at fracture site

Concurrent disease

Age

Overall health status

Complications

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

complications (early = within first few weeks)

A

Soft tissue injuries (muscles, ligaments, etc)

Acute compartment syndrome (within 48 hours):
Most commonly in forearm or leg

Swelling/bleeding increases pressure within fascial compartment

Cycle of reduced circulation -> ischemia -> edema -> reduced circulation

–>Leading to necrosis and gangrene
(Medical emergency)

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

complications (early)

A

Nerve compression

Bone/soft tissue infection

fever, pain, edema, pus

Deep vein thrombosis
(Blood clot in deep vein)

Cast dermatitis (allergic reaction)

Pressure or plaster sore
(ischemia over bony prominence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

late complications (few weeks to years)

A

Nerve compression or entrapment

Joint stiffness

Disuse atrophy

Disuse osteoporosis

Myositis ossificans

Metal plates may cause discomfort forever

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

other late compications

A

Delayed union:
Bone does not unite within expected time frame

Via inadequate circulation, insufficient splinting, infection

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

non-union

A

Failure of bone to heal before repair process finishes

Due to large gap, bone destruction, bone loss

rebreak bone and join together surgically so they form union and heal as one structure

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

malunion

A

union occurs but not correctly (offset, at an angle etc.)

Can lead to altered biomechanics, tendinitis, bursitis, osteoarthritis

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

other late complicaitons

A

avascular necrosis:
Tissue ischemia
via impaired vascular flow

Minimum of 2 hours of anoxia required for permanent loss of bone tissue

(May be secondary to trauma or thrombosis)

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

note tissue hypoxia survival time

A

Brain <3 min

Kidney and liver 15-20 min

Skeletal muscle 60-90 min

Vascular smooth muscle 24-72 h

Hair and nails Several days

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

osteonecrosis (same as avascular necrosis of bone????)

A

avascular necrosis of bone

Occurs in bones that are poorly vascularized

scaphoid, neck of femur, talus, lunate

Ischemia occurs shortly after fracture, but necrosis may not be noticed on x-ray for weeks

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

bone healing stage 1 (SEVERAL WEEKS)

A

fracture hematoma

Blood vessels are damaged and cause a mass of blood to form around Fx (Fx hematoma)

Forms 6 to 8 hours after injury

Lack of blood flow causes nearby bone cells to die, which creates additional swelling/inflammation.

Phagocytes and Osteoclasts clean up dead/damaged tissue around Fx

This stage may last up to several weeks.

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

stage 2

A

FC callus formation (3 weeks)

Fibroblasts invade fracture site and produce collagen fibers.

Chondroblasts invade fracture site and produce fibrocartilage

= SOFT CALLUS (FC callus)
helps to bridge the broken edge of the bones.

Formation of a soft callus takes about 3 weeks

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

chondrocytes and collagen

A

The pericellular region immediately surrounding the chondrocyte contains type VI collagen

(referring to a different area of cartilage, not FC callus, but FC callus also has collagen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

stage 3 (3-4 months)

A

bony callus

Osteogenic cells develop into osteoblasts and produce spongy bone trabeculae

The trabeculae join living and dead bone fragments together, replacing the fibrocartilage.

This new callus is referred to as a hard callus (bony callus)

The bony callus lasts about 3 to 4 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

stage 4

A

Bone remodeling is a slow process that may last 6-9 years, which is 70% of the total healing time. In the remodeling, osteoclasts (cells that break down bone tissue) resorb the trabecular bone, and osteoblasts deposit compact bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

stage 4 …

A

Bone remodeling of the callus

Remaining dead portions of bone are reabsorbed by osteoclasts.

Compact bone replaces around spongy

Realignment along lines of stress (Wolff’s law)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
general classification of fractures
via: 1. Site 2. Extent 3. Configuration 4. Relationship of fragments to each other 5. Relationship of fragments to external environment
26
1) site
Diaphyseal Metaphyseal Epiphyseal Intra-Articular (Articular surface) Fracture-dislocation
27
2) extent
Complete Bone is broken into two or more pieces Incomplete Bone is bent or cracked, but (most of?) the periosteum remains intact, which allows the bone to remain whole E.g. Compression Greenstick Stress/Hairline
28
compression fracture
The bone is crushed Occur in cancellous (spongy) bone E.g. Vertebral body
29
greenstick fracture
The bone is bent or partially broken ound in children younger than 10 years old --> Bones are more pliable than those of adults
30
stress/hairline fracture
Crack in the bone due to overuse or repetitive actions common @ MOST COMMON TIBIA (50%) MT (march fracture) navicular femur pelvis
31
3) configuration
Linear Parallel to the long axis of a bone Transverse (chalkstick) Right angle to the bone's long axis Oblique Diagonal to a bone's long axis Spiral at least one part of the bone has been twisted Comminuted Consists of two or more fragments Avulsion A ligament (or tendon) pulls a portion of the bone away from the bone itself
32
4) relationship of fragments to each other
Undisplaced Fragment ends are in line with each other Displaced Fragment ends have moved and no longer line up
33
5) relationship of fragments to external environment
Closed/simple fracture Skin is intact Open/compound fracture Ends of the bone have broken through the skin or into a body cavity; more prone to infection "Closed fractures are easier to treat with better prognosis."
34
named fractures
.
35
lower extremity named fractures
..
36
Galeazzi fracture
Fracture of radial shaft and dislocation of distal radioulnar joint FOOSH
37
Monteggia Fracture
A fracture in the proximal part of the ulna with dislocation of the head of the radius
38
Colles Fracture
Transverse fracture of distal radius Distal fragment rotates and displaces dorsally FOOSH “Dinner fork” deformity
39
Smith's Fracture
Aka reverse Colles fracture The distal fracture fragment is displaced ventrally (volar/palmar) "spoon"
40
Barton’s Fracture
An intra-articular fracture of the distal radius with dislocation of the radiocarpal joint Two types Dorsal and palmar (Reverse Bartons’s) FOOSH
41
Bennett's Fracture
Intra-articular fracture of proximal 1st metacarpal with dislocation of CMC joint Longitudinal force along the axis of the 1st MC when thumb is flexed
42
Reverse Bennett's
5th MC (proximal)
43
Rolando Fracture
comminuted intra-articular fracture through the base of the first metacarpal bone Fracture consisting of 3 distinct fragments --> T or Y shaped
44
Boxer's (Brawler's) fracture
Fracture of the (distal?) 5th MC Due to punching an object with a closed fist
45
Salter-Harris Fracture
Refers to any fracture that occurs through the growth plate. More common in the upper extremity Typically only happens in children (epiphyseal plate) (Growth plates are weak, joint capsules are strong in comparison)
46
named fractures of lower extremity
..
47
Pott’s Fracture
One or both malleoli Can also involve deltoid ligament rupture or avulsion to medial malleoli
48
Jones Fracture
Aka dancer’s fracture Is an injury to the 5th metatarsal (PROXIMAL END) Occurs at the proximal end (midfoot) MOI: forceful inversion and plantar flexion
49
Maisonneuve Fracture
Spiral fracture of the PROXIMAL third of the fibula associated with a tear of the DISTAL tibiofibular joint and interosseous membrane Medial malleolus avulsion and possible rupture of the deltoid ligament (???)
50
Toddler's Fracture
Aka childhood accidental spiral tibial fractures (CAST fracture) Occurs in children usually under 3 years old, but up to 8 years old Involves the distal third to distal half of the tibia Undisplaced and in a spiral pattern
51
Trimalleolar Fracture
A fracture of the ankle that involves the lateral malleolus, medial malleolus and the distal posterior aspect of the tibia
52
fractures of spine
..
53
skull fractures
linear fracture (most common depressed fracture (high velocity impact by small object)
54
Jefferson Fracture
AKA Burst Fracture of the Atlas Fracture(s) of anterior and/or posterior arches of C1 Compression injury Usually MVA or diving injuries
55
Clay Shoveler's Fracture
Avulsive fracture of the spinous process Occurs typically between C6-T1, C7 being most common MOI: Hyperflexion of neck with contraction of erector muscles
56
Teardrop fracture
Usually occur in the cervical spine Flexion Teardrop: Hyperflexion causes anterior vertebral body to compress and shear off an anterioinferior fragment. Extension Teardrop: Hyperextension causes an avulsion fracture of the anterioinferior portion. Usually very SEVERE and unstable: Due to ligamentous disruption the spinal cord can be compromised, leading to paralysis
57
Compression Fracture
Combined flexion and axial compressive forces Most common fracture of lumbar spine (M/C at T12 and L1) Commonly seen in patients with osteoporosis in C-spine --> Dowager’s hump
58
Rib Fracture
via blunt or penetrating chest trauma. Ribs 4-10 are most commonly fractured. Upper 3 ribs require higher force impact May lead to complications with internal organ injury
59
Flail Chest
When three of more contiguous ribs are fractured in two or more places. MOI High impact blunt trauma with severe anteroposterior compression.
60

Semester 3 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions