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Moving Exam 3 > SA Ortho - Bone Healing Stable/unstable > Flashcards

SA Ortho - Bone Healing Stable/unstable Flashcards

1
Q

fracture injuries

A

Soft tissue damage
Instability of bone
Loss of function

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2
Q

Fracture fixation purpose

A

Reestablish mechanic support

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3
Q

What does bone depend on to heal

A

Age, location, presence of necrotic debris, vascularity availability, stability, distance between fragments

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4
Q

Stable conditions for bone healing

A

Direct apposition of bone
Direct or primary bone healing

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5
Q

Unstable bone healing conditions

A

Connective tissue, fibrocartilage then bone
Indirect or secondary bone healing

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6
Q

Most important factor in bone healing

A

Vascular

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7
Q

Why is stability key in healing?

A

Allows vessels and cells to cross fracture line effectively
Interruptions in this connection from instability regresses progress

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8
Q

Distance can cause what in healing

A

If distance is too great the fracture will experience motion and callus will be large as a result

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9
Q

Stages of bone healing

A

Coagulation - fracture hematoma
Inflammation - clean up
Granulation - repair
Maturation - remodeling

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10
Q

Inflammation

A

Neutrophils
Macrophages
Osteoclasts
Help clean up the area, remove any bacteria present

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11
Q

Granulation

A

More stability = more cartilage
Fibroblasts produce fibrous tissue
Chondrocytes produce fibrocartilage
Osteoblasts produce bone

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12
Q

Stable conditions - type of callus

A

No gap due to good blood supply - direct or primary healing

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13
Q

Unstable conditions - callus type

A

Gap with good blood supply will result in indirect or secondary bone healing

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14
Q

Contact areas in primary healing

A

Contact between fragments - gap should be <1mm
GOOD BLOOD SUPPLY

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15
Q

Structures in contact area in primary healing

A

Osteoclasts create tunnels across fracture line
Vessels follow
Osteoblasts fill in tunnel in concentric ring

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16
Q

What location is NOT ideal for a callus ?

A

Joints ! Not helpful v v bad

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17
Q

Gap area <200Um

A

Hematoma in gap
Bv and mesenchymal cells
Osteoblasts deposit lamellar bone
Ideal gap space

18
Q

Gap >200uM but <1mm

A

Hematoma in gap
BV and mesenchymal cells
Osteoblasts deposit woven bone haphazard

19
Q

Indirect healing

A

Good blood supply
Large gaps
Not rigidily stable

20
Q

Tissue replacement in indirect bone healing

A

Fibrous tissue first
Fibrocartilage
Bone-woven

21
Q

Features of maturation

A

Remodeling
Modeling
Osteoclasts/blast

22
Q

Direct healing

A

Minimal callus
Takes longer to achieve full bone strength

23
Q

Indirect healing

A

More callus
Remodels faster and stronger but callus may impair

24
Q

Which is better healing for articular fractures

A

Direct - as smooth as possible

25
Q

Factors in describing bone healing

A

Mechanical
Biological
Clinical

26
Q

Each factor is scored from 1-10

A

1=factor does not favor rapid bone healing
10=factor favor bone healing

27
Q

Factors for an assessment scores

A

Age, health, condition of soft tissue, type of bone (cortical, cancellous) type of injury, open or closed fracture

28
Q

Low scores on fracture assessment

A

Implants bridge fracture and support all loads
Strong durable
Plate, external fixator, interlocking nail

29
Q

Mid score fracture assessment

A

Less implant strength and endurance needed
Plates and external fixators, interlocking nail, IM pins and wires

30
Q

High scores on fracture assessment

A

Bone and implants share load and rapid healing expected
External fixator, IM pins and wires, external coaptation

31
Q

Vascularity integrity

A
32
Q

Fracture location

A

Metaphyseal heal faster than diaphaseal
Distal antebrachium in mini dogs and tibial diaphyseal heal slowwwww

33
Q

Degree of immobilization

A

More rigid fixation = faster healing

34
Q

Fracture type

A

More complicated the fracture = slower healing

35
Q

Degree of post-reduction apposition

A

Better apposition = faster healing

36
Q

Age of animal in healing

A

Younger = faster

37
Q

Degree of location in healing

A

Fractures w lots of soft tissue damage - slower healing

38
Q

Degree of bone loss in healing

A
39
Q

Types of bones involved in healing

A

Cancellous bone = rapid + rich blood supply
Cortical bone = slower (direct healing)

40
Q

Local malignancy in healing

A

Pathologic fractures can heal just slowly

41
Q

Corticosteroids in healing

A

Use of corticosteroids will slow healing - inhibit differentiation of osteoblast form mesenchymal cells and decrease rate of synthesis of major components of bone matrix

Moving Exam 3 (34 decks)

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