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Med Procedures > Splinting and Fractures > Flashcards

Splinting and Fractures Flashcards

1
Q

Osteoblasts

A

Derived from mesenchymal cells
Produce osteocalcin
Needs 1,25-Dihydroxyvitamin D
Produce Type I collagen

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2
Q

Osteoblasts are effected by?

A

Interleukins
Platelet derived growth factor
Insulin derived growth factor

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3
Q

Receptors for osteoblasts

A 
Estrogen 
Prostaglandins  
Glucocorticoids  
1,25 vitamin D  
PTH
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4
Q

Osteoclast stimulated by?

A

stim by calcitonin and inhibited by PTH

Multinucleated Giant cells

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5
Q

collagen

A

90% of organic matrix

Tensile strength

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6
Q

Prosteoglycans

A

Inhibit mineralization

Partially responsible for compressive strength

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7
Q

3 Non-Collagenous proteins

A

Osteocalcin
Osteonectin
Osteopontin

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8
Q

Bone Matrix (inorganic)

A

Calcium Hydroxyapatite
Responsible for compressive strength
Osteocalcium Phosphate
Brushite

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9
Q

Cortical bone (Lamellar)

A

80% of skeleton
Haversian canals – nutrient supply
Stress oriented formation

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10
Q

Cancellous bone (Lamellar)

A

Trabecular (spongy)

Higher rate of remodeling

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11
Q

Immature (Woven)

A

Not stress oriented
Elastic in nature
Embryonic skeleton
Fracture healing

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12
Q

Pathologic (Woven)

A

Random organization
Weak
Tumors

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13
Q

Inflammatory response

A

Bleeding to area of insult

Hematoma – fibrin clot, growth factors

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14
Q

repair of fracture

A

Primary callous @ 2 wks
Bridging occurs
Assisted by medullary callous

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15
Q

remodeling of fracture

A

Initiates during repair

Complete when repopulation of marrow space

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16
Q

initial response for fracture healing

A

decrease blood flow
Hours – days begins increase
Regional acceleratory phenomenon-
Returns to normal 3-5 months

17
Q

kids bone pathology

A

Thicker periostium

Cambium has increased ability for osteoblast formation

18
Q

Wolffs Law

A 
Decrease stress = decrease density
Piezoelectric charges
Compression – electronegative
Stimulates osteoblasts
Tensile – electropositive
Stimulates osteoclasts
19
Q

Classification of Bones (6)

A 
Long bones
Short bones
Flat bones
Irregular bones
Sesamoid bones
Accessory bones
20
Q

Closed reduction fractures

A 
Most fractures can be treated closed
Must understand anatomy
Need good plain films minimum of 2 views
Peri-ostium can hold you up
Can’t accept rotation deformity
Difficult to manipulate after 10 days
21
Q

Kids and Fractures

A 
Kids - angulations can be accepted
Kids remodel
Mid-shaft doesn’t remodel as well
Kids ok for shortening
Kids rarely form non-unions
Kids rarely need physical therapy
22
Q

2 layers of physis

A

Horizontal - physis

Spherical- epiphysis

23
Q

2 types of growth plate fractures

A

Traction
Usu. apophyseal
Compression
Usu. epiphyseal

24
Q

Salter Harris Classification Type 1

A

Type I – Transverse fracture through physis

25
Q

Salter Harris Classification Type 2

A

Type II – Fracture through physis with metaphysis fragment

26
Q

Salter Harris Classification Type 3

A

Type III – Fracture through physys with epiphysis fragment

27
Q

Salter Harris Classification Type 4

A

Type IV – Fracture through epiphysis, physis and metaphysis

28
Q

Salter Harris Classification type 5

A

Type V – Crush injury to physis

29
Q

Type I and Type II emergent open fractures

A

Type I <10 cm

Moderate energy

30
Q

Type IIIa emergent open fractures

A

Type IIIa
High energy
Adequate soft tissue coverage

31
Q

Type IIIc emergent open fractures

A

Type IIIc
High energy
Vascular injury

32
Q

Type IIIb emergent open fractures

A

Type IIIb
High energy
Massive soft tissue destruction
Exsposed bone

33
Q

High complication rate of fractures in children

A

Supracondylar humerus fractures
Radial neck fractures
Radial head fractures
Lateral condylar humerus fracture

34
Q

High complication rate of fractures in adults

A

Both bone extremity fractures
Pilon fractures
Distal Humerus fracture

35
Q

Splints for fractures

A 
Immobilize fracture
Joint above and below
Allows for swelling
Most swelling 6-12 hours post injury
Extra padding to bony prominence
Well applied splint is as good as a cast acutely
36
Q

Casting fractures

A 
Apply after swelling decreases
Extra padding of bony prominences
Do not use fingers for molding
Any complaints evaluate
May need to remove
Caution about reduction
Apply without tension
37
Q

Caution for splinting and casting

A

Compartment syndrome
Skin necrosis
Foreign bodies

38
Q

Surgical Treatment for fractures

A 
Percutaneous pinning
Closed reduction with internal fixation
Open reduction with internal fixation
Intramedullary fixation
External fixation

Med Procedures (5 decks)

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