Sprains, Strains and Fractures

Question 1

what are ligaments

Answer 1

bind bone to bone

Question 2

what are tendons

Answer 2

bind muscle to bone

Question 3

what are sprains

Answer 3

ligament tears

Question 4

where are sprains most commons in

Answer 4

wrist, ankle, elbow and knee

Question 5

what type of sprain is an avulsion

Answer 5

complete tear

Question 6

what are strains

Answer 6

stretch or tear to muscle or tendon

Question 7

where are strains most common

Answer 7

ankle, achilles, hamstrings, biceps, triceps, patellar, hands and feet

Question 8

what is the presentation of sprains and strain

Answer 8

painful
swelling
dislocation/subluxation
limited ROM
instability

Question 9

when does collagen begin to repair

Answer 9

4-5 days after damage

Question 10

what is tendinopathy

Answer 10

tendonitis
inflammatory condition of the tendon
often chronic, repetitive injury

Question 11

what is the purpose of bursas

Answer 11

they cushion and lubricate areas

Question 12

what are bursa filled with

Answer 12

synovial fluid

Question 13

what is bursitis

Answer 13

inflammation or enlargement of bursa usually due to overuse, excess pressure and infection

Question 14

what is the presentation of bursitis

Answer 14

normal ROM (unless limited by discomfort)
swelling
warmth
erythema

Question 15

where is infected bursitis most common

Answer 15

superficial bursa

Question 16

what is the presentation of infected bursitis

Answer 16

erythema, warmth, pain and edema

Question 17

what are the grades of muscle strains

Answer 17

1-3
1: pain w/o deformity
2: muscle body intact but some torn fibers with welling, pain and bruising
3: trauma resulting in tearing of the fascia and muscle - notable deformity

Question 18

what forms around/between damaged area in a muscle strain

Answer 18

hematoma

Question 19

what phagocytize the necrotic tissue after a muscle strain

Answer 19

monocytes

Question 20

what fills in the scar tissue

Answer 20

myoblasts

Question 21

how long do muscle strains take to heal

Answer 21

typically take up to 6 weeks

Question 22

what is a subluxation

Answer 22

partial dislocation

Question 23

what is a dislocation

Answer 23

articulating surfaces of a joint are disrupted and loose contact with eachother

Question 24

what are the most common dislocation areas within the body

Answer 24

shoulder, finger, hip, knee, elbow and wrist

Question 25

what are other structures that may be damaged in dislcoations

Answer 25

capsule nerves and blood vessels

Question 26

what is the presentation of dislocations

Answer 26

painful, limited ROM, deformity, nerve injury and swelling

Question 27

what is entrapped in a nursemaids elbow

Answer 27

annular ligament

Question 28

what are the types of displaced fractures

Answer 28

bayonetted, distracted, angulated and displaced

Question 29

what are comminuted fractures

Answer 29

multiple fragements that make up the fracture due to high velocity injury

Question 30

what is associated with comminuted fractures

Answer 30

significant soft tissue injury

Question 31

what is a transverse fracture

Answer 31

most common fracture fracture line is perpendicular to the length of the bone can be displaced and involves all cortices

Question 32

what is the typical MOA for transverse fractures

Answer 32

direct blow to the bone

Question 33

what is an oblique fracture

Answer 33

fracture that runs diagonally to the length of the bone likely to have angulation

Question 34

what is a spiral fracture

Answer 34

fracture line runs around the bone

Question 35

what is the MOA for spiral fractures

Answer 35

high energy

Question 36

what is an impacted/compression fracutre

Answer 36

fracture fragments are pushed into eachother such that bone will appear shorted

Question 37

what bones are typically associated with impacted/compression fractures

Answer 37

vertebrae

Question 38

what condition is typically associated with compression fractures

Answer 38

osteoporosis

Question 39

what type of fracture is a traction related injury

Answer 39

avulsion fracture

Question 40

what is a intracapsular fracture

Answer 40

fracture line extends into the joint capsule - also known as intra-articular

Question 41

what is a greenstick fracture

Answer 41

outer cortex of one side of the bone fractures with splintering extending into the spongy bone

Question 42

what is the patient population that greenstick fractures are seen in?

Answer 42

children and elderly

Question 43

what is a torus fracture

Answer 43

another name for buckle fracture cortex squishes down and bulges outward but the bone does not break

Question 44

what is the MOA for buckle fracture

Answer 44

axial loading - FOOSH

Question 45

what is a bowing injury

Answer 45

bone will bend instead of snap or crack

Question 46

what is the MOA for bowing injuries

Answer 46

longitudinal force

Question 47

what is a stress fracture

Answer 47

pathological fracture where the stress placed on the bone is greater than the tensile strength

Question 48

what is a pathologic fracture

Answer 48

fracture occurs at the site of disease or weakness

Question 49

what is pathological fractures usually associated with

Answer 49

ostoeporosis or bone tumors

Question 50

what effect does a tumor have on a bone

Answer 50

may cause up-regulation of osteoclastic activity leading to bone breakdown

Question 51

what type of malignancies lead to bone cancer

Answer 51

breast cancer lung cancer thyroid cancer kidney cancer prostate cancer

Question 52

what is the most common location of bone metastasis

Answer 52

the spine

Question 53

what is direct healing of fractures

Answer 53

primary healing with the cortex of bone aligns often through surgical ORIF

Question 54

what is indirect healing fractures

Answer 54

secondary healing where callus forms around uneven bone surfaces eventually having remodeling

Question 55

in what time frame after a fracture does a hematoma form

Answer 55

day 1-5

Question 56

in what time frame after a fracture does fibrocartilaginous callus begin to form

Answer 56

day 5-11

Question 57

in what time frame after a fracture does bony callus begin to form

Answer 57

day 11-28

Question 58

what are possible complications of fracture healing

Answer 58

non-union delayed union malunion

Question 59

what is non-union

Answer 59

gap edges between the fractured pieces of bone fills with tissue instead of bone

Question 60

what is delayed union

Answer 60

healing is still occurring 8-9 months after initial injury

Question 61

what is malunion

Answer 61

incorrect alignment of the bone