Unit 13 - Fractures Flashcards
3 phases of fracture healing
inflammatory phase
reparative phase
remodeling phase
Fracture Healing:
- damage causes bleeding and formation of hematoma around the injury; inflammatory cells enter the wound and degrade debris and bacteria
inflammatory phase
Fracture Healing:
- osteoblasts promote formation of new bone and osteoclasts destroy dead bone, assist in synthesis of new bone -> collagen formation, calcium deposition continue
Reparative phase
Fracture Healing:
- excess callus removed, new bone lain down along fracture line -> site calcified, bone reunited
Remodeling phase
bone that fractures and undergoes normal healing
union
fracture that shows no progress toward healing for at least 3 months
nonunion
when healing process takes longer than expected
delayed union
when bone fragments join in an incorrect position
malunion
occurs when excess pressure in a limited space constricts structures in a compartment -> reducing circulation to muscles, nerves
Compartment Syndrome
Compartment Syndrome:
- result from hemorrhage, edema in compartment following fracture, crush injury, external compression by cast that is too tight
Acute Compartment Syndrome
Compartment Syndrome:
- Entrapment of _____ _____ limits tissue perfusion -> begins cycle of events that may result in _____ _____ _____
blood vessels
loss of limb
Compartment Syndrome:
- Fasciotomy -> surgical intervention -> muscle fascia is cut to relieve _____
pressure
Compartment Syndrome:
- incision left _____, passive ROM on extremity
open
blood clot forms along intimal lining of a large vein
DVT
occurs when fat globules lodge in the pulmonary vascular bed or peripheral circulation
fat emboli
Signs of _____:
- neurologic dysfunction, pulmonary insufficiency, petechial rash on chest, axilla, upper arms
FES (Fat embolism syndrome)
Early stabilization of _____ _____ fractures in preventive for FES
long bone
fat particles or droplets that travel through the circulation
fat emboli
a process by which fat emboli passes into the bloodstream and lodge within a blood vessel
fat embolism
serious manifestation of fat embolism occasionally causes multi system dysfunction, the lungs are always involved and next is brain
Fat embolism syndrome (FES)
infection is more likely to occur in _____ fracture than _____
open
closed
infection usually result from _____ at time of injury
contamination
_____ may lead to sever gas gangrene and cellulitis
clostridium
metal pins and screws placed in bone above and below fracture, and then attached to a metal bar outside the skin
external fixation
bone is placed in correct alignment; nails, screws, wires, plates or rods are inserted to hold bone in place
internal fixation (ORIF; open reduction and internal fixation)
rigid device used to immobilize, support, and protect fractured bones and surrounding soft tissue
cast
a cast is usually applied to stable fracture (before, after) reduction
after
provides less support than a cast, but easily adjusted to accommodate swelling
splint
often used to stabilize fresh injuries and during reparative phase of healing
splint
Femoral shift fractures:
- early ambulation stimulates _____
healing
RICE
rest
ice
compression
elevation
used to manage open fractures with soft tissue damage
external fixation devices
provide support for complicated or comminuted fractures
external fixation devices
fracture of femur at the neck, head, trochanteric regions
hip fracture
involve head or neck of femur
intracapsular fracture
_____ fractures frequently impair flow of blood to femoral head
intracapsular
involve trochanteric region
extracapsular fracture
_____ fractures cause acute blood loss from vascular cancellous bone srufaces
extracapsular
within the joint capsule
intracapsular
outside the joint capsule
extracapsular
