Week 12 - Bone & Joint Conditions

Question 1

Growth plate:
What does it consist of
& what can it affect

Answer 1

Consists of cartilage until skeletal maturity (typically fuses by your early 20’s)
- Important for fractures because it can affect growth if the fracture happens in that area.

Question 2

Diaphysis:

Answer 2

Consists of cortical bone (shaft)

Question 3

Metaphysis/epiphysis:

Answer 3

Consists of spongy/cancellous bone
meta - in between
epi - ends

Question 4

Cortical bone (tubular)

Answer 4

Found particularly in diaphysis / strong in compression + sheer
Weaker in tension

Question 5

Cancellous bone (spongy)

Answer 5

Found particularly in meta/epiphysis, more susceptible to compression

Question 6

Dislocation:

Answer 6

Joint surfaces are compeltely displaced + the articular surfaces are no longer in contact.

Question 7

Subluxation:

What is it, why can it happen?

Answer 7

Incomplete/partial dislocation

- Often happens after a history of dislocation leading to laxity in joint

Question 8

Pathological vs. stress fractures:

Answer 8

• Path: caused by normal forces in abnormal bone

- Stress: caused by repetitive normal forces

Question 9

Stress fractures (diagnosis/continuum/impact):

Answer 9

• Diagnosis: clinical, XR, bone scan, + CT
• Continuum: bone strain, stress reaction, stress fracture
• Impact forces/muscle pull

Question 10

Green stick fracture:

Answer 10

Incomplete fracture that occurs in children

Question 11

Open (compound) vs. closed (simple) fracture:

Answer 11

-Skin overlying fracture site is breached in open fractures, in comparison to a closed frac. where skin remains intact

Question 12

Life-threatening injuries:

Answer 12

• major pelvic disruption w/ haemorrhage
• Arterial haemorrhage
• Crush syndrome (kidney damage)
• Vascular injuries
• Neuro
• Compartment syndrome (pressure w/ fluid can start to occlude nerves/blood vessels)

Question 13

Signs/symptoms of fractures:

Answer 13

• Localised tenderness (palpate)
• Deformity possibly
• Pain
• Noise
• Swelling
• High force mechanism
• “Spring sign”

Question 14

POLICE

Answer 14

• Protect
• Optimal loading
• Rest, ice elevation

Question 15

Management options for fractures:

Answer 15

• Learning optimal loading w/o immobilisation (i.e. rib fracture)
• Splint/plaster
• closed reduction / immobilisation
• Open reduction / internal fixation (cutting in)
• External fixation (not surgically cutting in)

Question 16

Non-immobilised fractures:

Answer 16

• stable fractures
• removable splint/brace
• stable internal/external fixation

Question 17

immobilised fractures:

Answer 17

• Cast/ traction

Question 18

What does an immobilised fracture cast maintain:

Answer 18

• Need for stability

- Maintains ROM + strength @ uninvolved joints/some strength/ aerobic + fitness level

Question 19

Non-immobilised fracture: (healing pattern + what to maintain for physio)

Answer 19

• tends to heal w/o full immobilisation (cast imm. may be greater concern)
• Maintain/regain ROM of both involved / uninvolv joints
• Maintain / regain muscle strength
• Assist w/ pain + swelling