Fractures

Question 1

What are the 4 stages to fracture repair?

Answer 1

1. Hematoma formation & inflammation.
2. Fibrocartilaginous callus formation.
3. Bony callus formation / Consolidation.
4. Bone remodelling.

Question 2

How does fixation affect fracture healing time?

Answer 2

• Adequate fixation prevents impairment of the blood supply, which may be caused by movements of the fragments.
• Maintains the reduction so prevents deformity and loss of function.

Question 3

How does age affect fracture healing time?

Answer 3

• Children = Quicker and consolidation may occur at b/n 4-6 weeks.
• Adults = Makes little difference depending on other factors.

Question 4

How does smoking affect fracture healing time?

Answer 4

Increased rate of delayed union and non-union.

Question 5

How does diet affect fracture healing time?

Answer 5

Bone and soft tissue healing requires large amount of calories, proteins and minerals.

Question 6

How does infection affect fracture healing time?

Answer 6

Colonisation of bacteria = Necrosis & Oedema = Slow healing or Cellular death.

Question 7

How does ultrasound affect fracture healing time?

Answer 7

Low intensity US may accelerate fracture healing.

Question 8

How long does union of the proximal 1/3 humerus take?

Answer 8

7-10 days.

Question 9

How long does union of the distal 1/3 radius take?

Answer 9

4-6 weeks.

Question 10

How long does union of the proximal 1/3 femur take?

Answer 10

4-6 weeks.

Question 11

How long does union of the distal 1/3 tibia take?

Answer 11

6-8 weeks.

Question 12

How long does consolidation of the proximal 1/3 humerus take?

Answer 12

3-4 weeks.

Question 13

How long does consolidation of the distal 1/3 radius take?

Answer 13

8-10 weeks.

Question 14

How long does consolidation of the proximal 1/3 femur take?

Answer 14

8-12 weeks.

Question 15

How long does consolidation of the distal 1/3 tibia take?

Answer 15

16-20 weeks.

Question 16

What are (15) complications of fracture?

Answer 16

• Adhesions.
• Avascular necrosis.
• Compartment syndrome.
• Fat embolism –> acute respiratory distress syndrome.
• Growth disturbance.
• Hypovolemic shock or loss of blood.
• Injury to large vessels.
• Intra-articular fractures.
• Muscle damage and atrophy.
• Nerve injury.
• Oedema.
• Problems with union.
• Pulmonary embolism and deep vein thrombosis.
• Skin plaster sores.
• Visceral injuries.

Question 17

What are some clinical features of fractures?

Answer 17

• Abnormal movement.
• Crepitus.
• Deformity.
• Hypovolaemic shock.
• Limitation of joint movement.
• Loss of function.
• Muscle atrophy.
• Muscle spasm.
• Oedema.
• Pain.

Question 18

How do we know when a fracture is healed?

Answer 18

• Absence of pain on weight-bearing, lifting or movement.
• No tenderness on palpation at the fracture site.
• Blurring or disappearance of the # line on x-ray.
• Full or near full functional ability.

Question 19

How long does cancellous (spongy) bone take to heal?

Answer 19

Approx. 3-12 weeks.

Question 20

How long does is take compact bone to heal?

Answer 20

Approx. 12-18 weeks.

Question 21

What does it mean for healing time if a fractured bone has poor blood supply?

Answer 21

Healing takes longer.