Fractures

Question 1

site of fracture (5)

Answer 1

diaphyseal, metaphyseal, epiphyseal, intra-articular, fracture/dislocation

Question 2

extent of fracture (2)

Answer 2

complete and incomplete

Question 3

examples of incomplete fractures (4)

Answer 3

hairline, buckle, greenstick, stress fractures

Question 4

configuration of a fracture (4)

Answer 4

transverse, oblique, spiral, comminuted

Question 5

comminuted fractures (2)

Answer 5

1 fracture line, >2 fragments

Question 6

segmental fractures

Answer 6

2 fracture sites

Question 7

relationship of the fragments (2)

Answer 7

undisplaced, displaced

Question 8

types of displaced fractures (6)

Answer 8

translated-shifted sideways, angulated, rotated, distracted, overriding, impacted-crush fx

Question 9

relationship of the fracture to the environment

Answer 9

closed (skin intact), open/compound (fracture or object penetrated the skin)

Question 10

stress fractures (4)

Answer 10

repetitive trauma, often seen in LE due to WB, often a hairline fx, and non-displaced

Question 11

stress fractures: failure of osteogenesis (2)

Answer 11

osteoclastic activity outpaces osteoblastic activity, seen in athletes who over train (soldiers)

Question 12

cortical bone and fractures (2)

Answer 12

withstands compression and shearing forces, has less resistance to tension forces

Question 13

tension force on bone causes? (2)

Answer 13

oblique or transverse fracture

Question 14

cancellous bone and fractures (2)

Answer 14

more susceptible to compressive forces, often a crush fracture

Question 15

injury to periosteum of bone because of fracture

Answer 15

osteogenic sleeve surrounding the bone forms

Question 16

osteogenic sleeve

Answer 16

surrounds bone and intact portion aids in healing of fx

Question 17

signs and symptoms of a possible fracture (4)

Answer 17

sharp localized pain, muscle guarding with passive movement, decreased functional use, swelling/deformity

Question 18

acute signs of a fracture (5)

Answer 18

swelling/ecchymosis, unable to move joint or pain with movement, unable to WB, localized tenderness (jump sign)

Question 19

healing of cortical bone in first 48 hrs (3)

Answer 19

inflammation phase, blood vessels are torn, hematoma formation

Question 20

reparative phase of cortical bone healing (2)

Answer 20

soft callus stage in first 2 wks, osteoblasts lay down woven tissue (2-6 wks)

Question 21

reparative phase: osteogenic activity (2)

Answer 21

osteogenic cells proliferate to form a thick callus, callus does not contain bone (radiolucent)

Question 22

soft callus stage

Answer 22

platelets and WBC release chondrocytes

Question 23

remodeling phase: stage of clinical union (3)

Answer 23

fracture site is firm, callus continues to harden/ossify (endochondral ossification), immob is no longer required (6-8 wks)

Question 24

stage of radiological union (3)

Answer 24

bone is considered radiographically healed, temp callus is replaced by bone, callus is absorbed (3-6 months)

Question 25

cancellous bone (3)

Answer 25

Sponge-like lattice in metaphysis of long bones and body of short and flat bones

Question 26

healing of cancellous bone (4)

Answer 26

formation of an internal or endosteal callus, rich blood supply and large area of bony contact makes more rapid and dense union than cortical bone (healing time quicker)

Question 27

healing time for fractures in children

Answer 27

4-6 wks

Question 28

healing time for fractures in adolescents

Answer 28

6-8 wks

Question 29

healing time for fractures in adults

Answer 29

10-18 wks

Question 30

complications of healing (5)

Answer 30

compartment syndrome, fat embolism, skin ulceration, displacement of screws/breakage of wires, delayed union/malunion