Fractures

Question 1

What is a fracture?

Answer 1

Partial or complete break in bone

Question 2

Prinicples of x-ray reporting of fractures

Answer 2

Where
Type
Position

Question 3

Fracture x-ray: where

Answer 3

What bone?
Which side?
Where on bone?

Question 4

Fracture x-ray: type

Answer 4

Complete

• transverse
• linear
• oblique
• spiral
• comminuted

Incomplete
- greenstick

Question 5

Fracture x-ray: position

Answer 5

Of the distal fragment

Translation
Angulation
Shortening
Rotation

Question 6

How do fractures heal?

Answer 6

Secondary

Primary

Question 7

What is primary fracture healing?

Answer 7

Fragments in contact with each other

Bones fixed together

No callus formation

Question 8

Indications for primary healing

Answer 8

Displaced intra-articular fractures
Non-unions
Unstable

Question 9

What is secondary fracture healing?

Answer 9

Gap between bone fragments

Natural

Callus formation

Question 10

How to fractures heal?

Answer 10

1. Haematoma formation
   - blood clot forms
   - granulation tissue arises
2. Soft callus formation
   - procallus replaced by fibrocartillaginous callus
   - bony trabeculae start to develop
3. hard callus formation
   - endochrondal and intramembranous ossification
   - give rise to bony callus
   - spongy/cancellous bone
4. Bone remodelling
   - cancellous bone replaced by cortical bone

Question 11

Principles of fracture management

Answer 11

Reduce
Hold
Rehabilitate

Question 12

Fracture reduction

Answer 12

Restoration of anatomical alignment of a fracture

Allows for

• stoppage of bleeding at site
• reduction in traction of soft tissues
• reduces swelling
• reduces pressure on nerves/blood vessels

Clinical requirements
- analgesia

Question 13

Fracture holding

Answer 13

Immobilisation of a fracture

Splints / plaster casts

Question 14

Fracture rehabilitation

Answer 14

Period of physiotherapy