Module 3: Lesson 3: Fracture

Question 1

How many different types of fractures are there?

Answer 1

9

Question 2

Name the different types of fractures.

Answer 2

1. Transverse
2. Spiral
3. Oblique
4. Comminuted
5. Segmental
6. Avulsed
7. Greenstick
8. Torus
9. Impacted

Question 3

True or false:

Fractures can be intra-articular or extraarticular, open or closed?

Answer 3

True

Question 4

Name some common types of wrist fractures

Answer 4

• Colles fracture
• Smiths fracture

Question 5

Name a common hand fracture

Answer 5

Boxers fracture

Question 6

Name a common type of elbow fracture

Answer 6

Distal humerous

Question 7

Name a common type of shoulder fracture

Answer 7

• Proximal humerous
• Humeral shaft

Question 8

What is the general healing time for a callus formation?

Answer 8

2-3 weeks

Question 9

What is the general healing time for a union fracture?

Answer 9

4-6 weeks

Question 10

What is the general healing time for a consolidation fracture?

Answer 10

6-8 weeks

Question 11

What are some common complications associated with fractures?

Answer 11

• CRPS
• Arthritis
• Unhealed fractures/nonunion
• Heterotopic ossifications
• CTS
• Frozen shoulder

Question 12

Name some coordination/dexterity assessments

Answer 12

• O’conner Tweezer Dexterity Test (FM using a small tool)
• Minnesota Rate of Manipulation Test (arm/hand dexterity)
• Purdue pegboard test

Question 13

Describe conservative management for shoulder fractures.

Answer 13

• Sling immobilization for up to 6 weeks
• AROM of elbow, forearm, wrist and hand
• Controlled exercises begin 1-2 wks post injury with pendulum and PROM (elevation, IR/ER)

**Passive stretching is contraindicated during initial phase of fracture healing
- 4-6 weeks post AA/AROM can begin (start supine)
- Strengthening can begin when cleared by MD (typically 8-12 weeks)

Question 14

What are the most common elbow fractures?

Answer 14

• Radial head
• Olecranon
• Distal humeral

Question 15

What is the most common surgical procedure for elbow fractures?

Answer 15

ORIF

Question 16

Describe post surgical treatment for shoulder fractures.

Answer 16

• Some surgeons begin with early ROM programs, others wait
• Post surgical protocols follow the same ROM as non surgical except for timing.
• May be ROM (ER limited to 30 degrees)
• Strengthening delayed until 12 wks post op

Question 17

Humeral shaft fractures require what type of brace?

Answer 17

Sarmiento brace - allows ROM below fracture site

Question 18

With what type of fracture might the patient present with a radial nerve palsy?

Answer 18

Humeral shaft

Question 19

Describe conservative management for elbow fractures.

Answer 19

• If stable and aligned: Therapy can begin 2-3 days after injury
• Goal is to restore motion and protect elbow to allow optimal healing.
• Use removable posterior thermoplastic elbow orthosis
• Initiate AROM of uninvolved joints immediately after injury

Week 1: Remove orthosis for AA and AROM elbow and forearm (gravity assisted positions)
- When there is evidence of fracture union/stability begin PROM in hinge orthosis, joint and soft tissue mob, affected UE for light fx activities.
- Week 6-8: Begin strength exercises
- Week 8: Increase ROM through full range, increase strength

Question 20

Describe distal radius fracture interventions

Answer 20

• Edema management
• ROM in pain free range (extend their wrist while their digits are in composite flexion and during wrist flexion, the digits can relax)
• Strengthening
• ADLs/occupations

Question 21

Describe orthosis for boxers fracture

Answer 21

May include wrist in slight extension, MCPs flexed to 60 degrees or more and IP extension

Question 22

Describe treatment for boxers fracture

Answer 22

• Orthosis
• Early, controlled AROM when MD approves
• 8-12 weeks gentle strengthening on the ulnar side of the hand

Question 23

What type of pelvic fracture is classified as stable?

Answer 23

Type A

Question 24

What type of pelvic fracture is classified as rotationally unstable, but vertically stable?

Answer 24

Type B

Question 25

What type of pelvic fracture is described as unstable?

Answer 25

Type C