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Surgical skills > Fracture biomechanics and classification > Flashcards

Fracture biomechanics and classification Flashcards

1
Q

What are the forces that must be neutralized for a fracture to heal?

A
  1. bending
  2. torsion
  3. compression
  4. tensino
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2
Q

What determines what forces predominate at a fracture site?

A
  1. geometry of fracture

2. location of muscle groups

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3
Q

Compression is good for what type of fracture and bad for what other type of fracture?

A
  1. good for transverse fracture to reduce motion

2. bad for oblique fracture because fragments shear past

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4
Q

How are fractures classified?

A
  1. extent of soft tissue
  2. degree of cortical disruption
  3. geometry
  4. location in bone
  5. degree and direction of displacement
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5
Q

What does bending cause?

A

agnulation

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6
Q

What happens to the bone with bending?

A
  1. one side is being compressed (concave) and one side is has tension (convex)
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7
Q

Where is the neutral axis of a bone?

A

usually in the centre of the medullary canal and is where there is neither tension nor compression

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8
Q

What happens if you fix a bone with something that runs down the neutral axis?

A

the apparatus will be subjected to less bending force than something running down the outside of the bone

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9
Q

What does torsion cause?

A

rotation

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10
Q

What is torsion

A

the tendency for a bone or its pieces to twist around long axis

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11
Q

Where does compressino act?

A

along the long axis of bone and moves ends of bone twoard eachother

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12
Q

What happens if compression is applied to an oblique fracture?

A

there is overriding–>shear

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13
Q

What does tension cause?

A

distraction/avulsion fractures of apophyses (olecranon and calcaneus)

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14
Q

What control do casts and splints provide?

A
  1. bending

2. ok torsion

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15
Q

What control do wires provide

A
  1. good tension

no others

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16
Q

What control do intramedullary pins provide?

A
  1. good bending

no others

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17
Q

What control do interlocking nails provide

A
  1. bending
  2. tension
  3. torsion
  4. compression
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18
Q

What control do external skeletal fixation provide?

A
  1. bending
  2. tension–but rare use for this
  3. torsion
  4. compression
19
Q

What control do bone plates provide?

A

good control of all but

weakest in combined compression and bending

20
Q

What control do bone plates provide?

A

good control of all but

weakest in combined compression and bending

21
Q

When does a bone fracture?

A

when the magnitude of the force placed upon it at a specific site exceeds its ability to resist the force without deforming permanently

22
Q

What is a closed fracture?

A

no wound connecting bone to outside world

23
Q

What is an open fracture

A

there is a connection with open world

24
Q

What is a greenstick gracture

A

bending or folding fracture. the cortex doesn’t actually break all the way through but bones deforms

25
Q

What is a fissure?

A

it is a crack and only involves one cortex and is usually longitudinally oriented

26
Q

What is a saucer?

A

a divot that gets taken out of one cortex (e.g. horse 3rd metacarpal)

27
Q

what is a complete fracture?

A

both cortices are disrupted

28
Q

What is a depression

A

e.g. in skull

29
Q

What is a transverse fracture?

A

A fracture perpendicular to long axis of bone

Torsion is a big problem, compression good

30
Q

What is an oblique fracture?

A

short or long.

31
Q

What are the two types of oblique fracutre?

A

short and long (long is more than twice the diameer of the bone

32
Q

What is a big problem with oblique fractures?

A

shearing

33
Q

What is a spiral fracture

A

a spiral, shearing also a problem

34
Q

What are types of comminuted fractures?

A
  1. butterfly
  2. highly comminuted
  3. segmental
  4. multiple fracture
35
Q

What two things determine if a fracture is simple or highly comminuted?

A
  1. the magnitude of the force and the speed of the force
36
Q

What does it mean that bone is a viscoelastic force?

A

it means that its deformation properties depend on loading rate

37
Q

Distinguish bone breaking between slow and fast application of force?

A
  1. slow application: less force before bone bends and breaks
  2. fast application: more energy absorbed, but more energy so shatters–more concomitant soft tissue damage (high energy)
38
Q

Where can fractures be located?

A
  1. articular
  2. physeal
  3. metaphyseal
  4. diaphyseal (proximal, middle or distal third)
  5. condylar/suparcondylar/subtronchanteric
39
Q

Where can fractures be located?

A
  1. articular
  2. physeal
  3. metaphyseal
  4. diaphyseal (proximal, middle or distal third)
  5. condylar/suparcondylar/subtronchanteric
40
Q

What are to ways you can describe displacement with regard to fracture?

A
  1. displaced

2. non-displaced–suggests intact periosteal sleeve

41
Q

How do you describe displacement?

A

by referring to the distal fragment location relative to proximal

42
Q

How can you describe the angle made by fragments?

A

describe what way the vertex of the angle is pointing

43
Q

What are 4 causes of fracture?

A
  1. traumatic
  2. pathologic
  3. fatigue
  4. iatrogenic
44
Q

why do we care about fracture classification?

A
  1. strong influence on how will heal

Surgical skills (23 decks)

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