8. Fractures Flashcards Preview

LCRS Y2: Musculoskeletal > 8. Fractures > Flashcards

Flashcards in 8. Fractures Deck (16)
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1

Recall the changes in bone structure from foetus to 2 year-old infant

In utero foetus lays down as much calcium-rich bone as possible - it is very dense but ill-structured
Following birth, in accordance with when the child begins to walk, the trabeculae realign to provide strength
Ca++ laid down before birth as mother has very little Ca++ to give in breast milk

2

Recall the T score that is diagnostic of osteoporosis

Less than 2.5SDs below the mean

3

Why is early-life exercise so important for bone health?

Helps you to lay down as much bone as possible so that when it starts to depreciate you will have enough left that you won;t get issues

4

Recall the body's primary bone healing process following a fracture

Blood supply from medullary canal (periosteal and metaphysial vessels)
Haematoma forms containing all your healing cells

5

Recall the surgical intervention into primary bone healing following a fracture

Remove haematoma
Realign bone to reduce angulation
Hold it in place by rod/ plate and screws/ plaaster cast - it needs to be stable to heal

6

How can bone reform when there is absolute realignment and zero movement following fracture?

No callous, perfect reformation = PRIMARY bone healing

7

Describe the healing of a fracture that has relative stability

Secondary bone healing
Callous develops which eventually develops into bone, leaving a little lump

8

Summarise the events of the 4 stages of bone healing

1. Inflammation and progenitor infiltration
2. PtG involvement, soft callus
3. Type 1 collagen production and calcification, angiogenesis to produce woven bone
4. Remodelling to lamellar bone, reformation of medullary canal

9

Recall the 5 classifications of fracture you have to know

Spiral
Oblique
Communitive
Transverse
Greenstick

10

Recall the sort of injury that produces a spiral fracture

Twisting arm in arm wrestle

11

Recall the sort of injury that produces an oblique fracture

Blunt trauma

12

Recall the sort of injury that produces a communitive fracture

Blunt trauma with whiplash

13

What is a communitive fracture?

Fracture which produces multiple "bits"

14

Recall the sort of injury that produces a transverse fracture

Hitting something with blunt force and then withdrawing

15

Recall the sort of injury that produces a greenstick fracture

Not a clean snap - this is a paediatric fracture

16

What is an important sign of child abuse orthopaedically?

Non-greenstick paediatric fracture - indicative of very strong force