Bone fractures

Question 1

What are 3 types of etiologies for bone fractures?

Answer 1

1. Trauma
2. Repetitive stress
3. Pathological

Question 2

What are 2 kinds of pathologies that can cause bone fractures?

Answer 2

1. Metabolic/generalized disorders (e.g. osteoporosis)
2. Structural/localized disorders (e.g. tumour)

Question 3

What are the 4 steps of bone repair, and how long does each step take?

Answer 3

1. Inflammation & hematoma (6-8 hrs)
2. Fibrocartilaginous procallus (2-3 weeks)
3. Bony callus (months)
4. Remodelling (years)

Question 4

During the hematoma stage of bone repair, what important structure is formed?

Answer 4

Fibrin mesh

Question 5

What are 2 important players in the procallus stage of bone repair?

Answer 5

1. New capillaries infiltrate site
2. Fibroblasts

Question 6

What is the term for the conversion of cartilage into bone by osteoblasts?

Answer 6

Ossification

Question 7

What kind of bone is deposited by osteoblasts during the bony callus stage of bone repair?

Answer 7

Spongy bone trabeculae

Question 8

What 2 processes occur during the remodeling stage of bone repair?

Answer 8

1. Dead portions of bone removed by osteoclasts
2. Spongy bone becomes compact bone

Question 9

Why is bleeding/hematoma formation a sign of fracture?

Answer 9

Damage to periosteum, blood vessels, and bone marrow

Question 10

What is the term for a fracture caused by muscle/ligament breaking away a fragment of bone attached to it?

Answer 10

Avulsion

Question 11

What are 2 terms for a fracture that communicates with the external environment?

Answer 11

Open or compound

Question 12

What are 2 terms for a fracture that does not communicate with the external environment?

Answer 12

Closed or simple

Question 13

What are 2 terms used to describe the alignment of bone fragments in a fracture?

Answer 13

Displaced or nondisplaced

Question 14

What are 2 terms used to describe the extent of a fracture?

Answer 14

Complete or incomplete

Question 15

What are 3 linear type fractures?

Answer 15

1. Transverse: straight across bone
2. Longitudinal: Straight down long axis
3. Oblique: Diagonal across bone

Question 16

What is the term for a fracture that rotates around the bone, usually from rotational force?

Answer 16

Spiral

Question 17

What is the term for a fracture that involves many bony fragments, usually from crushing?

Answer 17

Comminuted

Question 18

What is the term for a fracture that involves a complete break in at least 2 places, leaving a fragment completely separated?

Answer 18

Segmental

Question 19

What is the term for a fracture caused by vertical force (usually from falling) which drives the distal fragment into the proximal fragment?

Answer 19

Impacted

Question 20

What is the term for two oblique (diagonal) fractures meeting to form a triangular bone fragment?

Answer 20

Butterfly

Question 21

What is the term for a star shaped fracture in flat bones?

Answer 21

Stellate

Question 22

What is the term for a segment of bone depressed into the cranium?

Answer 22

Depressed

Question 23

What is the term for a fracture near or inside a joint?

Answer 23

Interarticular

Question 24

What is the term for a common fracture involving the distal end of the fibula?

Answer 24

Pott

Question 25

What is the term for a common fracture involving the distal end of the radius, the distal fragment of which is displaced posteriorly?

Answer 25

Colles

Question 26

What is the term for a fracture common in children that results from immature bone being compressed until it bulges out?

Answer 26

Buckle

Question 27

What is the term for a fracture common in children where immature bone breaks on one side and bends on the other side?

Answer 27

Greenstick

Question 28

What is the term for movement of bone fragments back into alignment without surgery?

Answer 28

Closed manipulation

Question 29

What is the term for surgical alignment of bone fragments?

Answer 29

Open reduction

Question 30

What is the term for using weight to counteract muscles which are pulling bones out of place?

Answer 30

Traction

Question 31

What is the term for application of external devices to immobilize the fracture site?

Answer 31

External fixation

Question 32

What is the term for use of prosthetics (e.g. screws, plates, nails, rods, etc.) to immobilize the fracture site?

Answer 32

Internal fixation

Question 33

Why may hypercoagulability paradoxically cause hemorrhage in a patient with bone fracture?

Answer 33

All the clotting factors are used up

Question 34

Why may a foreign body or tumour cause hemorrhage in a patient with bone fracture?

Answer 34

Blood vessel erosion

Question 35

Why may periosteal stripping lead to surgical site infection in patients with bone fracture?

Answer 35

Periosteum is involved in sequestering infection

Question 36

Why may cold temperatures or hypovolemia lead to surgical site infection in patients with bone fracture?

Answer 36

Reduced perfusion to site

Question 37

What condition affects nearly all knee surgery patients?

Answer 37

DVT

Question 38

What are 2 theories behind the cause of fat emboli syndrome?

Answer 38

1. Mechanical: injury to adipose tissue or intramedullary compartment releases fat particles 2. Biochemical: fatty acids cause endothelial damage, which leads to platelet aggregation and atheroma formation

Question 39

Why are glycocalyx molecules on endothelial cells relevant to thromboembolic disorders?

Answer 39

They reduce friction of blood against the endothelium

Question 40

What are 3 interventions for delayed union in bone repair?

Answer 40

1. Bone graft 2. Internal/external fixation 3. Electrical bone stimulation

Question 41

What is the term for if a bone fracture has not healed within 4-6 months?

Answer 41

Nonunion

Question 42

What is the term for if a bone fracture heals in the wrong position?

Answer 42

Malunion

Question 43

What joint disease can develop as a complication of bone fracture?

Answer 43

Osteoarthritis