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Bone injury and healing Flashcards

(35 cards)

1
Q

what are the different mechanisms of action that can lead to bone fracture?

A

Trauma- Low or HIgh energy

Stress- abnormal stress on normal bone

Pathological- normal stress on abnormal bone

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2
Q

what are the different types of fracture?

A
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3
Q

what type of fracture is it if the bony ends arent aligned?

A

displaced

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4
Q

what are the questions you ask yourself when trying to figure out what type of fracture it is?

A
  • are the soft tissues intact?
  • is the break complete? if so how many pieces
  • are the bony ends aligned?
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5
Q

Whats the difference between high energy and low energy trauma?

A

High energy- car crash

Low energy- simple fall

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6
Q

Describe how abnormal stress on bone can lead to fracture

A
  • Overuse
  • stress exerted is GREATER than bone capacity to remodel
  • Bone weakens
  • Stress fracture
  • Risk of complete fracture increases
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7
Q

what are the types of bone typically affected by abnormal stresses?

A

Weight bearing bones like:

Tibia, Metatarsals, navicular

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8
Q

what are the related activities that can lead to abnormal stresses on bone

A

Athletes, military, femal athlete triad

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9
Q

In pathological mechanisms, what are the common pathologies and what can they lead to?

A
  • Osteoporosis- soft bone
  • Malignancy- caused by bone metastases or primary
  • Vit D deficiency- rickets or osteomalacia
  • Osteomylitis
  • Osteogenesis imperfecta
  • Paget’s disease
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10
Q

what are the 2 different types of bone metastases malignancy; give examples

A

BLASTIC- Prostrate and breast; increase in size

LYTIC; decrease in size by breaking down- Breast, kidney, thyroid, lung

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11
Q

what are the examples of primary bone cancers?

A

Osteosarcoma

Chondrosarcoma

Ewing sarcoma

Chordoma

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12
Q

Contrastthe effects of Vit D def on kids and adults, explain why

A

kiDS: cause RICKETS- bowing of legs. this is due to deficeny before epiphyseal plate closes

ADULTS: Osteomalacia; physis has already closed. No deformity seen but bone is soft and can EASILY fracture

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13
Q

Describe the pathophysiology of Osteogenesis imperfecta

A

decreased Type 1 collagen secretion OR abnormal collagen secretion

insuffucient osteiod production

effects:

  • Blue sclera
  • heart, and hearing problems.Bone problem
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14
Q

How does Paget’s disease develop?

A

caused by GENETIC AND ACQUIRED factors

XS bone breakdown and disorganised remodelling. Lead to deformity, pain, fracture or arthritis

May develop into a malignant disease

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15
Q

what are the four stages of Pagets disease

A
  1. Osteoclastic activity
  2. Mixed osteo-osteoblast activity
  3. osteoblastic activity
  4. malognant degeneration
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16
Q

what are the different stages of fracture healing?

A
  1. Heamatoma, release of cytokines and granulation tissue
  2. Week2-4 soft callus (type 2 collagen) and then gets turned to hard callus (type1)
  3. 4-12 months; bone remodels to external activityand forces. excess bone is removed
17
Q

What is Wolff’s law

A

bone remodels and grows in responseto forces placed on it

18
Q

what is primary bone healing?

A

Intermembranous healing; osteocytes easily jump across gaps

absolute stability

19
Q

What is secondary bone healing?

A

Endochondral healing

involves responses in periosteum and external soft tissues

Relative stabiltiy

20
Q

what is normal fracture helaing time

A

3-12 weeks depending on site.

it takes longer the further it is from the heart.

healing signs seen on X rays from 7-10 days

21
Q

what are the 3 steps in effective fracture mangement?

A

Reduce

Hold or fix

Rehabilitate

22
Q

what are the different ways of reduction?

23
Q

what are the different ways of holding

24
Q

what are the different ways of fixation

25
what is an advantage of external fixation over internal
can easily tell if there's infection
26
what are the methods of rehab?
27
what are the different forms of tedinopathy
1. Tendinosis- abnormal; thickening 2. Tendinitis- inflammation 3. rupture
28
what are the ligament injury classification?
Grade 1- sloght tear; no notable joint instabiltiy Grade 2- moderate tear; maybe 1 ligament completely torn. some notable joint instabilty Grade 3- complete tearing of more that 1 ligament. obvious instabiltiy. surgery required
29
what are the factors affecting tissue healing?
Mechanical environ- movement and forces Bio environ- blood supply, infection, nutrition, immune function
30
describe the features of osteoporosis
Firstly there's ostepenia which leads to osteporosis more dominant in female (4:1) ratio occurs when osteoclast activity is gretaer than osteoblast activity which leads to a disrupted microarchitecture associated with fragility fractures of hip, spine and wrist due to low trauma
31
what are the different stages of life that osteporosis can occur?
Senile osteoporosis- over 70 yr post menopausal- 50-70 women secondary; any age; cuased by: alcoholism, XS cortisol or hypogonadism
32
what are the T scores for normal, osteopenia and osteoporosis?
Normal: greater than -1 Osteopenia- -1 to -2.5 osteoporosis; less than -2.5
33
what are the merits and problems of immobilisation and mobilisation for healing ligamentous tissue
34
What are the stages of Ligament & tendon healing?
Inflam phase- fibrin clot forms in tear. (within a week) proliferation- tendons and ligaments weakest. builds stremgth. 7-21 days remodelling- heal with scar tissue that reduce ultimate strength Maturation- max strength reached within a year
35
What are the complications of surgically reparing tendons
tendon made too tight nerve damage, infection, blood vessels, muscle damge anaesthetic risk pulmonary embolism bleeidng blood clots