Fracture management

Question 1

what are the symptoms/signs of a possible fracture?

Answer 1

• history of a fall/direct blow/twisting injury/accident
• localized pain aggravated by movement
• muscle guarding with passive
• decreased function of part
• swelling
• sharp, localized tenderness at site

Question 2

how do we describe a fracture?

Answer 2

1. mechanism of injury: traumatic, pathological, stress
2. anatomical site: bone and location in bone
3. configuration displacement: 3 planes of angulation, ttranslation, shortening
4. articular involvement/epiphyseal injuries: fracture involving joint, dislocation, ligamentous avulsion
5. soft tissue injury

Question 3

what is a bending (angulatory) force effect on bone?

Answer 3

long bone bends causing failure on convex side of bend

Question 4

what is a bending (angulatory) force type of fracture?

Answer 4

transverse
oblique
greenstick in kids

Question 5

what is a twisting (torsional) force effect on bone?

Answer 5

spiral tension failure in long bone

Question 6

what is a twisting (torsional) force type of fracture?

Answer 6

spiral

Question 7

what is a straight pulling (traction) force effect on bone?

Answer 7

tension failure from pull of ligament or muscle

Question 8

what is a straight pulling (traction) force type of fracture?

Answer 8

avulsion

Question 9

what is a crushing (compression) force effect on bone?

Answer 9

usualy in cancellous bone

Question 10

what is a crushing (compression) force type of fracture?

Answer 10

compression

torus (buckle) in kids

Question 11

what is a repetitive microtrauma force effect on bone?

Answer 11

small crack in bone unaccustomed to repetitive/rhythmic stress

Question 12

what is a repetitive microtrauma force type of fracutre?

Answer 12

fatigue

or stress

Question 13

what is a normal force on abnormal bone effect on bone?

Answer 13

such as with osteoporosis, boney tumor or other diseasesd bone

Question 14

what is a normal force on abnormal bone type of fracture?

Answer 14

pathological

Question 15

what are the kinds of fractures?

Answer 15

1. closed
2. open: comes out through skin
3. transverse
4. spiral
5. comminuted: multiple parts
6. impacted: bone driven into itself
7. greenstick
8. oblique

Question 16

list the fracture types in order of severity from least to greatest

Answer 16

simple>displaced>comminuted>intra-articular>compound

Question 17

What is the Salter-Harris classification of epiphyseal complex fractures for Type I?

Answer 17

fracture through the physis (widened)

Question 18

What is the Salter-Harris classification of epiphyseal complex fractures for Type II?

Answer 18

fracture partway through the physis extending up into metaphysis

Question 19

What is the Salter-Harris classification of epiphyseal complex fractures for Type III?

Answer 19

fracture partway through the physis extending down into the epiphysis

Question 20

What is the Salter-Harris classification of epiphyseal complex fractures for Type IV?

Answer 20

fracture through metaphysis, physis and epihysis can lead to angulation deformities when healing

Question 21

What is the Salter-Harris classification of epiphyseal complex fractures for Type V?

Answer 21

crush injury to physis

Question 22

what is closed reduction

Answer 22

manioulation
mechanical (traction)

Question 23

what is open reduction

Answer 23

surgery w screws

Question 24

what is fracture retention for closed methods?

Answer 24

sustained traction
cast/splint
functional bracing

Question 25

what is fracture retention for open methods?

Answer 25

internal fixation external fixation arthroplasty

Question 26

explain the parameters for non-op treatment

Answer 26

rehab, WB start later risk of joint stiffness,malunion, non union are present fracture healing is rapid risk of infection low

Question 27

explain the paramters for operative treatment

Answer 27

``` rehab, WB start sooner risk of sitffness and malunion low risk of non-union present fracture healing slower risk of infectinon present ```

Question 28

explain fracture management in immobilization stage

Answer 28

1. educate patient 2. decrease effects of inflammation 3. decrease effects of immobilization 4. if patient confied to bed, maintina strength and ROM in major muscles

Question 29

explain fracture management in post-immob stage

Answer 29

1. educate patient 2. provide protection until radiologically healed 3. initiate active exercises 4. increase joint and soft tissue mob 5. increase strength and endurance 6. improve cardio fitnesss