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Medicine II: Orthopedics > Fractures > Flashcards

Flashcards in Fractures Deck (94)
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1

Metaphysis

Flare; the transitional zone at which the diaphysis and epiphysis of a bone come together. Stops growing at 18-25 yo and ossifies.

2

Physis

Growth Plate

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Epiphysis

Rounded end of a long bone, at its joint with adjacent bone(s). Between the epiphysis and diaphysis.

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Salter Harris Fractures

Salter fractures are fractures of the epiphyseal plate in a growing child. They are classified into five types, based on the pattern of the fracture line. Generally correlates with the potential for future growth disturbance.

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What Salter Harris Fracture has the lest impact on growth disturbances, which is the worst?

The potential for growth disturbance is least for type I and increases with the classification number, the worst prognosis being associated with type V injuries.

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Salter Harris Type I

The entire epiphysis

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Salter Harris Type II

The entire epiphysis with a portion of the metaphysis

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Salter Harris Type III

A portion of the epiphysis

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Salter Harris Type IV

A portion of the epiphysis with a portion of the metaphysis

10

Salter Harris Type V

Nothing "broken off"; compression injury of the epiphyseal plate

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Diagnosing Type I S-H Fractures

Type I and type V Salter fractures may be radiologically undetectable. Type I injuries usually involve little or no separation of epiphysis from rest of bone, and lucent fracture line is not visible along equally lucent epiphyseal plate. Diagnosis of acute Salter type I fractures is usually clinical, based on presence of swelling and tenderness in region of physis.

12

Diagnosing Type V S-H Fractures

Type V injuries may be evident only retrospectively, when growth disturbance first begins to appear. At the time of initial presentation, however, a history of a significant axial loading force, coupled with significant tenderness in the area of the epiphyseal plate, should suggest the possibility of a type V injury. Such injuries should be immobilized and referred for orthopedic follow-up.

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Avulsed Fracture

fx where a fragment of bone is separated from the main mass

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Angulated Fracture

degree and direction: need to estimate amt of unbending to make fragments parallel, specify direction of deviation of distal fragment

15

Night Stick Fracture

isolated fx of ulna (from lifting arm to protect against night stick strike, usu midshaft)

16

Green stick fracture

Extends into the midpoint of the bone and becomes oriented along the longitudinal axis of the bone with out disrupting the opposite cortex. Bone failure on tension side and bend deformity on compression side

17

Pathologic Fracture

fx that occur from relatively minor trauma to diseased or otherwise abnormal bone; preexisting process have weakened the bone and rendered it susceptible to fx

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Examples of Pathologic Fractures

Metastatic lesions, fx thru bone cysts, compression fx with osteoporosis

19

Shortened Fractures

amount by which a bone’s length has been reduced. May be from impaction (telescoping) or overlap of fragments

20

Stress Fracture

Overuse injury. Bone is constantly attempting to remodel and repair itself, esp when extraordinary stress is applied. When enough stress is placed on bone, causes an imbalance b/t osteoclastic and osteoblastic activity and a stress fracture may appear.

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Areas most prone to stress fractures

Most common in weight-bearing bones of lower extremity, esp in lower leg and foot.

22

Transverse Fracture

fx that is at right angle to bone’s long axis

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Comminuted Fracture

fx in which bone has broken into several pieces

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Oblique Fracture

fx that is diagonal to a bone’s long axis

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Spiral Fracture

fx where at least one part of the bone has been twisted

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Segmented Fracture

fx in multiple pieces

27

Rank these in strength: Physis, Metaphysis, Ligament

Just know that physis is weakest and that it is most resistant to traction and least resistant to torsional fxs

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Open Fractures

The implications of open fracture are of such significance that this factor alone may determine the patient's immediate care or ultimate disposition. An open fracture has bone aspects that are visible through broken skin.

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Intraarticular Fractures

When a fracture extends into the adjacent joint, it is termed intraarticular. Intraarticular fractures have special significance because disruption of the joint surface may warrant surgery to restore the joint's contour and prevent subsequent traumatic arthritis. This feature of a fracture line, if present, constitutes important information.

30

Supracondylar Fracture

A fracture just above the condyles. Usually in the femur or the humerus.