Fractures Flashcards
(25 cards)
What are the 5 ways of classifying a fracture?
a. complete (fracture crosses the entire width or length of bone) or incompleteb. locationc. presentation: open on closed (bone pierces skin)d. type: non complex, complex or greensticke. alignment
What is meant by non-complex fracture?
Non complex = one line of damageCan be transverse, oblique, spiral, avulsed
What is meant by complex fracture?
multiple lines of damageCan be comminuted, segmented
What are the three types of alignments to describe a fracture?
union - aligned and healing process taking placenon-union - aligned but no healing presentmal-union - fracture with parts out of alignment
What is a comminuted fracture?
Shattering of bone from severe (single) direct force. Often it originates from one spot and then impact spreads e.g. bullet
What is a greenstick fracture?What is it usually caused by?
- Bending force on bone* Increase incidence in paediatrics as bones are softer (collagenous)* Xray: see bend to the bone, but only small degree of trauma
What is a transverse fracture?What is it usually caused by?
- Fracture 90 degrees to long axis * Sharp direct blow * Stress fractures are considered small transverse fractures aka ‘hairline fractures’ e.g. lots of stress on tibia, bones of foot with intense running regime
When are you able to see evidence of a hairline fracture?
Will not see xray abnormalities until app 1 week after symptoms as the fracture is too small, we can only see it during healing (appears white thin line)
What is an oblique fracture?What is it usually caused by?
Diagonally orientatedSharp, angled blow
What is a spiral fracture?What is it usually caused by?
3D oblique (helical) fracturedue to a twisting force* usually due to unusual activities: arm wrestling, wrestling in awkward position, heavy machinery (limb stuck and twisted)*High specificity for child abuse as 1. children do not engage in activities that involve twisting2. not from impact e.g. falling off monkey bars
What is a segmental fracture? What is it usually caused by?
Multiple similar fractures not meeting at the same point therefore broken up into segments (vs comminuted where they all meet at same point of origin)e.g. can be multiple transverse, oblique, spiral etc
What is an avulsed fracture?What is it usually caused by?
Portion of the bone is fractured off from the main bone Common at tuberosities as they are usually attached to a ligament *Occurs mostly in athletes near ligamentse.g. if contract muscle, then the site of the breakage is near that ligament, as the support is around tuberosity not the rest of the bone
What is a torus fracture?
Fracture due to compression of the bone resulting in bulging or bowing
What is meant by displacement in a fracture?
Describes the abnormal positioning of the distal fragment in relation to proximal bone- shortening, angulation, rotation, distraction/impaction, medial/lateral displacement
What does shortening mean?What type of fracture normally causes a shortening?
Proximal migration of the distal fractureNormally occurs in oblique fracture (more likely than transverse fracture - as you would need to be fully offended before it can shorten)
What does a fracture being fully off-ended mean?
Distal and proximal segments (e.g. in transverse fracture) are completely out of line
What does angulation mean?What is medial angulation?What is lateral angulation?
Measures the degree of angulation of the distal bone to proximal bonemedial angulation (where the distal fragment is angled medially): creating a varus shape lateral angulation: valgus
What does distraction mean?
increase in overall bone length (widening of bone components without the loss of bone alignment)
What does impaction mean?
Shortening of bone without loss of bone alignment
What is the average healing time of a fracture and what are the exceptions?
Average healing time is 6 weeks for initial healing (allowed to start doing normal functions) and 3 months until final healing (allowed to play contact sport)Exceptions are: Clavicle and scaphoid which take an average of 8 weeks
What type of fracture is a FOOSH at 45 degrees of extended at wrist vs > 45 degrees?
45 degrees = radial fracture> 45 degrees = scaphoid fracture due to nutcracker effect (compression)
What is the acronym used for the order of elbow ossification?
CRITOE - it is important to know this when looking at children’s x rays to not mistake it for a fracture, rather it is an ossification centre (seen as bits of bone or radioopacities)CapitellumRadial headInternal epicondyleTrochleaOlecranonExternal (lateral) epicondyleC - age 2CR - age 4CRI - 5CRITO - 9CRITOE - 11
What is meant by volar?
Another word for palmar. e.g. Distal fragment of radial fracture is displaced with volar angulation
What does GAMP stand for and mean?
General anaesthetic, manipulation and plaster- it is a method of closed reduction that is only suitable for stable fractures - anaesthetic can be local, sedation or general
