Fractures Flashcards

(32 cards)

1
Q

What is a fracture?

A

A soft tissue injury where there is also a break in the continuity, surface, substructure of bone

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2
Q

What are the most common sites of fracture?

A

Fibula
Radius + Ulna
Humerus
Tibia

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3
Q

What is the difference between adult and paediatric bone?

A

Paediatric bone:
- less dense

  • more porous
  • lower mineral content
  • penetrated throughout with capillaries
  • extremely thick periosteum
  • presence of physis (growth plates)
  • soft tissue attachments are strong
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4
Q

When do children’s bones grow until?

A

Girls: until 2yrs after they start menstruation

Boys: until about age 16

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5
Q

What is a physis? Describe it.

A

A growth plate

Cartilage cells that create solid bone in time, with growth

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6
Q

What is the:

  • epiphysis
  • metaphysis
  • diaphysis?
A

Epiphysis: the head of the bone, associated with joint cartilage

Metaphysis: area below the physis and near the diaphysis

Diaphysis: the long shaft of the bone

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7
Q

What is the periosteum?

A

Thick nutrient layer that wraps around the bones

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8
Q

Why do children get more fractures than adults?

A

Less careful

Children’s ligaments are stronger, so forces are more likely to be transmitted to the bone and cause a fracture in a child

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9
Q

What is a plastic deformation fracture?

A

A force produces a microscopic failure on one side of a bone causing that side to become convex

No actual fracture, the bone is bent

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10
Q

What is a buckle fracture? And what’s another name for one.

A

Torus fracture

Compression failure of a bone
Usually at the junction between the metaphysis and the diaphysis

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11
Q

What is a greenstick fracture?

A

Bone is bent and the convex side of the bone breaks

Not all the way through though

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12
Q

How do you treat a buckle fracture?

A

Immobilisation, should heal in 3 weeks

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13
Q

How do you treat a greenstick fracture?

A

Immobilisation

Sometimes you need to break the other side of the bone to restore alignment

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14
Q

What types of complete fractures can you get?

A

Transverse: break straight across

Oblique: break diagonally

Spiral: occur by rotational force

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15
Q

What are physeal fractures?

What causes them?

A

Fractures to the growth plate

Caused by:

  • crushing
  • vascular compromise of physis
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16
Q

What’s the problem with physeal fractures?

A

Damage to the growth plate can result in progressive angular deformity

Also leg length mismatch

17
Q

What is the Salter Harris Classification?

A

Defines types of breaks in paediatric fractures

18
Q

What Salter Harris Classification do most fractures belong to?

19
Q

Explain what a type II Salter Harris fracture is like?

A

Fracture through a portion of the physis that extends through the metaphyses

20
Q

What is an Alder Hey splint?

A

A gentle support for mild problems

21
Q

How do you treat displaced fractures?

A

A well moulded cast

That applies pressure either side to maintain alignment

22
Q

What are K wires?

A

Surgical wires used to hold bone in a corrected position

They remain inside the bone for 4 weeks

23
Q

K wires are easy to remove, why?

A

They are left sticking out of the skin so can be removed easily in a clinic

24
Q

What is an intramedullary rod?

A

A metal rod that is passed up inside bone to stabilise the joint

25
Do intramedullary rods remain within the joint permanently?
Sometimes yes
26
At what age can children start using crutches?
Age 7
27
Briefly describe the process of bone repair? And give timescales for each.
Haematoma (hours) Inflammation (days) Repair (weeks) Remodelling (months-years)
28
What is a haematoma?
Bleeding leads to a blood clot being formed at the site Blood brings nutrients needed to heal fracture
29
What occurs during the inflammation phase of fracture healing?
Fibrin clot organisation Neovascularisation Cellular invasion: - stem cells - haemopoietic cells
30
What happens during the repair phase?
``` Formation of a callus: bony healing tissue - fibroblasts - Chondroblasts - osteoblasts These help repair ``` Matrix remineralisation High vascularity
31
What is a callus?
Bony healing tissue That contains fibroblasts, Chondroblasts, osteoblasts
32
What happens during the remodelling phase of fracture repair?
The temporary bone is replaced by lamellar bone Increased bone strength Vascularity returns to normal