Fractures Flashcards
Fractures may result from…
- single, highly stressful, traumatic incident (traumatic #)
- repetitive stress of normal degree persisting to point of mechanical fatigue (stress #)
- normal stress acting on an abnormally weakened bone (pathological #)
What are the fracture types?
- closed/open (simple/compound)
- complete/incomplete
- complicated
Describe a closed fracture.
Bone doesn’t communicate externally
Describe an open fracture.
Fractured bone or penetrating object communicates externally. Greater amount of soft tissue damage and issue of pathogens/infection.
Describe a complicated fracture.
Blood vessels, nerves or organs suffer significant damage.
Describe a complete fracture.
Bone is completely broken into 2 separate parts.
- Transverse
- Oblique
- Spiral
- Segmental
- Avulsion
What is a comminuted fracture?
Bone is broken into more than two fragments.
Describe an incomplete fracture.
Bone is divided but the periosteum remains in continuity. E.g. greenstick #, compression #, stress #
What is a pathological fracture?
Due to a disease:
- osteoporosis
- Paget’s
- infection
- tumour
What is a physeal fracture?
Damage through the growth plate that has long term consequences. Can cause progressive deformity. Harris-Salter classification system used.
What are the symptoms of a fracture?
- swelling, ecchymosis and deformity
- localized persistent pain
- marked or total loss of function
- localized bone tenderness
- crepitus
- may be sudden or insidious onset depending on #
How are fractures diagnosed?
- examination and palpation of tender point and surrounding tissue
- neurovascular assessment
- radiographs (new # may not show immediately)
- CT, spiral CT, MRI
- bone scans
- ultrasound or vibration
What does fracture management involve?
Fracture reduction, immobilisation and rehabilitation
How is a fracture immobilized?
- internal or external fixture
- splints/casts/strapping and walking aids
- screws, k-wires, plates
How are fracture rehabilitated?
With joint mobilization and exercises.
How are fractures reduced?
With an open (surgical) or closed procedure.
What further treatment may complicated fractures require?
- antibiotic treatment
- debridement
- irrigation
- dressings
How long does a fracture take to heal?
A fracture without complications will heal in 6-16 weeks.
Callus visible: 2-3 weeks
Union: 8-12 weeks
Consolidation: 12-16 weeks
What osseous complications can arise from fractures?
- osteomyelitis
- delayed union, non-union or mal-union
- avascular necrosis
- joint problems
- shortening of the bone
- osteoarthritis
What soft tissue complications can arise from fractures?
- nerve or vascular damage
- compartment syndrome
- CRPS
What is a pilon ankle fracture?
of metaphysical area of distal tibia (and sometimes fibula) extending to articular surface.
How are pilon ankle fractures classified?
RUEDI-ALLGOWER
- malleolar # with large posterior plafond fragments
- spiral extension #
- central compression # w/ or w/o fibula #
What is the Lauge Hansen Classification System?
A way of classifying ankle fractures by their MOI.
- Supination/adduction Injuries
- Supination/external rotation injuries
- Pronation/Abduction injuries
- Pronation/External Rotation injuries
What is the Weber Classification System?
A classifications system for ankle joint fractures.
