Fractures Flashcards
(32 cards)
3 Influencing factors of bone remodeling
1) Closer to skeletal maturity, bone remodel potential decreases
2) Closer fx is to growth plate, the better the remodel
3) Better remodel when the fx angulation occurs in plane of ROM of nearest jt
4 “…physis” regions of bone
1) Metaphysis - what growth plate rests on
2) Epiphysis - joint
3) Apophysis - tendon attachment in bone
4) Diaphysis - cortical bone (shaft)
Case: Treating a 9 year old boy who twisted ankle at a trampoline park. You have been working with the kid to rehab an ACL sprain on opposite leg. Kid can’t bear full weight on twisted ankle and it is swollen. What should you do:
1) Begin treating for ankle sprain
2) Refer to ortho MD for x-ray
3) Apply lace-up ASO brace
2) Refer to ortho MD for x-ray
2 Types of Abuse fx
Corner fx and bucket handle fx
What part of a spine can be fx in shaken baby syndrome
Cervical
Multiple fx at what bone if highly predictive of abuse
Ribs
Signs of chronic compartment syndrome (4)
1) Tensely swollen
2) Pain with passive stretch
3) Decreased sensation
4) Decreased motor function
Signs of acute compartment syndrome (6 “P”s)
1) Pain out of proportion
2) Pain with passive stretch
3) Pulselessness
4) Parasthesia
5) Paralysis
6) Pallor
Neuro disorders that cause pathologic fx (3)
1) CP
2) SCI
3) Myelomeningocele
Ortho disorders that cause pathologic fx (3)
1) DMD
2) OI
3) JIA
Cancers that cause pathologic fx (x)
1) Osteocarcoma
2) Acute leukemia
Case: 13 year old female who is a year long track and cross country runner. You have been treating her for back pain which has been reducing consistently and was back to full daily function. She presents to clinic with new onset bilateral shin pain. She reports no other symptoms or incident causing new pain. She recently increased running duration from 1 to 4 miles a day. What type of fx is she at risk for?
Tibial stress fx
Pre-disposing fx
1) Year round activity
2) Repetitive loading (runner most common)
3) Sudden change in intensity/frequency/duration
4) Tibia most common location
5 Salter Harris fx patterns
1) Growth plate only (through)
2) GP and metaphysis
3) GP and epiphysis
4) GP, metaphysis, and epiphysis
5) Crush to GP
Most common SH fx
Type 2
What nerve(s) can be damaged with clavicle fx?
Brachial Plexus (palsy)
Clavicle fx occur most commonly in first/middle/last third of bone
Middle
What nerve is at risk with humeral shaft fx?
Radial
Why is it difficulty to diagnosis SH fx at birth?
Epiphysis not yet ossified until 3-6 months
What end of humerus does 80% growth stem from
Proximal
Clincal red flag when screening for elbow fx (2)
1) Swelling
2) Decreased ROM
In wrist and forearm fx, what can be secondary complication?
Dislocation of proximal/distal jt
Fx of navicular bone can cause tenderness at what landmark?
Snuffbox
Name and differential dx of spine apophyseal fx
Name: Limbus fx
Diff dx: Herniated nucleus pulposus
Common cast used w femur fx in young kids
Spica
