Injury and Healing Flashcards
(48 cards)
What are the causes/mechanisms of actin for bone fractures?
- Trauma -low energy, high energy
- Stress- abnormal stress on normal bone
- Pathological- normal stresses on abnormal bone
What are the fracture patterns?
Soft tissue integrity:
open or closed
Bony fragments:
greenstick or simple or comminuted/multi-fragmentary
Displacement:
displaced (bone moved) or undisplaced
What does an open fracture mean?
-the skin has been breached
An amateur runner is training for his first marathon. He is trying to make a positive change from his otherwise sedentary lifestyle and has really been pushing himself. What type of fracture might he be at risk of developing?
-stress
What is ‘stress’ on a bone causing fractures?
- stress exerted on bone is greater than bones capacity to remodel
- causes bone weakening
- stress fracture
- risk of complete fracture
What are the weight bearing bones?
- tibia
- metatarsals
- navicular
What are the risk factors for bone fractures due to stress?
- disordered eating
- amenorrhea
- osteoporosis
(-army personnel)
What are pathological bone fractures?
-normal stress on abnormal bone
What are the causes of pathological bone fractures?
- Osteoporosis- soft bone
- Malignancy- primary & bone metastases
- Vit D deficiency- osteomalacia (in adults) & Ricket’s (in children)
- Osteomyelitis (bone infection)
- Osteogenesis imperfecta
- Paget’s disease
When does osteopenia & osteoporosis occur?
- when osteoclast activity>osteoblast activity
- causes disrupted microarchitecture
What are the risk factors for osteopenia & osteoporosis?
- more common in females
- postmenopausal osteoporosis women 50-70
- senile osteoporosis >70
- secondary osteoporosis: any age:
- hypogonadism
- glucocorticoid excess
- alcoholism
- associated with ‘fragility fractures’ - hip, spine, wrist
- low energy trauma - fracture
What are -blastic malignancies?
- prostate
- breasts
What are the -lytic malignancies?
- breasts
- kidney
- thyroid
- lung
What are the primary bone cancer?
- osteosarcoma
- chondrosarcoma
- ewing sarcoma
- chordoma
What primary malignant tumours metastasise to bone?
-prostate, breast, kidney, thyroid, lung
What are the conditions associated with vitamin D deficiency?
Rickets:
- paediatrics
- before physis closure
Osteomalacia:
- adults
- after physis closure
What are physes?
-growth plates founding bones
What is osteogenesis imperfect?
- ‘Brittle Bone Disease’
- hereditary - autosomal dominant or recessive
Decrease in type 1 collagen due to:
- decreased secretion
- production of abnormal collagen
Results in insufficient osteoid production
What areas are affected by osteogenesis imperfect?
- bones
- hearing
- heart
- sight (collagen in sclera of eyes- blue sclera)
What is Paget’s disease?
- genetic and acquired factors
- excessive bone break down and disorganised remodelling
- may transform into a malignant disease
Four stages:
- Osteoclastic activity
- Mixed osteoclastic-osteoblastic activity
- Osteoblastic activity
- Malignant degeneration
What are the effects of Paget’s disease?
- deformity
- pain
- fracture
- arthiritis
A 6-year old South Asian boy moves to Glasgow with his family. His mother is concerned that he is complaining of aches and pains and his growth seems to have plateaued. What test would you order? What’s the diagnosis?
- low vitamin D level
- rickets
What is Wolff’s Law?
-bone grows and remodels in response to the forces that are placed on it
What is the process of fracture healing?
Week 1:
- haematoma formation (due to ruptured blood vessels)
- release of cytokines
- granulation tissue
Week 2-4 & 1-4 months:
- soft callus formation: Type II Collagen- cartilage
- converted to hard callus: Type I collagen -bone
4-12 months:
- callus responds to activity, external forces, functional demands and growth
- excess bone is removed.
