MS: Fractures Flashcards by Jared winston

what is the percentage of injuries in U.S are MS?

50%

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Why do females have double the rate of injury during ovulation?

increased estrogen levels

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Female vs. Male strentgh training info

males gain two times faster but lose two times faster

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What type of connective tissue makes up MS system?

bone, cartilage, ligaments, tendons, fascia

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What is the diaphysis of the bone?

mid shaft

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What is the metaphysis of the bone?

flared portion at distal end

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What is the physis of the bone?

growth plate, important in young kids

x-ray can show if plate is fused which means maturing is complete

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What is the epiphysis of the bone?

adjacent to physis and and most distal

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what part of the bone is covered by articular cartilage?

epiphysis

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What are osteoblasts?

cells the make bone

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What are osteoclasts?

break down boneand release the minerals, resulting in a transfer of calcium from bone fluid to the blood

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what are osteocytes?

maintain the bone

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What is a fracture?

a breakdown or defect in bone continuity

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What is a trasnverse fracture?

a clean break, easiest to heal

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what is a spiral fracture?

when torque or rotating force is applied to axis of bone

more surface area for site of fracture

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What is an oblique fracture?

A fracture in which the line of break runs obliquely to the axis of the bone.

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what is a comminated fracture?

A fracture in which a bone is broken, splintered, or crushed into a number of pieces.

always a trauma associated with this

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What is a segmental fracture?

a bone break in which several large bone fragments separate from the main body of a fractured bone. The ends of the fragments may pierce the skin, as in an open fracture, or may be contained within the skin, as in a closed fracture.

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What is an avulsion fracture?

A fracture occurring when a joint capsule, ligament, tendon, or muscle is pulled from a bone, taking with it a fragment of the bone to which it was attached.

What is an impacted fracture?

A bone fracture in which one of the fragments is driven into another fragment.

What is a greenstick fracture?

A fracture in which one side of the bone is broken and the other side is bent

common in kids potentially child abuse b/c bone is young and doesn’t break clean

What is a compression fracture?

impaction of bone

seen in vertebrae due to vertebral body collapsing, common in osteoporosis due to minerlization

What is a pathological fracture?

fx through bone weakened by disease or or tumor

ex) lung, breasts and colon cancer

What is an intra-articular fracutre?

fx line crossed articular cartilage and enters joint

the joint is now architecturally changed

What is a non-displaced vs displaced fracture?

NP: bone is still in alignment (easier to treat) D: a traumatic bone break in which two ends of a fractured bone are separated and out of their normal positions.

What is an angulated fracture?

fragments are maligned

What is a boyonetted displacement?

distal fragment longitudinally overlaps the proximal fragment

What is a distracted displacement?

distal fragment seperated from proximal fragment by a gap

Why is a road burn still considered an open fracture?

b/c the skin is opened near the trauma

What is a Salter Harris classification?

fracture to the epiphysial plate usually in girls u16 boys u 21 could lead to bone growth discrepency

What is an exotosis fracture?

is the formation of new bone on the surface of a bone, because of excess calcium forming.

What is Wolff's law?

long term stress to bone due to microtraumas bone growth due to pressure

what is a stress fracture?

is a fatigue-induced fracture of the bone caused by repeated stress over time.

What are risk factors for a fracture?

smoking, diabetes, poor blood pressure, nutrition

Physical examination for fracure?

common signs of inflammation: redness, tenderness, possible deformity eval the skin, stability of jts, functions of nerves/vessels distal to site of injury tend to open lacerations as it is open fracture

What is the order for diagnostic tests?

1. Xray | 2. MRI - gold standard for stress fracture due to visible vascularity and bone density

What bones are common for undetected stress fx?

navicular, ribs and schapoid due to poor blood supply usually pt will experience strong pain 1-4 weeks after injury

What is first step in fracture healing?

hematoma- a fibrin mesh forms as a base for healing

What is procallus formation?

second step in fracture healing where fibroblasts, capillary beds and osteoblasts move into wound

What is callus replacement?

osteoblasts replace callus with trabecular or lamellar bone

What are possible adverse outcomes to healing?

delayed union- healing slower than normal (infection? etc.) nonunion- failure of healing (lack of blood flow?) malunion- healing with unacceptable deformity (massive trauma?) limb function may be affected- contracture, swelling

What is prognosis for PT and fractures?

6 weeks in cast roughly 6 weeks of PT

Prognosis for healing?

children- 4-6 weeks adolescents- 6-8 weeks adults- 10-18 weeks

Negative predictors for healing?

renal or vascular insufficiency- electrolyte or homeostasis imbalance smoking, alcohlosim, diabetes (even if properly managed) can increase healing by 50%

PT implications acute post cast?

swelling reduction, restore mvmt skin integrity+ mobility-----PRICE

PT implications subacute?

after 2 weeks restore mvmt, add strength

PT implications chronic?

functional activities