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Flashcards in Treatment of Fractures Deck (77)
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1

What does the skeleton provide for the body?

Strength
Stiffness
Rigidity

2

Types of Cells within Bones

Osteoblasts
Osteocytes
Osteoclasts
Marrow elements

3

What does type 1 collagen provide for the bone?

Tensile strength
Resiliency

4

What does the periosteum provide for healing of fractures?

Vascular supply

5

What triggers the healing process in bone fractures?

Bleeding

6

3 Phases of Fracture Healing

Reactive phase
Reparative phase
Remodeling phase

7

What is part of the reactive phase of fracture healing?

Fracture & inflammatory phase
Formation of granulation tissue formation
Vessels contrac
Hematoma
Fibroblasts take over

8

Parts of the Reparative Phase of Fracture Healing

Cartilage callus formation
Lamellar bone deposition
Periosteal cells -> chondroblasts
Form fracture callus

9

Parts of the Remodeling Phase of Fracture Healing

Remodeling to original contour
Trabecular bone replaced with compact bone

10

Factors Affecting Healing Rates

Age
Comorbidities
Nutritional Status
Thyroid & GH levels
Calcitonin

11

Common Conditions that Impair Healing

DM
Arteriovascular disease
Anemia
Vitamin A, C deficiencies
Tobacco use
Chronic alcohol abuse

12

Medications that Impair Healing

NSAIDs
Glucocorticoids
Cipro

13

Evaluation of the Fracture Patient

Vitals
Mental status
Mechanism of injury
Neurovascular status of the extremity
Where is the deformity?
Open or closed?
Check joints above and below
Minimum of 2 X-ray views

14

Common Fractures when Landing on an Outstretched Hand

Scaphoid
Radial head
Wrist
Proximal humerus

15

Common Fractures When Falling off of a Roof

Os calcis
Tibial plateau
TL compression fracture

16

Describing Fractures

Name of bone
Location
Orientation of fracture
Condition of overlying tissues (open vs. closed)
Unique fracture names

17

Location of Fractures

Dorsal
Volar
Epiphysis
Metaphysis
Diaphysis (proximal, middle, or distal third)

18

Orientation of Fractures

Transverse
Oblique
Spiral
Angulated
Comminuted
Segmental
Intra-articular
Displaced
Compression
Impaction

19

Unique Names of Fractures

Supracondylar
Colles
Boxer's

20

Factors that Effect Treatment

Open vs. closed
Nature & severity of fracture
Possible neuro-vascular injuries/complications
Age
Health
Demands of patient

21

Complications of Fractures

Pelvic & femoral: severe bleeding
Injuries to other structures
Acute compartment syndrome
Increased risk of venous thrombosis with major trauma
Fat embolism syndrome
Complex regional pain syndromes
Osteomyelitis
Non/mal-union, post-traumatic arthritis

22

Principles of Fracture Treatment

Acute stabilization
Definitive treatment

23

Possible Options when Stabilizing a Fracture

Splinting
Provide analgesia: ice, elevation, pain meds
Decide on definitive treatment

24

Definitive Treatment of Fractures

Create conditions where body will heal the fracture while keeping the patient as functional as possible

25

Treatment Options for Fractures

Reassurance
Immobilization: cast, sprint, brace
Traction: more historical
Reduction: cast, hardware, both
Surgical fixation

26

When is surgical fixation warranted?

Displaced,unstable fractures
Early mobilization
Quick return to function
Displaced intra-articular fractures
Down side: cost, complications

27

When are casts the prescription of choice for fractures?

Undisplaced
Stable
Some reduced fractures

28

How do you cast a diaphyseal fracture?

Include joints above & below

29

Complications of Casting

Pressure sores
Neurovascular compromise
Compartment syndrome
Disuse atrophy
Joint stiffness

30

Surgical Options for Fractures

Pins & wires
Plates & screws
External fixtures
Intramedullary devices
Replacements