Fractures

shock

A hemorrhage complication can cause_____

shortening of the bone

Angulated fractures could lead to _____

Early Complications

Can occur at the time of fracture or the weeks to follow.

Soft Tissue between the bony ends; Nutritional Deficits; Inadequate Blood Supply; Infection; Excess Motion during Healing; and Idiopathic

Causes of delayed and nonunion Complications

burn or open wound would restrict ability to cast

Complication issue with presence of associated damage

Right or Left Side involved; Name of Specific Bone Involved; Cause of Fracture; Classification of Type of Fracture; Level of Bone Injury; Descriptive Terms; and Presence of Associated Damage

Components that should be included by the health professional when describing a fracture include ?

hemorrhage, fat embolism, nerve damage, and infection during the healing process

Early complications of fracture healing

hip fracture in car accident where trauma was through floor on floorboard could have knee involvement

Example of a indirect trauma

respiratory problems, cardiac arrest, or death

Fat embolisms may lead to _____

Reduction

Following a fracture, the bones must be realigned or setting the fracture

good healing

Good Health supports ______

older people heal more poorly

How does age influence the rate of fracture healing?

comminuted fracture is longer than transverse

How does the degree of violence affect the rate of fracture healing?

simple manipulation

Physician moves the part into alignment by feel then determines complete alignment by x-ray

Contractures due to immobilization; Muscle Atrophy due to disuse; and Potential Pressure Sores from casting

Secondary complications of fractures

Degenerative Joint Disease

This may occur if the fracture is in the area of the joint

Consolidation

This phase is up to 1-2 years healing period for the bones to complete the healing process and regain original strength & shape

malunion, delayed union, nonunion, DJD, and myocitis ossificans

What are some late complications of fracture healing?

Clinical Union & Consolidation

What are the phases of healing ?

blood supply

What does the location of the fracture influence?

flat bones such as patella, skull, etc.

Where are stellate fractures most common?

piceces must be realigned like a puzzle or removed

Why are comminuted fractures most difficult to set?

increased surface area

Why are spiral fractures more difficult to heal?

Fracture

a break in the continuity of a bone, an energy absorbing mechanism which acts to protect soft tissue in the area.

Oblique Fracture

a diagonal fracture

Transverse Fracture

a fracture straight across the bone; easy to set

Stellate Fracture

a starburst fracture

Clinical Union

approximately 6 weeks healing period when the groundwork is laid by the body to join the ends of the bones; usually see a bony nodule around the joined ares to aid in union

Transverse, Oblique, Spiral, Greenstick, Comminuted, Stellate, Avulsion, Epiphyseal, Impacted and Fissure

classifications of fracture types

Open Fracture

compound fracture where the bone penetrates the skin; opening is exposed to the environment; at risk for infection

Displaced, Angulated, Impacted, Open or Close

descriptive terms with fractures

X-ray

diagnoses of fractures is made by ______

Direct Trauma

expect changes in the area of trauma

Age; Degree of violence to bone; General health; Location of fracture; Early use of fractured part

factors that influence the rate of healing ?

Avulsion Fracture

fracture in which the tendon pulls away from the bone at its attachment site into the bone

Comminuted Fracture

fracture in which there are multiple pieces of bone; most difficult to set

Pathological Fracture

fracture secondary to some underlying disease process; Larger possible picture of involvement- neoplasia impacting bone & rest of body

Spiral Fracture

fracture that looks like a spiral staircase around a long bone; these are most difficult to heal

Epiphyseal Fracture

fracture that occurs at the growth plate due to its softness; occurs in young children and often leads to length discrepancy

Greenstick Fracture

fracture when a part of the bone breaks and the other side bends; most often occurs in children; much like a tree branch break

Impacted fracture

fracture where a piece of bone is pushed down into another piece of bone

Stress Fracture

fracture where the tendon is avulsed due to a sudden violent muscle contraction or less violent muscle contractions over a period of time. Might be related to a pattern of movement of stress which might need changing. Common in athletes.

Fissure fracture

fracture where there are cracks in the bone

Direct Trauma, Indirect Trauma, Stress Fracture, Pathological Fracture

identify the causes of fractures

Myocitis Ossificans

inflammatory process in area of fracture; leads to bony particles being laid down in the muscle

ORIF Open Reduction Internal Fixation

more severe fractures when setting is done surgically with pins & plates

Nerve, Muscle, or Blood Vessel Damage that occurred in conjunction with the fracture

presence of associated damage

Pain or Acute tenderness over fractured area; Swelling; Bruising; Loss of power of Movement; Deformity or Shortening; and Unnatural Mobility

signs of a possible fracture

Closed Fracture

simple fracture that doesn't penetrate the skin

Indirect Trauma

the fracture occurs at a site distant from where the force was applied; might expect additional involvement in between sites

avulsed

torn away where the tendon inserts into the bone

Fat Embolism Complication

when a fat globule is pushed from the bone and travels thru the bloodstream which may lodge in the lung

Nonunion

when after 9 months there is still no clinical union

Delayed Union

when clinical union doesn't happen until after 3 months

Impacted

when one end of the bone is broken and shoved into the other end; causes shortening of the whole bone

Malunion

when the bone heals out of alignment

Displaced

when the bone is out of alignment

Hemorrhage complication

when the bone shifts and punctures a major blood vessel causing a great loss of blood

Angulated

when the bones are still in contact but at an angle to each other; with slight rotation or turn of the bone could mess up line or pull tendons attached during healing

Level of Bone Fracture

where the fracture occurs is important because if its in the mid-shaft you have poor blood supply but if its in the head you have good blood supply

This gives an idea about the functional impact depending on dominance

why is it important to specify if the fracture involves the right or left side?

Body senses need to send strengthening elements

why would a physician order early use of the healing fractured bone?