fracture
is a disruption or break in the continuity of the bone
traumatic injuries account for the majority of factures
causes of fracture
infection in bone
steroids causing bone changes
chemotherapy leading to osteopenia
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fracture
is a disruption or break in the continuity of the bone
traumatic injuries account for the majority of factures
causes of fracture
infection in bone
steroids causing bone changes
chemotherapy leading to osteopenia
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fracture classification
open (compound)
closed (simple)
incomplete or complete
displaced or non-displaced (still in good alignment)
comminuted (multiple bone fragment)
traumatic or pathologic
anatomic location
-intra-articular or extra-articular
-proximal, mid-shaft, distal
,fracture pattern (transverse, oblique)
fragment alignment (displaced, nondisplaced)
fracture manifestations
localized pain
decreased function
inability to bear weight or use the affected part
obvious bone deformity may not be present
bone goes through six stages of healing
union
many factors influence union
age
blood supply
infection
hormones
immobilization
site of the fracture
poor nutrition
displacement
implants
-stablize fracture
electrical stimulation
-help with healing
-10-12 hours a day
-enhance activity of calcium of area
fracture healing
, hematoma formation: 2-3 days
granulation tissue (basis for new bone): 3-14 days
callus formation: 2 weeks; ossifies in 3 weeks-6 months
remodeling (callus reabsorbs): up to 1 year-complete healing
gradual weight bearing over time
remodeling stage
radiologic union
absorption of excess bone cells
return to preinjury strength and shape
deposition and absorption of bone in response to stress
fracture healing time
not occur in the expected time- delayed union
not occur at all- nonunion
healing time increases with age
x-ray to look how much have healed before taking off cast
(1 year for complete healing to occur although differs on age and other factors)
malunion
when the two bony ends of the fracture fail to heal together correctly
The goals of fracture treatment are
anatomic realignment of bone fragments
immobilization to maintain realignment
restoration of function
closed reduction
is the nonsurgical, manul realignment of bone fragments
treatment following reduction includes:
-traction
-casts
-splints
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