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Fractures and Bone Healing PowerPoint Presentation

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Published on : Aug 10, 2021 | Views : 4727 | Downloads : 20

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Slide 1-

Fractures and Bone Healing
Slide 2-

Statistics • Fractures of extremities most common • More common in men up to 45 years of age • More common in women over 45 years of age Before 75 years wrist fractures (Colles’) most common • After 75 years hip fractures most common
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Types of fractures Magnitude and direction of force Closed – Bone fragments do not pierce skin Open/compound – Bone fragments pierce skin Displaced or undisplaced
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Transverse fracture Usually caused by directly applied force to fracture site
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Spiral or Oblique Caused by violence transmitted through limb from a distance (twisting movements)
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Greenstick Occurs in children: bones soft and bend without fracturing completely
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Crush fractures Fracture in cancellous bone: result of compression (osteoporosis)
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Burst fracture Occurs in short bones, e.g. vertebra from strong direct pressure such as impaction of disc.
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Avulsion fracture Caused by traction, bony fragment usually torn off by a tendon or ligament. What muscle group attaches to this bony prominence and what nerve also runs in close proximity? Forearm flexors (common flexor origin) ulnar nerve
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Fracture dislocation/subluxation Fracture involves a joint: results in malalignment of joint surfaces.
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Impacted fracture Bone fragments are impacted into each other.
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Comminuated fracture Two or more bone pieces - high energy trauma
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Comminuated fractures can require serious hardware to repair.
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Stress fracture Abnormal stress on normal bone (fatigue fracture) or normal stress on abnormal bone (insufficiency fracture).
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Functions of the X-ray Localises fracture and number of fragments Indicates degree of displacement Evidence of pre-existing disease in bone Foreign bodies or air in tissues May show other fractures MRI, CT or ultrasound to reveal soft tissue damage
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How to Handle Fractures Reduction Open reduction – Allows very accurate reduction – Risk of infection – Usually when internal fixation is needed Manipulation – Usually with anaesthesia Traction – Fractures or dislocation requiring slo
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Holding the reduction 4-12 weeks External fixation Internal fixation – Intermedually nails, compression plates Frame fixation
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External fixation Used for fractures that are too unstable for a cast. You can shower and use the hand gently with the external fixator in place.
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Frame fixation Allows correction of deformities by moving the pins in relation to the frame.
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Internal fixation
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Bone Healing 1. Fracture hematoma – blood from broken vessels forms a clot. – 6-8 hours after injury – swelling and inflammation to dead bone cells at fracture site
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2. Fibrocartilaginous callus (lasts about 3 weeks (up to 1st May)) – new capillaries organise fracture hematoma into granulation tissue - ‘procallus’ – Fibroblasts and osteogenic cells invade procallus. – Make collagen fibres which connect ends together – Chondroblasts begin to produce fibrocatilage,
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3. Bony callus (after 3 weeks and lasts about 3-4 months) – osteoblasts make woven bone.
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4. Bone Remodeling Osteoclasts remodel woven bone into compact bone and trabecular bone – Often no trace of fracture line on X-rays.
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