FRACTURE
A _______ is a break in the continuity of the bone
fracture
what are the TYPES of fracture:
- Closed or simple fracture
- Open or compound fracture
- Transverse fracture
- Greenstick fracture
- Comminuted fracture
- Oblique Fracture
- Spiral Fracture
- Compression fractures
- Impacted fracture
- Avulsion fracture
– The bone is broken, but the skin is not lacerated.
Closed or simple fracture
- The skin may be pierced by the bone or by a
blow that breaks the skin at the time of the fracture. The bone may or may not be
visible in the wound.
Open or compound fracture
– The fracture is at right angles to the long axis of the bone.
Transverse fracture
– the bone partly fractures on one side, but does not break
completely because the rest of the bone can bend. More common among
children, whose bones are softer and more elastic.
Greenstick fracture
- A fracture that results in three or more bone fragments.
Comminuted fracture
– The fracture is diagonal to a bone’s long axis.
Oblique Fracture
– At least one part of the bone has been twisted.
Spiral Fracture
- usually occurs in the vertebrae, for example when the
front portion of a vertebra in the spine collapses due to osteoporosis (a medical
condition which causes bones to become brittle and susceptible to fracture, with
or without trauma).
Compression fractures
- A fracture caused when bone fragments are driven into each
other
Impacted fracture
- a muscle or ligament pulls on the bone, fracturing it.
Avulsion fracture
Repair in a simple fracture involves four major stages:
1. Hematoma formation
2. Fibrocartilaginous callus formation.
3. Bony callus formation.
4. Bone Remodeling.
When a bone breaks, blood vessels in the bone and
periosteum are torn and hemorrhage. As a result, a hematoma, a mass of
clotted blood, forms at the fracture sight. Soon, bone cells deprived of nutrition
die and the tissue at the site becomes swollen and painful and inflamed.
1. Hematoma formation:
Within a few days, several events lead
to the formation of soft granulation tissue. Capillaries grow into the hematoma
and phagocytic cells invade the area and begin cleaning up the debris.
Meanwhile, fibroblasts and osteoblasts invade the fracture site from the nearby
periosteum and endosteum and begin reconstructing the bone. The fibroblasts
produce collagen fibers that span the break and connect the broken bone ends
and some differentiate into chondroblasts that secrete cartilage matrix. This
entire mass of repair tissue, now called fibrocartilaginous callus, splints the
broken bone.
2. Fibrocartilaginous callus formation.
Within a week, osteoblasts begin forming spongy
bone and new bone trabeculae begin to appear in the fibrocartilaginous callus
and gradually convert it to a bony or hard callus of spongy bone. Bony callus
formation continues until a firm union is formed about two months later.
3. Bony callus formation.
Beginning during bony callus formation and continuing for
several months after, the bony callus is remodeled. The excess material on the
diaphysis exterior and within the medullary cavity is removed, and compact bone
is laid down to reconstruct the shaft walls. The final structure of the remodeled
area resembles that of the original unbroken bony region because it responds to
the same set of mechanical stressors.
4. Bone Remodeling.
Inorder for a bone to heal properly ______ (realignment of bone ends) must
occur.
reduction
There are two types of reduction...
1. Closed Reduction
2. Open Reduction
- the bone ends are coaxed back into their normal
position by the physician's hands
1. Closed Reduction
- surgery is performed and the bone ends are secured
together with pins and wires
After the broken bone is reduced, it is immobilized by a cast or traction to
allow the followinghealing process to begin...
2. Open Reduction