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23 Cards in this Set
- Front
- Back
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What are the 2 types of incomplete fractures?
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Greenstick- fracture through cortex
Torus- Buckling of cortex |
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Dislocation vs. Subluxation
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Dislocation- bony components of a joint are NO LONGER IN CONTACT with each other. Complete disruption of joint.
Subluxation- bony components of a joint are PARTIALLY in contact with each other. There is partial disruption of the joint. |
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What is a transverse fracture?
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- Perpendicular to the long axis of the bone
- Caused by a force perpendicular to the shaft |
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How is an Oblique fracture caused?
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- Caused by a force applied in the same direction as the long axis of the bone
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What is a spiral fracture?
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Twisting or torque- oblique and spiral can be interchanged
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What terms are used to describe fracture fragments in relation to each other?
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Describe the distal fracture fragment to the proximal fracture fragment
- Displacement- Translation - Angulation - Shortening - Rotation |
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Displacement- Translation
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- sideways motion of the fracture
- described as a percentage of movement when compared to the diameter of the bone - Amount of off-set of the distal fracture fragment relative to the proximal - The distal femoral fracture fragment is translated laterally |
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Displacement- Angulation
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- amount of bend at a fracture described in degrees.
- Angle away from the normal that the distal fragment makes with the proximal - Distal fragment is angulated medially or varus from the position it would have were it not fractured. |
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Displacement- Shortening
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- Shortening is the amount a fracture is collapsed expressed in centimeters
- Overlapping of the ends of the fracture fragments - Shortening is usually described by the number of centimeters of overlap |
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How are the number of fracture fragments described?
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Simple- 2 fragments
Comminuted- more than 2 |
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Open Fractures
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- exposure to the atmosphere
- a break in the skin and underlying soft tissue leading directly into or communicating with the fracture and its hematoma - EMERGENCY- can't just be splinted - Always take off current splint and look at the skin to make sure you don't miss an open fracture - Evaluate periosteal stripping and consider soft tissue injury - Gustilo classification for prognosis |
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Type I Open Fracture
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- inside-out injury
- Clean wound - minimal soft tissue damage - No significant periosteal stripping |
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Type II Open Fracture
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- Moderate soft tissue damage
- ouside-in mechanism - higher energy injury - Some necrotic muscle and some periosteal stripping |
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Type IIIA Open Fracture
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- high energy
- outside- in injury - Extensive muscle devitalization - bone coverage with existing soft tissue not problematic |
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Type IIIB Open Fracture
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- high energy
- outside to in injury - extensive muscle devitalization - Requires a local flap or free flap for bone coverage and soft tissue closure - PERIOSTEAL STRIPPING |
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Type IIIc Open Fracture
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- High energy
- increased risk of amputation and infection - Major vascular injury requiring repair CIRCULATION COMPROMISED |
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Treatment for Open Fractures
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Immediate
- irrigation and cover - Cephalosporin intravenously every 8 hours until 24 hours after the wound is closed - Type III fractures give intravenous gentamicin levofloxacin - tetanus - Debridement of skin, muscle, bone, tendon |
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Colle's Fracture
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- Fracture of the distal radius with dorsal angulation
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Jones' Fracture
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Fracture base of 5th metatarsal
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Boxer's Fracture
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Fracture of the 5th metacarpal with volar angulation
- most often the result of punching a person or wall - Look for fight bite |
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Types of Splints
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Look at picture
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What are the ages that ossification of bone occurs?
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"Come Rub My Tree of Love"
2- Capileum 4- Radial Head 6- Medial Epicondyle 8-Trochlea 10- Olecranon 12- Lateral Epicondyle |
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When to suspect child abuse?
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- parents or caregivers account of the injury is vague and incomplete
- Degree of physical injury may be inconsistent with the history given - Delay in seeking treatment - History of repeated trauma, with the child treated in several different facilities - NEED AT LEAST 2 RADIOGRAPHIC VIEWS - Spiral fractures and transverse long bone fractures - Femoral shaft fractures and humerus and tibia - Diaphysis fractures > Epiphyseal-Metaphyseal Fractures - Skul fractures |
