what are some further classifications of fractures
open
closed
location
displaced
intra-articular
what kind of fracture is this?
closed fracture
gunstock deformity
true or false – an open fracture breaks the skin
true
what kind of fractures are these: 1 – 6
1transverse fracture
2 oblique fracture
3 spiral fracture
4comminuted fracture
5 compression fracture
6 green stick fracture
compression fractures are most common in what area
lumbar spine
what is a nondisplaced fracture
there is a break but the bone is not angled
what does ORIF stand for
open reduction internal fixation
what kind of fracture is this
fracture dislocation
true or false – when providing rehabilitation it is important to only consider the joint inferior of the fracture
false – it is important to consider the joint above and below the fracture
what happens during the first and second week of healing of the fracture
wound site fills with blood and the ends of the fractured bone become necrotic. The blood clot is invaded with macrophages to remove the necrotic tissue, and osteoblast move-in to produce bone
what happens during the 2-6 weeks
callus forms that holds the fracture together. Ossification begins
what happens during 6 – 12 weeks of fracture healing
solid bone ossification occurs across the fracture site. The bone regained significant strength at this time
what happens in bone healing from weeks 12 – 26
mature callus
what happens during bone healing from six months through 12 months
gaps of cortical edges are bridged
what happens during bone healing from the first year through the second year
bone remodels, becomes smooth, normal structure is restored
why do doctors offset bone fractures so much in children
because if they put the top end directly above the bottom end there will be an overproduction of osteoblast activity, which will cause the leg to be longer than the other.
what are some complications of fractures
malunion
nonunion
compartment syndrome
neural injury
deep vein thrombosis
AVN
RSD
what is this condition
anterior compartment syndrome
what is the cause of anterior compartment syndrome
trauma
is anterior compartment syndrome a medical emergency
yes
when assessing anterior compartment syndrome what should you check
sensation in the toes
a pulse in the foot – dorsal pedal pulse
the condition is this
neural injury posterior fracture
axillary nerve that travels around the neck of the humoral head
AVN stands for
avascular necrosis
what is avascular necrosis
is a condition where bone does not receive a blood supply resulting in death of the bone
typically the femoral head
what does RSD stand for
reflex sympathetic disorder
what is reflex sympathetic disorder
Reflex sympathetic dystrophy (RSD), also called complex regional pain syndrome (CRPS), is a chronic, painful, and progressive neurological condition that affects the skin, muscles, joints, and bones. The syndrome usually develops in an injured limb, such as a broken leg, or following surgery. However,
many cases of RSD involve only a minor injury, such as a sprain. And in
some cases, no precipitating event can be identified.
how do you treat reflex sympathetic disorder
do everything you can to stop the pain that the patient is experiencing
stop pain with medications, heat, cold, electrical stimulation, etc.
range of motion and activity in the involved limb
what condition is this
reflex sympathetic disorder
reflex sympathetic disorder is commonly associated with a fracture that occurs in the wrist. What is this fracture called
collies fracture
avascular necrosis is, and what population – older or younger population
older
what is Holman's sign
a sign used to identify deep vein thrombosis
not very reliable
how should deep vein thrombosis be assessed
with the following tool
how should close reduction fractures be managed
immobilization – splendid/brace, cast, internal fixation or external fixation
how should open reduction fractures be managed
internal fixation
external fixation
what kind of fixation is this
open reduction internal fixation
use of plates, screws, pins, rods
what kind of fixation is this
external fixation
what are some principles for physical therapy fracture management
most fractures immobilize 6 to 8 weeks ( less in children.... Longer in elderly)
avoid two and 3D stresses on bone or early
if you move a limb that is fractured, early use a single plane motion
ask about callous information is asked to move a limb
look at joints above and below fracture sites
attempt to gain x-ray so you can see the fracture type and severity
true or false – whenever you get up patient that has had a fracture you should ask the doctor about the appropriate weight-bearing status
true
what is the management for fractures post-op
nonweightbearing eight – 10 weeks
early range of motion started by two weeks postop
soft tissue in wound management first two weeks
be sure to read PowerPoint because some information I was not able to include
