Bone Injuries

What is a dislocation

Injury that occurs at a join articulation

point where two bones come together

A significant force that displaces bone so that the two separate bones end no longer line up and forced from normal position.

What is a fracture

Commonly known as a broken bone

disruption in continuity of a bone because of failure point

Key Facts on dislocation

Not easily reduced

Must be reduced by physician

Present with deformity and pain

can cause a fracture and/or soft tissue damage

What is a classification of fracture?

based on the various characteristics of the broken bone

Open

bone will penetrate skin and be seen externally

Closed

bone ends will remain internal

Displaced

bone has shifted and the ends of the bone no longer align

Non-Displaced

Bone is fractured but has not shifted significantly

Linear

fracture extends over part or the entire length

Transverse

Fracture line is perpendicular to shaft of bone

Oblique

Fracture break is on an angle through the bone

Complete

Fracture goes through entire bone (Pieces of fracture are separated)

Incomplete

Bone does not break through entire bone (Bends or cracks)

Greenstick Fracture

the force created usually breaks only the outer portion f the bend

incomplete

common in children (bones are weaker)

Comminuted Fracture

a break where the bone is shattered into 3 or more pieces

common in those whose bones are more brittle

Stress Fracture

small incomplete breaks on bones that result from overuse, weakness, or biomechanical problems.

Epiphyseal Plate Fractures

break in the bone on the growth plate

susceptible injury in children between 10-16

Compression Fracture

Fracture due to extreme trauma, as in a fall

bone is actually crushed

Depressed Fracture

fractured portion is pressed inward

typical in a skull fracture

Avulsion Fracture

injury to the bone in a place where a tendon or ligament attaches to the bone

when it occurs, the tendon or ligament pulls off a piece of the bone

Spiral Fracture

occurs when excessive twisting forces are placed on the bone

common sports injury

Treatment for Bone Injury

Reduction

External Fixation

Internal Fixation

Reduction

process involving putting the fractured bone back into position

External Fixation

casting or other external apparatus used to keep the bone in proper alignment after reduction

Internal Fixation

surgical procedure required to secure alignment (screws, plates, rods)

Stages of Bone Healing

Acute

Repair

Remodeling

Acute

bleeding occurs in area of fracture

osteoclasts (begin to eat debris and reabsorb into body)

osteblasts (begin to add new layers outside of bone)

continues for 4 days

Repair

Osteoclasts and Osteoblasts continue to regenerate the bone

fibrous callus forms (“body splint” extends internally and externally)

begins at about 3 weeks and continues for three months

in most cases- 6 weeks of immobilization (strong enough to allow participation with protection)

Remodeling

Callus is responsible for being reabsorbed and replaced with a fibrous cord of bone

takes several years to complete

non-union fracture (if bone never heals)

Electrode implants (found to stimulate growth of fibrous cord of bone)

3 factors affecting bone healing

Displacement of fracture

Instability of the fracture

Poor Blood supply

Osteoclasts

eat debris and reabsorb into body

Osteoblasts

add new layers to outside of bone

what treatment to use for spiral?

internal fixation

which stage of bone healing will stress fractures be noticeable?

repair

treatment may be a vacuum splint or some form of emegency splinting equipment

acute

callus is reabsorbed and replaced with fibrous cord of bone

remodeling

majority of this phase will utilize an external fixation for treatment

repair

take several years to complete

remodeling

when 6 weeks of immobilization occur

repair

rehabilitation would bring and consist of weightlifting activities

remodeling

bleeding occurs in area of fracture

fibrous callus forms

repair

can greenstick be open

no

can greenstick be closed

yes

greenstick: displaced or non-displaced

displaced (g)

greenstick: complete or incomplete

incomplete (g)

greenstick: transverse, linear, oblique

transverse/oblique (g)

comminuted: open/closed

both (co)

comminuted: displaced/non-displaced

both (co)

comminuted: incomplete/complete

both(co)

comminuted: linear, transverse, oblique

all (co)

stress: open/closed

closed (st)

stress: displaced/non-displaced

non-displaced (st)

stress: complete/incomplete

incomplete (st)

stress: linear/transverse/oblique

all (st)

epiphyseal: open/closed

closed (e)

epiphyseal: non-displaced/displaced

non-displaced (e)

epipyseal: complete/incomplete

both (e)

epiphyseal: linear/transverse/oblique

all (e)

compression: open/closed

closed (c)

compression: non-displaced/displaced

non-displaced (c)

compression: complete/incomplete

both (c)

compression: linear/transverse/oblique

all (c)

depressed: open/closed

closed (d)

depressed: non-displaced/displaced

displaced (d)

depressed: complete/incomplete

both (d)

depressed: linear/transverse/oblique

all (d)

avulsion: open/closed

closed (a)

avulsion: displaced/non-displaced

displaced (a)

avulsion: complete/incomplete

complete (a)

avulsion: linear/transverse/oblique

transverse (avulsion)

spiral: open/closed

both (spiral)

spiral: displaced/non-displaced

displaced (spiral)

spiral: complete/incomplete

complete (spiral)

spiral: linear/transverse/oblique

oblique (spiral)