mod 6- UE fractures

fracture

an interruption in the continuity of bone and/or cartilage

fracture-dislocation

fracture through/near joint, accompanied by dislocation of the joint

pathologic fracture

fracture occurring through a weak or abnormal bone due to disease or illness

stress fracture

repeated overuse of a body part not accustomed to stress, resulting in fracture

open reduction internal fixation

what is ORIF?

open

kind of fracture where bone has broken through the skin

periosteal bridge is maintained

required to be called an incomplete fracture

translation

movement of fx bones away from each other (%) in the axial direction

angulation

description of the point of the angle in a fx

overriding

% apposition that describes the amount of overlap

transverse

fx where fracture occurs at a right angle to the long axis of the bone

oblique

fx where the line is <90d to the long axis of the bone

longitudinal

fx that occurs along the long axis of a bone

butterfly

fx due to 3-point bending force, where there is a transverse fx on the tensile side of the bone and oblique fx on the compressive side

spiral

fx where line curves around the bone

comminuted

fx with 2+ fracture fragments, usually to to high velocity impact

greenstick

incomplete fx of long bone due to soft bone bending rather than cracking

diaphysis

long shaft of bone

metaphysis

portion of bone between diaphysis and epiphysis

epiphysis

ossification center of bone

intra-articular

fx that affects the articulating surface of a bone

age, type, location, severity, area of contact

factors affecting the rate of healing

synostosis

fusion of separate bones

pseudoarthrosis

bone heals improperly in a non-union, creating a false joint

hydrostatic pressure results in successful reunion of fractures

what is the Sarmiento principle?

if a fracture is in the proximal/distal third of a bone, the next adjacent joint must be supported

what is the rule of thirds?

AC

joint dislocation that commonly occurs with clavicle fracture

impact, translation of forces from lateral joint

causes of clavicle fracture

benign

immediate risk level of clavicle

subclavian artery, trachea

structural injuries that would cause a clavicle fracture to become immediately dire

greenstick, complete

most common type of clavicle fracture

quick

healing time for clavicle fx

figure-8 harness or sling for comfort

typical orthotic treatment for clavicle fx

malunion, with visible anterior lump

typical aftermath of clavicle healing

figure-8 harness, clavicle

what is this? What kind of fx does it usually support?

high energy impact, chronic dislocation or separation

usual cause of scapula fx

head, clavicle, spine, ribs

common fx that occur along with scapula

sling

how is a scapula fx treated orthotically, if ever?

statue of liberty cast, proximal 1/3 humerus

what is this? what kind of fracture does it stabilize?

traction immobilization, statue of liberty cast

typical casting immobilization method for proximal 1/3 humerus fracture

mid-shaft, no significant angulation

conditions under which humerus fx brace can be used

brachial plexus

nerve structure that may be damaged by humerus fx

sling, humeral shaft fracture brace with/without shoulder cap, SEWHO

orthotic treatments for humerus fracture

humerus, forearm

immobilizing which two segments can help elbow dislocation/fracture?

internal fixation

surgical management for elbow dislocation/fracture

arm sling, traction immobilization, fx brace system with joints

orthotic management for elbow dislocation/fracture

both bone fracture

what is a BBF forearm fx?

percutaneously

how is a forearm BBF usually pinned?

0d, using palmar extension

what angle should the wrist be immobilized at in a forearm BBF?

fall on outstretched hand

what is FOOH?

Colles

what kind of Fx is usually caused by a FOOH?

distal radial

what kind of fx is a Colles?

brachioradialis

which muscle is most affected by a Colles fx?

supination/pronation

what functions are performed by the brachioradialis?

supination/pronation

what movements do we aim to prevent by immobilizing proximal to the elbow in the case of a severe Colles fx?

thumb, fingers, wrist, forearm up to elbow

what should be immobilized for a wrist fracture (scaphoid or carpal row)?

fracture orthosis with palmar extension and 0d wrist extension

style of orthosis to treat wrist fracture

not a lot of soft tissue

issue with applying Sarmiento principle to carpal region fx

hand, fingers, wrist

what should be immobilized in case of a metacarpal fx?

prefab WHFO, OH, MC fx orthosis

recommended orthoses for metacarpal fx

splint to adjacent finger

what is a buddy splint?

buddy splint, finger splint with volar strut for stabilization

orthotic treatment options for digit fracture

functional bracing

bracing that assumes the motion allowed at fx site is conducive to osteogenesis