Chapter 32: Orthopedic Injuries

skeletal muscle

aka striated muscle, attaches to bones and usually crosses at least one joint, voluntary muscle, movement and posture

smooth muscle

involuntary muscle, found in walls of most tubular body structures, contracts/relaxes to control movement of contents

cardiac muscle

specially adapted involuntary muscle with its own regulatory system

pectoral (shoulder) girdle

consists of two scapulae and two clavicles

scapula

flat, triangular bone held to rib cage by powerful muscles that buffer it against injury

clavicle

slender, s shaped bone attached by ligaments to sternum on one end and to acromion process on the other

tibia

aka shinbone, larger of the two lower leg bones, supports major weight bearing surfaces of knee and ankle

fibula

smaller of the two lower leg bones, anchor for ligaments surrounding knee joint

calcaneus

aka heel bone, largest of the tarsal bones and subject to injury with axial loading

joint

formed wherever two bones come into contact

ligament

bands of fibrous tissue that connects bone to bone

articular cartilage

thin layer of cartilage that covers ends of bones in moving joints, allow bones to glide easily

fracture

break in the continuity of the bone, can be either closed or open

nondisplaced fracture (hairline fracture)

simple crack of bone that may be difficult to distinguish from sprain/contusion

displaced fracture

produces an actual deformity/distortion of the limb by shortening, rotating, or angulating it

comminuted fracture

fracture in which bone is broken into more than two fragments

epiphyseal fracture

fracture that occurs in growth section of child’s bone and may lead to growth abnormalities

greenstick fracture

type of incomplete fracture that passes only partway through shaft of a bone

incomplete fracture

fracture that doesn’t run completely through the bone

oblique fracture

fracture in which bone is broken at an angle across the bone

pathologic fracture

fracture of weakened/diseased bone generally produced by minimal force

spiral fracture

fracture caused by twisting force, causing oblique fracture around bone and through bone

transverse fracture

fracture that occurs straight across the bone

linear fracture

fracture that runs the length of the bone, opposite of transverse

Le Fort fracture

fractures that separate all/part of the midface from skull base, 3 types with 3 being the worst

crepitus

grating or grinding sensation when bones rub together

false motion

any motion at a point in limb where there is no joint and motion isn’t supposed to occur

dislocation

disruption of a joint in which bone ends are no longer in contact

sprain

occurs when joint is twisted/stretched beyond its normal range of motion, capsule/ligaments are stretched or torn

strain

stretching or tearing of muscle, causes pain, swelling, and bruising of soft tissues in the area, usually no ligament/joint damage

amputation

injury in which an extremity is completely severed from body

pain, paralysis, paresthesias, pulselessness, pallor, pressure

the 6 P’s of musculoskeletal assessment

splint

flexible or rigid device used to protect and maintain position of injured extremity

rigid splints

made from firm material and are applied to sides, front, and/or back of injured extremity to prevent motion at injury site

formable splints

structural aluminum malleable (SAM) splints, vacuum splints, air/pillow/sling and swathe bandages, shapes around deformed limb

pelvic binders

used to splint pelvis to reduce hemorrhage from bones ends, venous disruption, and pain

acromioclavicular (AC) joint

joint between outer end of clavicle and acromion process of the scapula

nightstick fracture

isolated fracture of the shaft of the ulna as a result of a direct blow to it

Colles fracture

fracture of the distal radius, especially common in elderly patients with osteoporosis