Types of Trauma and Types of Fractures

What is peri-mortem trauma?

trauma @ time of death

fresh fractures/sharp edges but NOT brittle

no signs of healing

blunt force trauma, gunshot wound, fall-accidental sudden death

What is post-mortem trauma?

trauma after time of death

brittle, clean fractures with jagged edges, bone is lighter

no healing signs/ inflammatory response

What is ante-modern?

trauma before time of death

signs/evidence of healing (callus formation, remodeling, smoothing edges)

tons of different types of fractures

4 stages of bone healing

1. Inflammatory Phase (hemiatoma formation/pooling of blood) (1-7 days)

2. Soft Callus Formation (1-3 weeks) (formation of a barrier around the break, critical that the bone is in the correct position or else it will heal wrong)

3. Hard Callus Formation (3-6 weeks)

4. Bone Remodeling (3mo-many years) bone doing its best to return to its normal state, you’ll have a bump on your bone for a while where the break was.

stage 1 of bone healing: Inflammatory

formation of hematoma

immune response activated

inflammation, blood vessel formation

bone injury signs visible (irregular edges, soft callus)

stage 2 of bone healing: Soft Callus

cartilage formation bridging the fracture

fibroblasts and chondroblasts create soft callus

facture line still visible

stage 3 of bone healing: Hard Callus

cartilage replaced by WOVEN bone

osteoblasts lay down new bone at fracture sites

callus visible on x-rays

stage 4 of bone healing: Bone Remodeling

woven bone replaced by lamellar bone

osteoclasts reshape the bone to original contour

fully healed, but slight signs of healing may remain

types of fracures

simple (closed) fractures

compound (open) fractures

comminuted fracture

greenstick

spiral fracture

Simple (closed fracture

bone breaks but does not puncture the skin

heals with proper realignment and immobilization

types of simple fracture (transverse, oblique, spiral, greenstick, compression)

compound (open) fractures

bone breaks and pierces through the skin

requires medical intervention to prevent infection

often requires surgery to realign and stabilize bone

types of fractures that can be compound (transverse, oblique, spiral, comminuted, avulsion)

comminuted fracture

bone breaks into several pieces

typically requires surgical intervention to fix the bone

blunt force trauma

greenstick fractures

partial fracture, bone bends and cracks but does not break completely

common in childern due to more flexible bones

heals relatively easily due to incomplete break

ex) collar bone fractures

spiral fractures

caused by twisting or rotational force applied to the bone

results in a spiral-shaped break

may require surgical intervention (bone usually needs to be realigned)

usually displaced fracture

transverse fractures

a straight break across the bone

typically caused by direct impact

typically requires alignment and stabilization

oblique fracture

break occurs at an ageal to the bones axis

often requires surgical intervention to prevent displacement

usually simple break

compression fracture

occurs in spongy bone

bone collapses under pressure

treatment may involve bracing or surgery

often caused by snowmobile accidents

avulsion fracture

bone fragment pulled off by tendon or ligament

often occurs in areas of strong muscle force

may require surgical repair if large or displaced

stress fracture

small crack in bone caused by repetitive stress or overuse

common in athletes

heals with rest and reduction of stress on bone

pathological fracture

any fracture that occurs due to or weakened dieases (cancer, osteoporosis)

requires treating underlying condition in addition to managing fracture

What is osteoarthritis?

a degenerative joint disease affecting cartilage and subchondral bone

common affects weight-bearing joints (hips, knees)

characterized by joint degeneration, osteophytes, and eburnation

contains visible joint surface irregularities and spurs