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Fractures & Wounds

Learn about common fractures and wounds such as abrasions, lacerations, punctures, incisions, avulsions, calluses, blisters, hematomas, contusions, myositis ossificans, contrecoup, sprains, strains, tendonitis, synovitis, bursitis, fasciitis, dislocations, subluxations, and avulsions. Explore the three stages of soft tissue injury healing and the complications that may arise, including scar tissue formation.

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Fractures & Wounds

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  1. Fractures & Wounds

  2. Abrasion • Result from scraping off one or several layers of epidermis • usually superficial • Minimal bleeding

  3. Laceration • A jagged, irregular, wound caused by a tearing of the epidermis.

  4. Puncture • When a pointed object is driven deep into the tissue • minimal bleeding • high infection risk

  5. Incision • An open wound made by a sharp cutting object (i.e. medical scalpel in surgery) characterized by a straight line cut.

  6. Avulsion • A partial tearing away of a body part warning

  7. Calluses • A thickened usually painless area of skin caused by friction or pressure

  8. Blisters • A bubble-like collection of fluid beneath or within the epidermis of the skin

  9. Hematoma Blood filled swollen area under the skin – “goose egg”

  10. Contusion A closed wound that bleeds under the surface of the skin

  11. Myositis Ossificans • Bone formation within a muscle as a result of a deep contusion. (6 weeks post injury)

  12. Contrecoup • Occurs on the opposite side of the initial injury – usually occurs in the brain when the head hits against an immovable object or surface

  13. Soft Tissue Injuries

  14. Sprains & Strains

  15. Strains • A stretching or tearing of a muscle or tendon as a result of excessive force.

  16. Strains by degree • Strains involve muscle or tendon tissue. • A grade I strain means a tendon has been overstretched. • A grade II strain means a tendon has been partially torn. • A grade III strain means a tendon has been completely ruptured.

  17. Sprains • A stretching or tearing of ligaments as a result of excessive force at a joint.

  18. Sprains by degree • Sprains involve ligament tissue. • A grade I sprain means a ligament has been overstretched. • A grade II sprain means a ligament has been partially torn. • A grade III sprain means a ligament has been completely ruptured.

  19. Tendonitis • Inflammation of tendon due to repetitive motions or improper mechanics

  20. Synovitis • This is a chronic injury to the synovial lining of the joint. • Caused by an injury that was not treated properly or rested. • Most often is the result of a repeated joint injury.

  21. Bursitis • This is chronic inflammation of a bursa sac. • Bursa sacs are located near joints where soft tissue may rub near a bone. • When the bursa becomes irritated it swells and creates a pocket of swelling at the joint.

  22. Fasciitis • Fascia is thick tough connective tissue that surrounds muscles and binds the skin to fat and muscle • When the fascia becomes strained (overuse), it becomes thick, swollen, and painful

  23. Dislocations (luxation) • Occurs when a significant force displaces a bone from its joint (luxation) • Includes connective & soft tissue damage

  24. Subluxation • When a bone is temporarily displaced from its position (partial dislocation) • Includes connective & soft tissue damage

  25. Avulsion • A ligament or tendon pulls a portion of bone away from its attachment due to excessive tension on the attachment

  26. Soft Tissue Injury Healing • Stage I: Acute Inflammatory (2 days) • Increased flow of blood to the injured area • Phagocytes • Cells that engulf and eat up dead cells • Leucocytes • Infection fighting white blood cells • Platelets • Blood clotting

  27. Soft Tissue Injury Healing • Stage II: Repair • Fibroblasts: fiber building cells begin building fibers across injury • They form the scar – which takes 6 weeks to 3 months

  28. Soft Tissue Injury Healing • Stage III: Remolding • Takes up to 1 year • Depends on 3 Things: • Degree of injury • Location of and blood supply to injury • Age of athlete If blood supply to the area is poor, healing process takes longer. Ex: eye

  29. Scar Tissue • This can be a complication of the healing process if more tissue is laid down than what is necessary to repair the wound • Excessive Scar Tissue: • Can delay healing • Can interfere with functions • Sometimes has to be removed

  30. Scar Tissue • Large Wounds (edges are far apart) • Will take longer to heal • Try to keep wound closed • with stitches/skin closures • Skin Closures: • Butterfly Stitch • Tough piece of material that brings together the edges of a wound and can close a deep wound effectively

  31. Bone injuries: fracture types

  32. Stress • fatigue-related fracture that occurs as a result of repetitive stress • not always noticeable on x-ray • later x-ray shows healing bone callus

  33. Greenstick • indicated by the bone splintering as it is bent commonly as the result of a fall on an outstretched arm

  34. Impacted • compression of bone where pieces are embedded into other bone (red arrows indicate direction of force)

  35. Longitudinal • runs the length of a long bone as the result of repeated stress or axial force

  36. Oblique • indicated by a diagonal fracture line across a bone caused by bending or axial loading

  37. Spiral • indicated by a candy-cane striped appearance up the length of a long bone

  38. Transverse • travels across a bone as the result of bending or direct impact

  39. Comminuted • indicated by a bone being broken into 3 or more pieces commonly from a fall or large force (car accident)

  40. Blowout • Occurs around the eye. It is a comminuted fracture to the orbit as the result of a direct impact

  41. Salter-Harris (Epiphyseal) • any fracture that occurs at the growth plate in young athletes

  42. Compression • Occurs in the spine • Happens when opposing forces are applied to a bone from both ends at the same time

  43. Depressed • Occurs from a direct impact to the skull • Makes an indent

  44. Pathological • Disease process like a tumor weakens bones so that stress causes fracture • Improper nutrition and eat disorders

  45. Named after a French surgeon Lisfranc Injury • An injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus

  46. Skeletal Anatomy Terms

  47. Terms • Deformity • Misalignment of a body part • Osteoporosis • Caused in young people by lack of calcium & body’s inability to absorb minerals • Bones are porous & fragile Prefix “osteo” refers to bone

  48. Terms • Osteogenesis • Process of laying down new bone • Osteocytes • Bone cells • Osteoblasts • Bone forming cells • Osteoclasts • Cells involved in bone resorption (“eat” the interior layer of bone & allow new bone growth)

  49. Healing Fractures • Fracture • Broken bone • Failure Point • Amount of energy required to cause a fracture • Vary by athlete, age & structure • Time • Typically 6-8 weeks to heal a fracture

  50. Fracture Healing Process: Stage 1: Acute • Injury occurs • Bone breaks & bleeding occurs • Osteoclasts • “eat” the debris and reabsorb it into body • Osteoblasts • Add new layers to outside of bone • Length • Approximately 4 days

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