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FRACTURES. Maja Rožman Vanja Nikić Mentor: A. Žmegač Horvat. Introduction. frango, 3. fregi, fractum – to break most common pathologic conditions affecting bone. CLINICAL TYPES. closed open (compound) complicated. ANATOMICAL TYPES. compression Colles. stress (fatigue) fractures
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FRACTURES Maja Rožman Vanja Nikić Mentor: A. Žmegač Horvat
Introduction • frango, 3. fregi, fractum – to break • most common pathologic conditions affecting bone
CLINICAL TYPES • closed • open (compound) • complicated
ANATOMICAL TYPES • compression • Colles
stress (fatigue) fractures • pathological fractures
TREATMENT • Reduction: open or closed • Immobilization: a) semi-rigid (sling,splint,cast) b) rigid (internal fixation - screws,plates,pins)
HEALING • reactivation of embryogenetic processes • immediately after fracture -> haematoma • inflammatory cells, fibroblasts, capillary vessels • PDGF, TGF-β, FGF -> osteoprogenitor cells • end of week 1 -> soft tissue callus (procallus) recent fracture of fibula
osteoprogenitor cells -> subperiosteal trabeculae of woven bone • end of week 2/3 – max. girth of repair tissue, but not strong enough for weight bearing • enchondral ossification of cartilage -> bridging the fracture by a bony callus • mineralization -> toleration of weight bearing • overgrowth of callus -> reduction by resorption of parts that are not physically stressed • restoration of medullar cavity • impossible to demonstrate the site of previous injury 6 weeks later
http://video.about.com/orthopedics/Fractures-1.htm?rd=1 • http://video.about.com/orthopedics/Fractures-1.htm
References • Kumar et al., Pathologic Basis of Disease • Drake et al.: Gray’s Anatomy for Students • orthopedics.about.com • www.e-radiography.uk