1 / 15

Introduction to Fractures

Introduction to Fractures . Fractures - definitions, healing and management. Definitions. A Fracture is a break in the continuity of a bone A comminuted fracture is one with more than two fragments Gross comminution is usually caused by severe violence, union is often delayed or difficult.

stu
Download Presentation

Introduction to Fractures

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Introduction to Fractures Fractures - definitions, healing and management

  2. Definitions • A Fracture is a break in the continuity of a bone • A comminuted fracture is one with more than two fragments • Gross comminution is usually caused by severe violence, union is often delayed or difficult

  3. Types of Fractures(#) • Transverse # • Spiral # • Greenstick # • Crush # • Burst # • Avulsion # • # dislocation / subluxation

  4. Fracture definitions • Open / Compound # • some communication with the outside or an internal organ. • Infection a real possibility • Complicated # • important soft tissue damage present

  5. Fracture definitions • Impacted #’s • occurs when bone fragments are forced together • such #’s are usually stable • Unstable #’s are those that are displaced or have the potential to displace • important in spinal column #’s

  6. Definitions • Reduction • the realigning of fractures usually by manipulation under an anaesthetic - MUA or a local anaesthetic • once reduced fractures need maintaining in the correct position, usually by a plaster of Paris cast - POP • occasionally internal fixation is used - ORIF

  7. Definitions • Displacement • shortening, rotation, sideways shift or tilt. Reduction reverses the position of displacement • Dislocation • loss of joint integrity • Subluxation • partial loss of joint surface integrity

  8. Bleeding & fracture haematoma forms Inflammation 2-3 days. Phagocytosis,, Capillary budding - forms granulation tissue Osteogenic cells invade lay down osteoid 3 weeks soft callus cartilage and osteoid Callus forms, 6 - 12 weeks Clinical union 3 - 4 months Remodelling, 6 - 12 months Fracture healing

  9. Classical signs of a fracture • Pain and tenderness • Deformity • Swelling • haematoma, haemarthrosis • Local temperature increase • Abnormal mobility, occasionally crepitus • Loss of function

  10. Fractures - management • Open #’s, avoid infection risk - osteomyelitis • Reduction if necessary e.g impacted #’s or where alignment is not so important • manipulation • traction • open reduction

  11. Fractures - management • Maintain reduction • Intrinsic stability • External fixation • Splintage POP, Cast braces, Platazote etc • Traction • Internal fixation • Screws, plates, grafts, intramedullary nails, wires & pins • Frame fixators

  12. Fractures - management • How long ? Depends on method of fixation • Long bones 12 weeks • cancellous ends of long bones & in short bones 6-8 weeks • Children (& ? Elderly) 2-3 weeks • For pain relief only 2-3 weeks

  13. Fracture - Complications • At time of injury • Haemorrhage • Damage to important internal structures • Skin loss

  14. Fracture - Later Complications • Local • Tissue necrosis • Infection • Loss of alignment • General • Deep Vein Thrombosis, Pulmonary embolism & Fat embolism. • Pneumonia

  15. Late Complications • Delayed and Non Union • Late wound infection • Joint stiffness and contracture • Sudek’s atrophy • sympathetic malfunction ? • Osteoarthritis

More Related