Bone Fractures Bone Fractures Fracture broken bone General

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Bone Fractures

Bone Fractures

Bone Fractures • Fracture = broken bone • General Classification – Closed (simple) •

Bone Fractures • Fracture = broken bone • General Classification – Closed (simple) • Bone has not penetrated the skin – Open (compound) • Bone has penetrated the skin

Question • Open or closed fracture? http: //www. youtube. com/watch? v=Z 1 DCtgv. HU

Question • Open or closed fracture? http: //www. youtube. com/watch? v=Z 1 DCtgv. HU 0

Bone Fractures • 6 types – Comminuted – Compressions – Depression – Impacted –

Bone Fractures • 6 types – Comminuted – Compressions – Depression – Impacted – Spiral – Greenstick

Make a Table Fracture Type Description Picture

Make a Table Fracture Type Description Picture

Comminuted Fractures • Bone breaks into many fragments – Common in aged and those

Comminuted Fractures • Bone breaks into many fragments – Common in aged and those with brittle bones

Compression Fractures • Bone is crushed – Common in porous bones • osteoporosis

Compression Fractures • Bone is crushed – Common in porous bones • osteoporosis

Osteoporosis • Caused by decreased bone mass and density • More prone to fractures,

Osteoporosis • Caused by decreased bone mass and density • More prone to fractures, especially in the vertebrae • Women are more prone to this disease, but men can also experience it – Old age=less sex hormones – Also caused by malnutrition, excessive alcohol, inactivity • Osteoclasts are overactive which weakens the bone and makes it more prone to fractures • Management: – aerobics, weight bearing, and resistance exercises – Vitamin D and calcium may help when used together (insufficient evidence at this point)

Osteoporosis

Osteoporosis

Depressed Fracture • Broken bone is pressed inward – Typical of skull fractures •

Depressed Fracture • Broken bone is pressed inward – Typical of skull fractures • How might someone get this type of fracture?

Impacted Fracture • Broken bone ends are forced into each other – Commonly occurs

Impacted Fracture • Broken bone ends are forced into each other – Commonly occurs when one attempts to break a fall with outstretched arms

Spiral • Ragged break occurs when excessive twisting forces are applied to the bone

Spiral • Ragged break occurs when excessive twisting forces are applied to the bone – Sports injuries

Greenstick Fractures • Bone breaks incompletely – Common in children • Bones are more

Greenstick Fractures • Bone breaks incompletely – Common in children • Bones are more flexible than adult bones

Bone Fractures • Treated by reduction – Realignment of broken bone ends – Closed

Bone Fractures • Treated by reduction – Realignment of broken bone ends – Closed reduction • Bone ends are coaxed back into their normal position by a physician’s hands – Open reduction • Surgery is performed and bone ends are secured together with pins and wires

Bone Fractures-Healing • 4 major events – 1) Hematoma is formed • Blood vessels

Bone Fractures-Healing • 4 major events – 1) Hematoma is formed • Blood vessels within the Haversian system are ruptured when the bone breaks – Blood loss occurs • Osteons die from lack of blood • Hematoma=blood tumor

Bone Fractures-Healing – 2) A break is splinted by a fibrocartilage callus • The

Bone Fractures-Healing – 2) A break is splinted by a fibrocartilage callus • The blood clots • New capillaries begin to grow • Connective tissue forms a mass of repair tissue – Cartilage, bone, some collagen

Bone Fractures-Healing – 3) The boney callus is formed • Osteoclasts and osteoblasts migrate

Bone Fractures-Healing – 3) The boney callus is formed • Osteoclasts and osteoblasts migrate to the area and multiply – Osteoclasts destroy the fibrocartilage callus – Fibrocartilage callus is replaced by spongy bone by osteoblasts

Blast from the past…. . • So let’s get this straight… – When our

Blast from the past…. . • So let’s get this straight… – When our bones break, we form a cartilage patch around the site – Later, this patch is then converted into bone – WHERE HAVE WE SEEN THIS BEFORE? ? ? • Bone formation occurs the same way • What was that process called, again? – Endochondral ossification

Bone Fractures-Healing – 4) Bone remodeling occurs • Occurs in the next few weeks

Bone Fractures-Healing – 4) Bone remodeling occurs • Occurs in the next few weeks or months depending on bone’s size and site of break • Callus is remodeled in response to mechanical stress • Results in a strong, permanent “patch” at the fracture site

Question • Are bones stronger at the fracture site than a non-fracture site? –

Question • Are bones stronger at the fracture site than a non-fracture site? – NO! • Temporarily, this might be true. When your bone is in a cast, the break area is reinforced. However, the rest of the bone is immobilized so begins to atrophy since it is not in use. • Since remodeling is a continuous process based on the stress the bones receive, eventually they will become equal once the cast is removed

Another look at FOP • The body interprets everything as a bone break so

Another look at FOP • The body interprets everything as a bone break so this process occurs at inappropriate places for those with FOP