Fractures

FRACTURES

Causes –

Trauma – blow to body, fall
Pathologic – if a bone is weakened, fracture may be pathologic, consisting of a collapse of the bone – osteoporosis, bone cancer
Stress – if there is usual or repetitive force on a bone because of excessive muscle usage or strain, a stress fracture may occur – seen in athletes

Prevention:

Accident prevention – hand rails, no throw rugs, obstacles on floor, education concerning automobile safety, protective sports equipment

Avoid osteoporosis – small framed, non-obese, white females most at risk; contributing factors – diet low in calcium throughout life, smoking, excessive coffee intake, high protein diet, sedentary life style

Types of fractures:

Complete – complete separation of the bone, two fragments
Incomplete – only part of the bone is broken; not broken into two fragments
Simple – skin over break is intact
Compound or open – communication between skin wound and fracture site; high risk of contamination and infection
Fracture without displacement – bone ends in good alignment
Fracture with displacement – bone segments separated at the point of fracture
Greenstick – splintering on one side of the bone (young children)
Transverse – break straight across the bone
Oblique – line of fracture angled across bone
Spiral – fracture line partially encircling the bone
Telescoped or impacted – bone ends jammed together
Comminuted – several bone fragments

Healing of Fractures –

Immobilization is necessary for healing

Bone heals during a process called callus formation, in which new blood vessels are formed, dead bone is reabsorbed, new bone matrix is laid down and becomes filled with calcium;   this area of healing, the new bone is called the callus.

Process of healing:

Hematoma forms – bone is vascular; blood collects in the periosteal sheath; fastens the broken ends together
Fibrin meshwork – further clot formation
Invasion of osteoblasts – invade the fibrin, make it firm;... [continues]

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