Professional Documents
Culture Documents
14 Fractures PDF
14 Fractures PDF
DEFINITION
Is a structural loss of continuity in the surface of the bone produced by forces
exceeding the modulus elasticity of the bone.
EPIDEMIOLOGY:
M=F
Greenstick Fxchildren are most likely affected
Pathologic Fx elderly 60-70 y/o; f>m over 90 y/o
ETIOLOGY:
PATHOLOGIC FRACTURE
Occur in bones weakened by pre-existing disease such as tumors, cysts, or
osteomyelitis.
TRAUMATIC FRACTURE
EXTERNAL CAUSATIVE FACTORS
1. Violence /Trauma- the bone is normal and the causative force maximal
Direct Violence- Fx due to blows or falls to which break occurs at the
point of impact with the ground or object.
Indirect Violence- occurs when the force is transmitted to the bone
through some parts of the body.
INTERNAL CAUSATIVE FORCES
1. Muscular action- ex. Fx in the patella due to a sudden contraction of the
quadriceps; Fx of the arm in throwing a ball or Fx of the humerus of women
wringing clothes.
PATHOMECHANICS OF A FRACTURE
The energy imposed on the human body by the forces of impact must be
absorbed by non-injury producing methods. The principal energy absorbing
mechanism in the body is a lengthening contraction of muscle.
Therefore, strong muscles provide good protection from fracture. Energy can
also be absorbed by protective gear such as helmets, pads, etc. but these along are
inadequate to absorb the entire force of an impact. Load is transmitted through these
protective materials and absorbed in part by the body‟s own padding in the form of
muscle bulk, fats, bone and cartilage. If the energy at the time of impact is greater than
what can be absorbed by protective gear or lengthening contractions. Injury occurs first
to the soft tissue(bruise, strain) and then to bone or ligaments(fracture)
PATHOPHYSIOLOGY
In fracture, the actual damage to the bone consist of a break in the continuity
which results in damage to blood and lymphatic vessels. The periosteum will be
stripped off on the region of the injury and sometime it is torn but since it is a tough
fibrous membrane, it may remain intact. An intact periosteum is essential because it
traps the blood from the ruptured vessels that is essential from hematoma formation
needed in the repair process. Due to sharp edges of the broken bone or the force
impacted upon the body part, there are the damages on the surrounding soft tissue like
the torn muscle, muscle tearing of the fascia and other connective tissues, ruptured
blood vessels and considerable extravation of blood take place. Tissue debris and
blood clots as irritants and an inflammatory reaction occurs, neighboring small vessels
dilate and hyperemia results and the area affected is invaded by inflammatory cells.
Some salts are absorbed recalcification of the fracture bone ends may occur.
CLASSIFICATION OF FRACTURES
I. ACCORDING TO COMPLETENESS
1. Incomplete Fx- cortex is broken in the convexity of the curve whereas the
bone on the concave is bent.
Greenstik Fx-bone is bent and broken only part of the way through its shaft. Occur in
children at an age when bones are soft and pliable.
Fissured- a mere split of the bone without displacement of the fragments.
Perforating- there is a hole such as those made of bullets.
Interperoisteal Fx- Fx in which the periosteum is not disrupted.
156