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• http://www.iviewtube.com/v/95345/lt-breaks-joe-theisman's-leg-in-nfl-game
• http://www.viddler.com/explore/clint357/videos/264/
• http://www.ibeatyou.com/competition/08ff2b/worst-bone-break
Bone Fractures (Breaks)
• Bone fractures are classified by:
• The position of the bone ends after fracture
• Completeness of the break
• The orientation of the break to the long axis
• Whether or not the bones ends penetrate the skin
Typical Bone Fractures – General Classification
• Open Fracture – bone breaks through the skin, or at least causes a surface wound (bone may not break through skin)
• Closed Fracture – bone break occurs without causing damage to the skin
Typical Bone Fractures – General Classification
• Complete fracture: A fracture in which bone fragments separate completely.
• Incomplete fracture (greenstick): A fracture in which the bone fragments are still partially joined
Typical Bone Fractures - Specific Classification
Classified by direction of break / fracture line
• Linear fracture: A fracture that is parallel to the bone's long axis.
• Transverse fracture: A fracture that is at a right angle to the bone's long axis.
• Oblique fracture: A fracture that is diagonal to a bone's long axis.
• Spiral fracture: A fracture where at least one part of the bone has been twisted.
Typical Bone Fractures
• Linear fracture
• Transverse fracture
Classified by direction of break / fracture line
Typical Bone Fractures
• Oblique (diagonal) Fracture
• Spiral Fracture
Classified by direction of break / fracture line
More Bone Fractures• Simple fractures are
fractures that only occur along one line, splitting the bone into two pieces
•multi-fragmentary or comminuted fractures involve the bone splitting into multiple pieces
More Bone Fractures
• compression fracture usually occurs in the vertebrae, for example when the front portion of a vertebra in the spine collapses
More Bone Fractures
• An avulsion fracture is an injury to the bone in a place where a tendon or ligament attaches to the bone.
• When an avulsion fracture occurs, the tendon or ligament pulls off a piece of the bone.
More Bone Fractures• A stress fracture occurs
when the forces are much lower, but happen repetitively for a long period of time; these injuries are also known as "fatigue fractures."
• Stress fractures are commonly seen in athletes who run and jump on hard surfaces, such as distance runners, volleyball players, and ballet dancers.
Stages in the Healing of a Bone Fracture
• Hematoma formation
• Torn blood vessels hemorrhage
• A mass of clotted blood (hematoma) forms at the fracture site
• Site becomes swollen, painful, and inflamed
Figure 6.13.1
Stages in the Healing of a Bone Fracture
• Fibrocartilaginous callus forms
• Granulation tissue (soft callus) forms a few days after the fracture
• Capillaries grow into the tissue and phagocytic cells begin cleaning debris
Figure 6.13.2
Stages in the Healing of a Bone Fracture
• Bony callus formation
• New bone trabeculae appear in the fibrocartilaginous callus
• Fibrocartilaginous callus converts into a bony (hard) callus
• Bone callus begins 3-4 weeks after injury, and continues until firm union is formed 2-3 months later
Figure 6.13.3
Stages in the Healing of a Bone Fracture
• Bone remodeling
• Excess material on the bone shaft exterior and in the medullary canal is removed
• Compact bone is laid down to reconstruct shaft walls
Figure 6.13.4
Treatment of Bone Fracture
• In order for a fracture to heal as well as possible, a good reduction, or placement, of the bones must be attained.
• When doctors talk about reduction of a fracture, or reducing the broken bone, they are talking about improving the alignment of the broken ends of the bone.
Reduction of a Fracture
• In most cases reducing a fracture involves placing the broken bone in a cast, often after a little pulling and tugging to achieve improved alignment.
• If the reduction cannot be satisfactorily achieved surgery may be necessary (fixation of the bone with pins, plates, screws or rods).
Homeostatic Imbalances
• Osteomalacia
• Bones are inadequately mineralized causing softened, weakened bones
• Main symptom is pain when weight is put on the affected bone
• Caused by insufficient calcium in the diet, or by vitamin D deficiency
Homeostatic Imbalances
• Rickets
• Bones of children are inadequately mineralized causing softened, weakened bones
• Bowed legs and deformities of the pelvis, skull, and rib cage are common
• Caused by insufficient calcium in the diet, or by vitamin D deficiency
Homeostatic Imbalances
• Osteoporosis
• Group of diseases in which bone reabsorption outpaces bone deposit
• Spongy bone of the spine is most vulnerable
• Occurs most often in postmenopausal women
• Prevented or delayed by sufficient calcium intake and weight-bearing exercise
Paget’s Disease
• Characterized by excessive bone formation and breakdown
• Pagetic bone with an excessively high ratio of cancellous to compact bone is formed
• Pagetic bone, along with reduced mineralization, causes spotty weakening of bone
• Osteoclast activity wanes, but osteoblast activity continues to work
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