Introduction to bone fracture

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introduction to bone fracture, pathology, fracture types, bone healing, and treatment.


<ul><li> 1. INTRODUCTION TOBONE FRACTURESuheab A. Maghrabi, MBBS, MSc.Teaching Assistant, Orthopaedic Department,College of Medicine, University of Hail,Hail, Saudi Arabia.</li></ul> <p> 2. Definition A bone fracture is a break inthe structural continuity ofbone. 3. Pathology of bone fracture Single highly stressful traumatic incident . Repetitive stress of normal degree leading to mechanicalfailure Normal stress acting on an abnormally weakened bone(pathological fracture). 4. Types of bone fracture Complete, two or more fragments 5. Cont. Incomplete: Greenstick, in the pediatric age group. Due to thicker periosteum and softer bone. Stress fracture Compression fracture. 6. Cont. Physeal fracture Fracture through the physis(growth plate). Need special care. Can result in growth arrest. 7. Bone healing With-callus (secondary healing):1. Tissue destruction and hematoma development.2. Inflammation and cellular proliferation.3. Callus formation. Contains osteoprogenic, osteoclast, osteoblast, and chodroprogeniccells. Development of immature bone (woven).4. Consolidation. Woven bone turn into lamellar bone.5. Remodeling. 8. Cont. Without-callus (primary healing): Cutting cone mechanism. 9. Factors affecting bone healing Mechanical stability. Blood supply. Patient general health. Age. 10. Principle of fracture treatment REDUCE, HOLD, EXERCISE. Aim of reduction: Adequate apposition. Normal alignment. Restore length. 11. Cont. Reduction methods:1. Manipulation: Minimal displacement, most of children fracture. Stages: Pulling distal fragment (dis-impaction). Reverse the original direction of the deforming force. Alignment adjustment.2. Mechanical traction: Either until union or till the operation. e.g. Shaft of femur. 12. Cont.3. Open reduction, indications: Fail of closed reduction. Articular fracture. Avulsion fracture. Neurovascular injury. Pathological fracture. Unstable fracture. Multiple fractures. Poor healing potential. 13. Cont. HOLD. Methods: Cast/ splint. Internal fixation wires Screws Plates and screws IM Nail External fixation Ring and pins. Sever soft tissue damage. Sever comminuted fracture. Pelvic and open fractures. 14. Open fracture Bone Fracture with open wound. Gastilo classification I, less than 1cm, low energy, clean wound. II, more than 1cm, medium energy, clean wound. III, high energy, extensive soft tissue loss, vascular injury IIIA, minimum soft tissue damage IIIB, soft tissue damage and periosteal stripping. IIIC, vascular injury Treatment Wound debridement Prophylactic antibiotic Stabilization of fracture Early definitive wound care. 15. Thank you </p>


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