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BONE FRACTURE INJURY. ((BONE FRACTURE CLASSIFICATION: (Greenstick -…
BONE FRACTURE INJURY.
BONE FRACTURE CLASSIFICATION:
Greenstick - Incomplete fracture. The broken bone is not completely separated.
Transverse - The break is in a straight line across the bone.
Spiral - The break spirals around the bone; common in a twisting injury.
Oblique - Diagonal break across the bone.
Compression - The bone is crushed, causing the broken bone to be wider or flatter in appearance.
Comminuted - The break is in three or more pieces and fragments are present at the fracture site.
Avulsion: Complete severing of body part.
Colles: Distal end of radius
Compound(Open): Broken ends of the bone protruding through the skin.
Complete: Bone is broken into two or more pieces.
Depressed: Broken part of the bone forms a concavity(skull fracture)
Displaced: Fractured bone part are part of anatomic alignment
Epiphyseal: Epiphysis is separated from the diaphysis at the epiphyseal plate
Hairline: Fine crack in which sections of bone remain aligned.
LONG BONE ANATOMY (CELL LEVEL)
OSTEOCLASTS: They break down bone through bone resorption.
ORGAN LEVEL
METAPHYSIS: A thin layer of hyaline cartilage that provides for continue lengthwise growth of the bone
EPIPHYSIS: Knobby region at each end of a long bone. (Proximal & Distal Epiphysis).
DIAPHYSIS: Provides for the leverage and major weight support of a long bone.
MEDULLARY CAVITY: In children, this cavity contains red bone marrow, yellow in adults.
ARTICULA CARTILAGE: This cartilage covers the joint surface of an epiphysis, it helps reduce friction and absorb shock in movable joint.
OSTEOPROGENITOR: are stem cells derived from mesenchyme they divide and produce osteoblast.
OSTEOBLAST: Sythensize & secrete initial semisolid organic form of bone matrix(Osteoid).
OSTEOCYTES: Maintain the bone matrix and detect mechanical stress on a bone.
COVERINGS&LININGS OF BONE
PERIOSTEUM: Covers a long bone externally.
ENDOSTEUM: Internally lines a long bone
BONE HEALING
Hematoma formation: Blood vessels in the broken bone tear and hemorrhage, resulting in the formation of clotted blood, or a hematoma, at the site of the break.
Bone generation: Within days of the fracture, capillaries grow into the hematoma, while phagocytic cells begin to clear away the dead cells.
formation of a fibrocartilaginous callus: The fibrocartilaginous callus is converted into a bony callus of spongy bone. It takes about two months for the broken bone ends to be firmly joined together after the fracture.
Bone remodeling: The bony callus is remodeled by osteoclasts and osteoblasts, with excess material on the exterior of the bone and within the medullary cavity being removed. Compact bone is added to create bone tissue that is similar to the original, unbroken bone.
BONE FORMATION,GROWTH, & REMODELING
BONE FORMATION: Ossification.
INTRAMEMBRANOUS OSSIFICATION:
Intramembranous ossification mainly occurs during the formation of the flat bones of the skull, as well as the mandible, maxilla, and clavicles. The bone is formed from connective tissue such as mesenchyme tissue rather than from cartilage.
Development of ossification center
Calcification
Formation of trabeculae
Development of periosteum
ENDOCHONDRAL OSSIFICATION: is essential for the formation of long bones, as well as short bones. This process also forms the ends of flat and irregular bones. It is also part of the process that lengthens long bones, as well as the natural healing of small bone fractures.
BONE GROWTH
INTERSTITIAL GROWTH:
ZONE OF RESTING CARTILAGE.
ZONE OF PROLIFERATING CARTILAGE.
ZONE OF HYPERTROPHIC CARTILAGE.
ZONE OF CALCIFIED CARTILAGE.
ZONE OF OSSIFICATION.
APPOSITIONAL GROWTH: Occurs within periosteum, osteoblasts in the inner cellular layer of the periosteum produce and deposit bone matrix within layers parallel to the surface, called external circumferential lamellae
BONE REMODELING: Bone deposition (Continual addition of new bone tissue) and Bone resorption (removal of old bone tissue)
Normal bone growth requires vitamins D, C, and A, plus minerals such as calcium, phosphorous, and magnesium. Hormones such as parathyroid hormone, growth hormone, and calcitonin are also required for proper bone growth and maintenance.
EPIPHYSIS PLATE: Found in the boundary between the diaphysis and epiphysis, a thin layer in the hyaline cartilage that provide for the continued lengthwise of the bone
Calcium and, iodine, potassium, phosphorus and vitamins D, B2 and B12, periosteal chondrocytes, and osteoblasts, osteocytes, and osteoclast are needed for bone growth and repair.
An Open Fracture injury of a broken right elbow and part of the upper arm bone protruding from the skin which was obtained when running, falling forward and landing on right arm with signs of fragments in the wound
Fracture repair might affect healing due to poor diet due to lack of calcium & vitamin D (require for bone growth.)
Crookedness, swelling, acute pain, an inability to move the elbow, and bruising
Fractures around the elbow often cause the arm to heal abnormally, resulting in a crooked position.
Because the child’s bones are still growing the growth plates that regulate future growth at the end of the bone would be damaged, If this part of the bone does not heal properly after the fracture, the bone may grow at an angle or more slowly than the other bones in the body.
Compound (open) fracture allow for bacteria to easily travel down to the broken bone and this can lead to infection.
May have a fever, chills, and night sweats. numbness and tingling in the hand or forearm.
Infection after a fracture may require trips to the operating room, long-term antibiotic treatment, & a long period of healing.
A surgical procedure would replace & stabilize the fragments or remove bone fragments, urgent surgery is needed to clean out the wound and bone to minimize the risk of infection.
The disruption of blood flow to the bone results in the death of bone cells around the fracture.
A 12 boy, who is lactose intolerant, and only consumes unhealthy food. There is a possibility of him being obese
Calcitriol (Vitamin D) and Parathyroid hormones play a crucial role in the maintenance of blood calcium and phosphorus levels and in normal skeletal mineralization.