Please enable JavaScript.
Coggle requires JavaScript to display documents.
Bone Fracture (Downstream Affects (Proper treatment for the patient will…
Bone Fracture
Downstream Affects
Proper treatment for the patient will be affected by his age, his diet, and the location of the fracture.
Age: Because the patient is young he will heal a bit quicker but it may be a bit longer than 3 months. Although this may be compounded by the way he eats going forward.
Location of the fracture: The location of the fracture described is his right elbow and upper arm on the right. I would say the location anatomically is the humerus. With the location of the fracture, it will be difficult for the patient because he will not be able to use his right arm for a while. Because the patient may accidentally try to use it at times, this could impact the healing time as well.
Diet: As long as the patient starts on a better diet when he is discharged home, his healing time may improve and help keep him stronger.
Fracture clinically described: Compound - displaced bone fracture I clinically described his injury like this because part of his bone is protruding from the skin. Because of this protrusion I say it is displaced because it is no longer in anatomical alignment.
Proper treatment for the patient's injury will include:
- Stop any bleeding that may be happening
- Immobilize the injury with a cast or splint to assist with pain and to stabilize the bone so it can start to properly heal.
- Apply ice to further assist with decreasing the amount of pain.
- Treat the patient for shock
Website used - https://www.mayoclinic.org/first-aid/first-aid-fractures/basics/art-20056641
Upstream Affects
Direct Cause - Is the 12 year old boy running and falling forward, landing on his right arm.
Indirect Cause - Is the 12 year old boy's diet. Even though he is lactose intolerant there are ways to still maintain a healthy diet in order to provide his bone with the correct nutrients so they grow strong.
Background
Physiology
How bones form, grow, and remodelFormation of bones: Ossification begins in the embryo and continues as the skeleton grows during childhood and adolescence.
- Ossification centers from within thickened regions of mesenchyme beginning at the eight week of development.
- Osteoid undergoes calcification.
- Woven one and its surrounding periosteum form.
- Lemellar bone replaces woven bone, as compact bone and spongy bone form.
Bone Growth: As with cartilage growth, a long bone's growth in length is called interstitial growth, and its growth in diameter or thickness is termed appositional growth. Interstitial growth is dependent upon growth of cartilage within the epiphyseal plate. The epiphyseal plate exhibits five distinct microscopic zones that are continuous from he first zone nearest the epiphysis to the last zone nearest he diaphysis. Growth in length is due to growth in hyaline cartilages connective tissue, which is later replaced with bone.Bone Remodeling: Even When adult bone size has been reached, the bone continues to renew and reshape itself throughout a person's lifetime. This constant, dynamic process of continual addition of new bone tissue and removal of old bone tissue is remodeling. How it occurs is with osteocytes, osteoblasts, and osteoclasts.A and P textbook used to come up with these answers.
The stages of bone healing
- A fracture hematoma forms. A bone fracture tears blood vessels inside the bone and within the periosteum, causing bleeding. This bleeding results in a fracture hematoma that forms from the clotted blood.
- A fibrocartilaginous (soft) callus forms. Regenerated blood capillaries infiltrate the fracture hematoma. First, the fracture hematoma is reorganized into an actively growing connective tissue called a procallus. Fibroblasts within the procuallus produce collagen fibers that help connect the broken ends of the bones. Chondroblasts in the newly growing connective tissue form a dense regular connective tissue associated with the cartilage. Eventually], the procallus becomes a fibrocartilaaginous (soft) callus. The fibrocartilaginous callus stage lasts at least 3 weeks.
- A hard (bony) callus forms. Within a week after the injury, osteoprogenitor cells in areas adjacent to the fibrocartilaginous callus become osteoblasts and produce trabeculae of primary bone. The fibrocartilaginous callus is then replaced by this bone, which forms a hard (bony) callus. The trabeculae of the hard callus continue to grow and thicken for several months.
- The bone is remodeled. Remodeling is the final phase of fracture repair. The hard callus persists for at least 3 to 4 months as osteoclasts remove excess bony material from both exterior and interior surfaces. Compact bone replaces primary bone. The fracture usually leaves a slight thickening of the bone (as detected by x-ray); however, in some instances, healing occurs with no persistent obvious thickening.
Taken from page 237 of my A and P text.
-
Anatomy
Anatomy of long bones from cells to organ level:
Cells: Osteoprogenitor cells, osteoblasts, osteocytes, and osteoclasts.
Tissue: Compact bone and spongy bone.
Organ: Long bone (I.e. the tibia)
The raw materials needed for bone growth and repair:Growth includes:
- Chondrocytes undergoing mitotic cell division.
- Hyaline cartilage.
- Calcium
Repair includes:
- Fracture hematoma
- Fibrocartilaginous (soft) callus
- Hard (bony) callus
The LOCATION of the epiphyseal plate: "It is a hyaline cartilage plate in the metaphysis at each end of a long bone." https://en.wikipedia.org/wiki/Epiphyseal_plate
The classification of bone fractures (All taken from Figure 7.16 from the A and P book.):
Avulsion - Complete severing of a body part (typically a toe or finger)
Colles - Fracture of the distal end of the lateral forearm bone (radius); produces a "dinner fork" deformity.
Comminuted - Bone is splintered into several small pieces between the main parts.
Complete - Bone is broken into two or more pieces.
Compound (open) - Broken ends of the bone protrude through the skin.
Compression - Bone is squashed (may occur in a vertebra during a fall.
Depressed - Broken part of the bone forms a concavity (as in a skull fracture)
Continuation of the bone fracture classification list:
Displaced - Fractured bone parts are out of anatomic alignment.
Epiphyseal - Epiphysis is separated from the diaphysis at the epiphyseal plate.
Greenstick - Partial fracture; one side of bone breaks-the other side is bent.
Hairline - Fine crack in which sections of bone remain aligned (Common in skull)
Impacted - One fragment of bone is firmly driven into the other.
Incomplete - Partial fracture extends only partway across the bone.
Linear - Fracture is parallel to the long axis of the bone.
Continuation of the bone fracture classification list:
Oblique - Diagonal fracture is at an angle.
Pathologic - Weakening of a bone caused by disease process (e.g., cancer)
Pott - Fracture is at the distal ends of the tibia and fibula.
Simple (closed) - Bone does not break through the skin.
Spiral - Fracture spirals around axis of long bone; results from twisting stress.
Stress - Thin fractures due to repeated, stressful impact such as running (these fractures often are difficult to see on x-rays, and a bone scan may be necessary to accurately identify their presence)
Transverse - Fracture is at right angles to the long axis of the bone.