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Bone Fracture injury (Background (Fracture classifications (Complete (Bone…

- - - - Bone is broken in two or more pieces
    - - Broken ends of the bone protrude through the skin
    - - Bone is splintered into several small pieces between the main parts
    - - Bone is squashed (may occur in a vertebrae during a fall)
    - - Fracture of distal end of the lateral forearm bone (radius) ; produces a "dinner fork" deformity
    - - Broken part of the bone forms a concavity
    - - Complete severing of body part
    - - Fractured bone parts are out of anatomic alignment
    - - Epiphysis is separated from the diaphysis at the epiphyseal plate
    - - Partial fracture; one side of bone breaks - the other side is bent
    - - Fine crack in which sections of bone remain aligned (common in skull)
    - - One fragment of bone is firmly driven into the other
    - - Partial fracture extends only partway across the bone
    - - Fracture is parallel to the long axis of the bone
    - - Diagonal fracture is at an angle
    - - Weakening of a bone caused by disease process
    - - Fracture is at the distal ends of the tibia and fibula
    - - Bone does not break through the skin
    - - Fracture spirals around axis of long bone; results from twisting stress
    - - Thin fractures due to repeated, stressful impact such as running (often difficult to see on x-rays, bone scan may be necessary.
    - - Fracture is at right angles to the long axis of the bone
  - - - The Metaphysis of long bones
    - - Be cartilage until it ossifies and becomes the epiphyseal line and connects to the epyphysis
  - - - Calcitriol
        
        Promotes calcium and phosphate ion absorption along the digestive tract
      - Thyroxine
        
        with growth hormone, stimulates osteoblast and the synthesis of bone matrix
      - Growth Hormone (aka Somatotropin)
        
        stimulates osteoblast activity and the synthesis of bone matrix
      - Sex Hormones
        
        stimulate osteoblast activity and the synthesis of bone matrix; estrogens stimulate epithyseal closure earlier than androgens
      - Parathyroid Hormone
        
        Stimulates osteoclasts (and osteoblasts) activity; elevates calcium ion concentration in bodily fluids
      - Calcitonin
        
        inhibits osteoclast activity; promotes calcium loss by kidneys; reduces calcium ion concentrations in bodily fluids.
    - - Depends on cartilage growth within the epiphysial plate
      - Zones
        
        Zone 2
        
        Proliferating cartilage
        
        chondrocytes undergo mitotic cell division
        
        align into longitudinal columns of flattened lacunae
        
        sit parallel to the diaphysis
        
        Zone 3
        
        Hypertrophic cartilage
        
        Chondrocytes stop dividing, hypertrophy, and resorb matrix
        
        Zone 1
        
        Resting Cartilage
        
        Made up of chondrocytes
        
        Resembled mature hyaline cartilage
        
        Nearest the epiphysis
        
        secures epiphysis to epiphyseal plate
        
        Zone 4
        
        Calcified cartilage
        
        minerals deposit in the matrix between lacunae columns
        
        calcification destroys chondrocytes
        
        Zone 5
        
        Ossification
        
        walls between lacunae break down
        
        form longitunal channels that will be occupied by capillaries and osteoprogenitor cells
      - Growth is noted once hyaline cartilage is lost and an epiphyseal line is present
    - - Bone continues to add new bone
      - remove old bone at the peristeal and endosteal surfaces of bone
      - Weight bearing exercises and movement required
  - - - Articular cartilage
        
        made of hyaline cartilage
    - - Nutrient artery through nutrient foraman
      - Perforating fibers
      - Periosteum
        
        Osteocyte
        
        Cellular layer
        
        Fibrous layer
        
        Perforating fibers
        
        Dual layer tough outer sheath
      - Endosteum
        
        Osteocyte
        
        Osteoclast
        
        Nuclei
        
        Osteoblasts
        
        Osteoprogenitor cell
      - Spongy Bone
      - Compact Bone
      - Medullary Cavity
        
        Yellow bone marrow (adult)
        
        Formed from the degeneration of red bone marrow into a fatty substance
        
        Red bone marrow
        
        forms blood cells
        
        made of reticular connective tissue
        
        made of immature blood cells and fat
      - Elongated and cylindrical shaft
      - Provide support and leverage to soft tissues in the limbs
    - - Epiphyseal Line
        
        Thin layer of compact epiphyseal plate bone
    - - Articular cartilage
      - Spongy bone
  - - - aka dermal ossification
      - produces flat bones, some facial bones, the mandible, and the central part of the clavicle
      - at 8th week of development ossification centers form in thickened regions of mesenchyme and
        osteoblast numbers increase.
      - Osteoid calcification occurs when calcium salts are deposited onto the osteoid and crystallize or solidify
      - Woven bone, or primary bone, and periosteum form
      - immature woven bone is replaced by more mature lamellar or
        secondary bone.
      - Compact bone formed by filling spaces between trabeculae, spongy bone is formed by the slight
        modification of trabeculae.
    - - produces most bones of the skeleton and begins with the development of the fetal hyaline
        cartilage model.
      - chondroblasts secrete cartilage matrix
      - chondrocytes become trapped within
        lacunae
      - perichondrium surrounds the cartilage
      - During the fetal period cartilage calcifies
      - periosteal bone collar forms around the diaphysis
      - blood vessels grow toward
        the cartilage and start to penetrate the perichondrium
      - primary ossification center forms in the diaphysis
      - During the formation of the primary ossification center, capillary and
        osteoblast growth occurs, called a periosteal bud
      - Secondary ossification centers form from a process by which hyaline cartilage in the center of each epiphysis calcifies
        and begins to degenerate.
- - - - risk of infection
    - - tearing of blood vessels
  - - - Open wound
        
        Risk of infection
      - damage to muscles
- - - - weakened bones
        
        fragile/ easily broken
  - - - malnutrition
        
        lack of calcium and other important vitamins
        
        Inability to repair bone quickly and efficiently