NURS113 Lecture Notes - Lecture 21: Vertebral Compression Fracture, Pathologic Fracture, Epiphyseal Plate
14 Jun 2018
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UNIT 9: BONE INJURIES AND METABOLIC BONE DISEASES
Osteoblasts = build bones
- Using the calcium in order to make bone
Osteoclasts = cut down bones
- Take away bone mass and release calcium
Fracture pathophysiology
- Break in continuity of a bone, epiphyseal plate or cartilaginous joint
(abbreviated as a HASHTAG #)
- Bone integrity is broken
- Periosteum and blood vessels are disrupted
- Can easily leave to ischemia or infarction of the
surrounding tissue
- Bleeding, followed by hematoma formation (swelling)
- Adjacent bone tissue dies
- So when you have dead tissue you start the inflammation
process all over again; a continuous process.
- Dead tissue stimulates inflammation
- What makes fractures so painful: there are nerves outside of the bone that causes a lot of pain
Signs and symptoms of a fracture
- Pain and tenderness at the site of bone disruption
- Edema
- Loss of function
- Deformity at the affected part
- Abnormal mobility
Classifications of fractures
- By cause
- Acute (sudden) injury
- Chronic
- Overuse (stress)
- Athletes, dancers, obesity
- Pathological fractures
- Bone is weakened by a disease or a tumour (decrease in bone mass or there is a
disease process)
- Eg: osteoporosis
- By direction
- Transverse (so literally just in half; perpendicular to the bone)
- Oblique (split sideways one fracture that goes along a
diagonal)
- Spiral (spiral type of cracking; goes all the way around the
bone like a twisting motion)
- Type or nature of the fracture
- simple/closed
- Compound/opened
- Complete or incomplete
- Displaced or non-displaced
- Comminuted
- When it is fractured and broken into more than 2
fragments
- Compression or depression
- Impacted
- Greenstick
- Typically in children; one side is broken and one side is bent
Simple/closed fracture
- Bone breaks cleanly, but does not penetrate the
skin (so it’s a “closed” wound)
- Sometimes just called a “closed fracture”
Compound/open fracture
- So when broken ends of the bone protrude through the soft
tissues and skin
- More serious than a simple fracture; may result in bone
infection (osteomyelitis)
- Basically, your bone has broken so much that the bone protrudes OUTSIDE; so it is an OPEN
wound now and you can see the bone protruding from the inside
Types of fractures (cont’d)
- Nondisplaced
- Fragments remain in alignment and position
- So it’s just broken and cracked in the
middle, but the fragments are still together
- Displaced
- Ends of the fracture fragments are separated
- Complete
- Breaks through the entire bone (so it cracks
through the entire diameter of the bone)
- Incomplete
- Only breaks through a little portion or half of the bone
→ not completely all around yet
- Does not break through entire bone
In this photo, you can see for the incomplete fracture it is still not
completely a fracture for the incomplete one, as the two fragments are
not displaced (still sort of connected together) →
Comminuted fracture
- Bone fragments break, splinter or crushed into many little pieces
- Sharp, thin fragments called splinters
- Common in the aged, as bones are more brittle, so if you fracture the
brittle bones shatter easily into small little parts (you can have a lot of tissue
damage as well)
Compression fracture
- Bone is crushed (just completely crushed; whereas
comminuted is that it just breaks into little splinters
so little pieces)
- Spinal compression fractures occur at T11 -
L1
- Too much downward pressure on the
vertebral body; part of the vertebral body
becomes a wedge
- Common in porous bones as a result of osteoporosis
Depression fracture
- Broken bone portion is pressed
inward
- Typical of skull fractures
Document Summary
Unit 9: bone injuries and metabolic bone diseases. Using the calcium in order to make bone. Break in continuity of a bone, epiphyseal plate or cartilaginous joint (abbreviated as a hashtag #) Can easily leave to ischemia or infarction of the surrounding tissue. So when you have dead tissue you start the inflammation process all over again; a continuous process. What makes fractures so painful: there are nerves outside of the bone that causes a lot of pain. Pain and tenderness at the site of bone disruption. Bone is weakened by a disease or a tumour (decrease in bone mass or there is a disease process) Transverse (so literally just in half; perpendicular to the bone) Oblique (split sideways one fracture that goes along a diagonal) Spiral (spiral type of cracking; goes all the way around the bone like a twisting motion) When it is fractured and broken into more than 2 fragments.
