Traumatology

13 important questions on Traumatology

What is the definition of a fracture?

Loss of continuity in the substance of a bone

What are causes of a fracture

External or internal force:
- direct: kick, bullet
- indirect: fall on extended hand
- own muscles: epileptic insult, sports

What are the different types of fractures?

- Impression fractures
- Hairline fractures
- Greenstick fractures
- Simple fractures
- Multifragmentary fractures
- Intra-articular
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What are characteristics of hairline fractures?

- Minimal trauma
- No significant displacement
- Difficult to detect on Xray (e.g. stress fractures)

What are characteristics of greenstick fractures?

- Children
- Tearing of periosteum
- Rapid healing

What are types of simple fractures?

1. transverse
2. Oblique
3. Spiral

What are types of multifragmentary fractures

1. Spiral wedge
2. Bending wedge
3. Fragmented wedge
4. Complex spiral
5. Complex segmented
6. Irregular

What are different types of dislocation?

- Dislocatio ad axim
- Dislocatio ad latitudinem
- Dislocatio ad longitudinem (cum distractione, cum contractione)
- Dislocation ad peripheriam   (turn)

What are the stages of fracture healing?

Inflammation phase
Reparation phase
Remodeling phase

What happens during the inflammation stage of fracture healing? (Day 1-3)

Haematoma
Necrosis
Inflammation mediators
           - Vascular dilatation
           - Acute oedema
           - Inflammatory cells, macrophages, lymphocytes
Necrosis and exudate removed
Fibroblasts

What happens during the granulation phase (3-4 weeks)

Fibroblasts
Collagen
Capillaries
Mineral deposits
Osteoprogenitor cells (periosteum)
--> Soft callus     


12-15 days:
- Intramembranous bone formation
- Cartilage

21 days:
- Endochondral bone formation
- Calcium
- Woven bone
- Osteoclasts
--> Hard callus

What happens during the remodeling phase (months to years)

From woven to lamellar bone

What aspects are necessary for bone healing?

- Matrix
- Messenger proteins
- Stem cells
- Relative immobilisation
- Vascularisation

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