Fractures & complications

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Patho 305

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  • comminuted fracture > 1 fracture line & > 2 bone fragmentsgreenstick fracture incomplete break
  • Fractures & complications

    1. 1. Fractures & Complications
    2. 2. Fracture
    3. 3. Healing Process1. Hematoma  cortical bone fracture results in torn blood vessels within haversian system2. Granulation  clotting at fracture site3. Pro callus  avascular bone replaced by living bone via resorption & bone deposition4. Callus formation (splint)  new bone formation at edges of periosteum5. Remodeling  replacement of mature lamellar bone
    4. 4. Healing Process (Cont.)
    5. 5. Soft-Tissue Healing After Trauma  Disruption of circulatory & lymphatic systems; hemorrhage, fluid loss, cell death  Norepinephrine  Vessel constriction  Serotonin & platelets  Prolong vasoconstriction  Histamine  Vasodilation  Increased permeability of venules
    6. 6. Bone Healing Complications Infection Delayed healing  delayed union, malunion, or nonunion Fat emboli Osteoarthritis Soft tissue complications  Musclespasm  Neurovascular injury  Compartment syndrome
    7. 7. Bone Infection- Osteomyelitis  Hematogenous osteomyelitis  Infection (Staph aureus) elsewhere in body- introduced into blood then bone Etiology  Burns, CA tumor necrosis, sinus, periodontal or pressure ulcer infection  Direct infection rt  openfracture, penetrating wounds, surgical contamination, or prostheses insertion
    8. 8. Compartment Syndrome Vessels & nerves lie between muscles (compartment) & compressed  reduces capillary flow  muscle & nerves ischemic Etiology External compression- casts Decreased internal space  IVinfiltration  Crush injuries / bleeding/ tissue swelling
    9. 9. Acute Compartment Syndrome S&S Complications Pain  Permanent loss of Paresthesia/paralysis function Pallor  Limb contracture Pulselessness  Necrosis Poikilothermia

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