Bonefracture 091120114305-phpapp02

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Bonefracture 091120114305-phpapp02

  1. 1. FACTORS AFFECTING<br />BONE <br />FRACTURE<br />HEALING<br />PRESENTED BY<br />PRATHMA<br />B Ph T 2NDYEAR<br />PGIMER<br />
  2. 2. INTRODUCTION<br />A bone fracture is a medical condition in which there is a break in the continuity of the bone. <br />It is sometimes abbreviated FRX or Fx, Fx, or #.<br />2<br />
  3. 3. CAUSES OF BONE FRACTURE<br /> Fractures occur when bone cannot withstand those outside forces. Broken bones hurt for a variety of reasons including: <br />The nerve endings that surround bones contain pain fibers and these fibers become irritated when the bone is broken or bruised.<br />Broken bones bleed, and the blood and associated swelling (edema) causes pain.<br />Muscles that surround the injured area may go into spasm when they try to hold the broken bone fragments in place, and these spasms cause further pain.<br />3<br />
  4. 4. CLASSIFICATION<br />Based On The Extent Of The Break<br />1.     Complete fracture<br />2.     Incomplete fracture<br />4<br />
  5. 5. 1.     Open fracture(compound fracture)<br />2.     Closed fracture(simple fracture)<br />CLASSIFICATION<br />Based On The Extent Of Soft-tissue Damage<br />5<br />
  6. 6. 1. A stable fracture (non displaced fracture)<br />2. An unstable fracture (displaced fracture)<br />CLASSIFICATION<br />Based On The Anatomic Alignment Of The Bone<br />6<br />
  7. 7. CLASSIFICATION<br />Based On The Direction Of The Fracture Line<br />1.     Greenstick fracture<br />2.     Transverse fracture<br />3.     Oblique fracture<br />7.     Compression fracture<br />5.     Comminuted<br />(fragmented) fracture<br />6.     Impacted fracture<br />4.     Spiral fracture<br />7<br />
  8. 8. Pain<br /> Although bone tissue itself contains no nociceptors, bone fracture is very painful for several reasons:<br />Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple nociceptors.<br />Edema of nearby soft tissues caused by bleeding of torn periosteal blood vessels evokes pressure pain.<br />Muscle spasms trying to hold bone fragments in place<br />8<br />
  9. 9. BONE HEALING<br />The process of fracture/bone healing:<br />A hematoma is formed. Blood vessels are ruptured when bone breaks. As a result, a blood-filled swelling forms. Bone cells are deprived of nutrition and die.<br />
  10. 10. BONE HEALING<br />2) the break is splinted by a fibrocartilage callus. <br />Connective tissue cells of various types form a mass of<br /> Repair tissue called fibrocartilage callus <br />(containing cartilage matrix, bony matrix, and collagen fibers)<br /> Which act to “splint” the broken bone, closing the gap.<br />
  11. 11. BONE HEALING<br />3) A bony callus is formed. Osteoblasts and osteoclasts migrate to<br />the area and multiply. Thus the fibrocartilage callus is gradually<br />replaced by one made of spongy bone, known as the bony callus.<br />
  12. 12. BONE HEALING<br />4) Lastly, bone remodeling occurs. Over the next few weeks<br />to months, the bony callus is remodeled in response to mechanical<br />stresses placed on it, so that it forms a strong permanent (bone) patch at the fracture site.<br />
  13. 13. TREATMENT OF BONE FRACTURE<br />The types of treatment include: <br />closed reduction <br />traction <br />open reduction and internal fixation <br />external fixation <br />casts and splints and <br />functional casts or braces <br />13<br />
  14. 14. Therapeutic Implications for Treating Fractures<br />Active ROM exercises to joints above and below immobilized region<br />Resistive ROM exercises to muscle groups that are not immobilized<br />Once the cast or immobilization device has been removed:<br />gentle but progressive resistance exercises of all immobilized joints<br />evaluate strength of joint(s) and compare to non-injured counterparts<br />return to vigorous activity only after strength discrepency< 15%<br />
  15. 15. Factors Enhancing Bone Healing<br />Youth<br />Early Immobilization of fracture fragments<br />Maximum bone fragment contact<br />Adequate blood supply<br />Proper Nutrition<br />Vitamines A&D<br />Weight bearing exercise for long bones in the late stages of healing<br />Adequate hormones:<br />growth hormone<br />thyroxine<br />calcitonin<br />
  16. 16. Factors Inhibiting Bone Healing<br />Age<br />Fractured Femur Healing Time<br />infant: 4 weeks<br />teenager: 12 to 16 weeks<br />60 year old adult: 18 to 20 weeks<br />Extensive local soft tissue trauma<br />Bone loss due to the severity of the fracture<br />Inadequate immobilization (motion at the fracture site)<br />Infection<br />Avascular Necrosis<br />
  17. 17. CONCLUSION<br />17<br />
  18. 18. 18<br />THANKS<br />

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