This document provides an overview of musculoskeletal fractures, including:
1. It discusses the stages of fracture healing, classifications of fractures, and factors that can affect healing like smoking or diabetes.
2. The normal timescales for fracture healing are outlined in 5 stages from inflammation to remodeling, taking 6-8 weeks for bone to become secure.
3. Principles of fracture management include reduction, immobilization, and rehabilitation. Methods of stabilization range from splints to casts to internal or external fixation devices.
4. Potential complications of fractures are also reviewed from immediate issues like blood vessel injury to late issues like malunion, nonunion, or avascular necrosis.
Read Human Physiology PDF by Stuart Fox Online eBook - Published by McGraw-Hill Higher Education ISBN: B078SSXZDG. Listen to Human Physiology AUDIOBOOK from Stuart Fox / McGraw-Hill Higher Education . SUMMARY : #1 selling text with great explanations and just enough anatomy!Clear explanations and a solid learning framework have been market tested and refined. Fox helps students master the fundamentals by providing appropriate anatomical detail.Human Physiol.. PDF Human Physiology epub, McGraw-Hill Higher Education Bestseller author Stuart Fox
The geologic time scale, or geological time scale, (GTS) is a representation of time based on the rock record of Earth. It is a system of chronological dating that uses chronostratigraphy (the process of relating strata to time) and geochronology (scientific branch of geology that aims to determine the age of rocks). It is used primarily by Earth scientists (including geologists, paleontologists, geophysicists, geochemists, and paleoclimatologists) to describe the timing and relationships of events in geologic history. The time scale has been developed through the study of rock layers and the observation of their relationships and identifying features such as lithologies, paleomagnetic properties, and fossils. The definition of standardized international units of geologic time is the responsibility of the International Commission on Stratigraphy (ICS), a constituent body of the International Union of Geological Sciences (IUGS), whose primary objective[1] is to precisely define global chronostratigraphic units of the International Chronostratigraphic Chart (ICC)[2] that are used to define divisions of geologic time. The chronostratigraphic divisions are in turn used to define geochronologic units.[2]
While some regional terms are still in use,[3] the table of geologic time presented in this article conforms to the nomenclature, ages, and color codes set forth by the ICS as this is the standard, reference global geologic time scale – the International Geological Time Scale.[1][
Read Human Physiology PDF by Stuart Fox Online eBook - Published by McGraw-Hill Higher Education ISBN: B078SSXZDG. Listen to Human Physiology AUDIOBOOK from Stuart Fox / McGraw-Hill Higher Education . SUMMARY : #1 selling text with great explanations and just enough anatomy!Clear explanations and a solid learning framework have been market tested and refined. Fox helps students master the fundamentals by providing appropriate anatomical detail.Human Physiol.. PDF Human Physiology epub, McGraw-Hill Higher Education Bestseller author Stuart Fox
The geologic time scale, or geological time scale, (GTS) is a representation of time based on the rock record of Earth. It is a system of chronological dating that uses chronostratigraphy (the process of relating strata to time) and geochronology (scientific branch of geology that aims to determine the age of rocks). It is used primarily by Earth scientists (including geologists, paleontologists, geophysicists, geochemists, and paleoclimatologists) to describe the timing and relationships of events in geologic history. The time scale has been developed through the study of rock layers and the observation of their relationships and identifying features such as lithologies, paleomagnetic properties, and fossils. The definition of standardized international units of geologic time is the responsibility of the International Commission on Stratigraphy (ICS), a constituent body of the International Union of Geological Sciences (IUGS), whose primary objective[1] is to precisely define global chronostratigraphic units of the International Chronostratigraphic Chart (ICC)[2] that are used to define divisions of geologic time. The chronostratigraphic divisions are in turn used to define geochronologic units.[2]
While some regional terms are still in use,[3] the table of geologic time presented in this article conforms to the nomenclature, ages, and color codes set forth by the ICS as this is the standard, reference global geologic time scale – the International Geological Time Scale.[1][
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The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. Learning Outcomes
By the end of this lecture you should be able to
discuss:
• the healing process in bone.
• classifications of fracture.
• the normal timescales for the stages of healing.
• factors that affect healing.
• In-hospital principles of management of fractures.
4. Functions and Composition of Bone
Tissue components
• 25% water
• 25% protein fibres
(notably collagen)
• 50% mineral salts
(Primarily Calcium
Phosphate)
• Strong yet lightweight
Functions
• Support and Protection
• Assist movement
• Mineral "bank" (Ca & Phosphate)
• Blood cell production - haemopoesis
(red marrow)
• Energy storage - adipose tissue
(yellow marrow)
5. Fracture healing: Stage 1
Blood vessels and
nerves are ruptured
Haematoma formation
Macrophages remove
dead cell tissue
6. Fracture healing: Stages 2 and 3
• Chondrocytes and
fibroblasts form ‘soft
callus’
• Fracture unites – stage 3
7. Fracture healing: Stage 4
• Hard callus formation and
consolidation
• Callus becomes mineralized
into woven bone
• Osteoblasts lay down bone
8. Fracture healing: Stage 5
• Remodeling
• Osteoclasts erode surface to
allow osteoblasts to lay
down further bone
• Callus is reshaped along
lines of stress
9. Fracture healing timescales
Stage Features Time
Inflammation Site protection & clearance
Healing process begins
0 – 2 weeks
Callus formation Scaffold for new bone
Soft hard
Fluffy opacity on x-ray
2 – 3 weeks
Union Bridging by cartilage / immature bone
Fracture stable but weak
4 – 6 weeks
Consolidation All callus replaced by bone
Immature bone lamellar bone
Bone secure
6 – 8 weeks
Remodelling Continued osteoblast / osteoclast activity
Reshaping to best density and shape
1 – 2 years
11. Classification of Fractures: Aetiology
1. Direct violence
2. Indirect violence
Spontaneously e.g following a muscle contraction – avulsion
3. Pathological
Abnormally weak bone: tumours, cysts, osteoporosis
4. Fatigue/stress
Commonest in 2nd metatarsal in young adults (march #), also tibia in
runners and vertebrae in fast bowlers
13. Classification of Fractures:
Open or closed
• Also known as compound
and simple
• Closed fractures – no
open wound
14. Clinical Examination
• History
• Pain over # site
• Loss of function
• Deformity
• Crepitus
• Swelling
• Radiographically – at least
two different views
• Stress films, CT, MRI, bone
scans
21. Immediate Complications Following a
Fracture
• Injury to major blood vessels haemorrhage
• Damage and injury to surrounding soft tissues i.e. nerves,
viscera, ligaments, tendons, joints
• Compartment syndrome
23. Late complications
Delayed union (3-4/12)/ Mal union/ non union:
Smokers, Alcoholics, DM
Fear of WB
• Avascular necrosis – # NOF
• Shortening – especially in children when epiphyseal plate
disruption has occurred
• CRPS (complex regional pain syndrome)– on removal of
POP
• Secondary osteoarthritis
24. Mal-union
Healing with faulty
shape
Non-union
Healing process stops
Avascular necrosis
Ischaemia
bone death
