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Fracture Healing
| Question | Answer |
|---|---|
| What is it called when there is a break in a bone? | Fracture |
| What are the structural Components of morphology of long bone? | Diaphysis, Epiphysis, metaphysis and epiphyseal plate |
| What is morphology of long bone? | The structure of the bone |
| What is histology of long bone? | The microstructure of the bone |
| What is the bone growth plate? | Epiphyseal plate |
| What does the cancellous bone provide? | Flexibility |
| What are the spaces in bone? | Trabeculae |
| Degree of porosity is also known as? | Density of bone |
| What does the periosteum cover? | The cortex |
| Fibrous membrane covering consists of 2 layers, what are those layers? | Fibrous and osteogenic layer |
| Endosteum means? | Medullary cavity |
| What are the osteogenic cells responsible for? | Regeneration process |
| What are the main components of histology (microstructure) of long bones? | Cells and Fibers |
| What are the components of ground substances? | Water, GAGs, noncollagenous proteins Solid, mineralized |
| What do lucanae contain? | Small spaces with osteocytes |
| What is organized, cylindrical structural units, concentric lamellae, lucanae and canalicull? | Haversian Systems |
| Concentric lamellae are.... | Calcified rings |
| Spongy bone -Trabeculae contain lacunae and canaliculi | More osteocytes |
| Interstitial Lamellae are? | Bony layers that sit between Haversian canals |
| What connects the haversian’s canals and contains blood, lymph? | Volkmann’s canals |
| What are the main sources for blood supply? | Periosteal artery and Nutrient artery |
| What enters via nutrient foramen and branches out? | Nutrient artery |
| What goes through mitosis, differentiates into osteoblast and is in ther inner osteogenic layer of periosteum? | Osteoprogenitor cells |
| Whatare osteoblasts involved in? | Collagen synthesis and bone formation. |
| Give some information on osteocytes | They are surrounded by extracellular matrix, located in lucanae, and connect to creat a highly vascular environment. |
| Osteoclasts break down and what else do they do? | Deossification, located in bony marrow and Howship's lacunae-absorption of dead bones. |
| What is the relationship between osteoblasts and osteoclasts? | Normally equal, maintain and aid in fracture (Fx) healing |
| bone regeneration and repair means... | converting tissue into bone, also known as ossification or osteogenesis. |
| What does ORIF stand for? | Open Reduction Internal Fixation |
| What are the stages of bone regeneration and repair? | Hematoma formation and Inflammation Cellular proliferation and Callus formation Remodeling |
| Secondary bone healing vs. primary bone healing | Secondary-natural bone healing-casted immobilized |
| Hemotoma formation | Each bony end creates a hemotoma and likes to spread to healthy bone and develops within a few hours after fracture |
| What does a fracture hematoma do? | Bleeds a lot, is located at the bone ends and may extend into surrounding areas. |
| What is the absence of osteocytes from lacunae? (Death @ fracture site) | Necrosis |
| Replicate bone is also known as? Structural framework | Regeneration environment |
| Fracture hematoma: | create granulation tissue |
| Fibrocartilaginous callus leads to: | increased strength leads to bony matrix |
| Mineralization | stage 2: depositing of calcium and phosphorous |
| Divides into 3 phases | Early, intermediate, late |
| Early repair phase | needs a stimulus>disruption of periosteum |
| Proliferation of osteogenic cells | stronger callus does not form for a few days |
| Osteoprogenitor cells travel to the fx site | Osteoblasts and condroblasts (lay down cartilage) |
| Osteoblasts are.... | Stimulus for proliferation and Extends out from primary fx site |
| Pluripotent cells function is to? | Turn into a cell that is needed |
| What is involved in intermediate repair phase? | Formation of granulation tissue and fibrocartilaginous callus, Proliferation of osteoblasts,Granulation Tissue |
| Endothelial budding | Branching out of capillaries |
| What contains cortex, osteogenic cells, endothelial budding, fibrocarilaginous callus is replaced, begins @ sides of Fx site, visible callus formation via x-ray? | External Callus |
| When is the callus formation visible in an x-ray? | After 14 days |
| the internal Callus consists of... | Cancellous bone, osteogenic cells and bridges between the bone ends |
| What describes the hardening of callus, does not have movement between bony ends and the fracture line is still present? | Clinical Union |
| What happens in the late repair phase? | Ossification, mineral deposits and solid bony union. (between 14 and 30 days) |
| During mineralization the soft cancellous bone hardens, bone density is increased and ____ | The woven bone is replaced with primary bone |
| During primary bone formation the excess callus is absorbed, the medullary cavity is reastablished and the Haversian system is restored. | Osteoclasts create medullary cavity and the osteoblasts are in the Haversian system |
| What are the time factors that affect fracture healing? | Amount damaged Cell death Displacement Size of bone Blood supply Approximation of sites Age Nutrition |
| What is another word for set? | Reduce |
| what is the duration of remodeling ? | 6-24 weeks |
| What is involved in remodeling? | Resumes normal size, structure, and shape Begins with stability Osteoclastic activity Organization of trabecular structure Osteoclasts and osteoblast |
| What does ARF stand for? | Activation, Resisting and Formation |
| What kind of abnormal bone healing complication is not direclty related? | Extrinsic Complications |
| What is the build up of pressure within a staff infection and avascular cell death? | Compartment syndrome |
| Osteoporosis, degenerative joint disease and myocytosis are examples of what? | Late extrinsic complications |
| What kind of abnormal bone healing complication is direclty related? | Intrinsic complications |
| What is the failure of the fracture ends to unite? | Non Union |
| How much time must pass before a fracture is truly considered a nonunion? | 6 months |
| Causes of nonunion | vascular compromise not enough blood |
| What happens in nonunion? | Prolonged presence of Type III collagen, bone ends become hard and dense, no bridging |
| How can you help a nonunion fracture? | Rebreak to start the healing process again |
| What is the definition of a delayed union fracture? | Solid bony union, but not within normal time frame |
| What are some bones that may have delayed union because of the duration of healing? | Tibia, femur, humerus |
| What are some causes of delayed union fractures? | Infections, medical treatments |
| What is the union called when bones unite in a an imperfect position? | MalUnion |
Created by:
dmart171
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