HEALING OF OPEN AND CLOSE FRACTURES –

COMPARISON

DEFINITION – FRACTURE

Fractures are generally classified as: - Open - where there is a wound exposing the fracture site, or the bone is protruding from the skin. - Closed - where the bone has fractured but has no obvious external wound. Complicated - which may involve damage to associated vital organs and major blood vessels as a result of the fracture.

CAUSES OF FRACTURE

Fractures may be caused a number of ways:

Direct force; where sufficient force is applied to cause the bone to fracture at the point of impact

Indirect force; where force or kinetic energy, applied to a large, strong bone, is transmitted up the limb, causing the weakest bones to fracture

CAUSE OF FRACTURE- CONT

Spontaneous or spasm-induced; where fractures are associated with disease and/or muscular spasms

SIGNS AND SYMPTOMS

• pale, cool, clammy skin • rapid, weak pulse • pain at the site • tenderness • loss of power to limb • associated wound and blood loss • associated organ damage • nausea • deformity

DEFINITION –OPEN FRACTURE

An open fracture is one in which the fractured bone penetrates the skin

This is an important distinction because when a broken bone penetrates it required immediate treatment

An operation is often required to clean the area of the fracture

CAUSE OF OPEN FRACTURE

Caused by high energy injuries such as Car crashes Falls Sport injuries

CLOSE FRACTURE- DEFIATION

A closed fracture is a broken bone that does not penetrate the skin

It will need for more immediate treatment

There are more often problems associated with healing compare to a fracture that is open to skin

CAUSE OF CLOSE FRACTURE

High impact sports injuries Traumatic, forceful and unnatural

movements Overuse - prolonged long-distance walking

or running Falls Accidents Osteoporosis Tumors growing near the bone

CARE AND TREATMENT FOR FRACTURE

Common treatment for fracture are:

Braces Casts Medication Injection for pain

relief Often surgery will

take place when other treatment fail to relief pain

HEALING PROCESS OF FRACTURE

1. Reactive Phase i. Fracture and inflammatory phase ii. Granulation tissue formation 2. Reparative Phase iii. Callus formation iv. Lamellar bone deposition 3. Remodeling Phase v. Remodeling to original bone contour

STAGE I THE INFLAMMATION STAGE

Stage where the fracture healing start with the bleeding, tenderness and swelling

It is a very complex symphony of cellular changes modulated by cytokines, which are protein chemical messenger

Usually Stage I is the first few days to few weeks

STAGE II REPARATIVE STAGE

This is the stage where the fracture get “healed”, that is the bone ends become joined and stabilized

It is a very complex cellular symphony modulated by cytokines just like Stage I

The cells of the body that are capable of changing into bone cells

This stage starts within a week and continues for months

STAGE III THE REMODELLING STAGE

This is the final stage where the body changes the wake bone material into strong bone material

The body will remodel the fracture callus down to normal sized bone

The cell density increase, the collagen reorient along the lines of stress and the bone material itself increases in strength

This stage continues for many months to few years in adults

COMPLICATION OF FRACTURE HEALING Infection Poor nutrition

QUESTIONS

1.How are fractures causes?2.What are the two main types of

fractures?3.What are the phases of fracture healing?4.What are the signs and symptoms of

open fracture?5.What are the signs and symptoms of

closed fracture?

REFERENCE