Lecture on Bone Fractures and Repair

Bone Repair Process

Three Phases of Bone Repair:
- Inflammatory Phase (Reactive Phase):
  - Formation of a hematoma around the bone break.
  - Characterized by swelling (inflammation).
  - Initial treatment with a splint to allow swelling to subside before casting.
- Reparative Phase:
  - First Step: Fibrocartilaginous Callus Formation
    - Cartilage fills the space in the fracture.
  - Second Step: Bony Callus Formation
    - Bone replaces cartilage similar to endochondral bone formation.
  - Creation of a temporary bulge (scar tissue) visible on X-rays.
- Remodeling Phase:
  - Bony callus is remodeled into mature bone.
  - Edges of the bone are converted to compact bone.

Open vs. Closed Fractures:
- Closed Fracture: Bone is broken but does not penetrate the skin.
- Open Fracture: Bone protrudes through the skin; infection risk; often requires surgery.
Common Types of Fractures:
- Comminuted Fracture: Bone breaks into several pieces; often due to impact injuries.
- Greenstick Fracture: Incomplete fracture common in children where the bone bends but does not break completely.
  - Occurs because children's bones are more flexible.
- Impacted Fracture (Buckle Fracture): One end of the bone is driven into the other.
- Transverse Fracture: Complete fracture with a break perpendicular to the bone shaft.
- Spiral Fracture: Twisting fracture, often seen in cases of physical abuse.
- Oblique Fracture: Fracture at an angle, common in falls and motor vehicle accidents.

Pott's Fracture:
- Break of the fibula at the lower leg, affecting the lateral malleolus (ankle area).
Colles' Fracture:
- Fracture of the distal radius in the wrist area.

Bone Flexibility in Children:
- Children's bones are not fully calcified, leading to increased flexibility and the possibility of partial (greenstick) fractures.
Significance of Fracture Types:
- Understanding different types of fractures aids in diagnosing and determining treatment strategies.
- Some fractures suggest causes such as trauma or abuse, requiring different medical and social responses.