MDPT: Fracture & Bone Disorders

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Questions and Answers

Which structure within the Haversian system serves as a central space containing blood vessels and nerves?

Lamellae

Lacunae

Canaliculi

Haversian canal (correct)

What type of fracture is characterized by a break that creates a right angle along the shaft?

Spiral fracture

Oblique fracture

Transverse fracture (correct)

Comminuted fracture

Which of the following structures are responsible for housing osteocytes within bone?

Haversian canal

Canaliculi

Lamellae

Lacunae (correct)

Which type of fracture occurs as a result of strong muscle pulling forces?

Avulsion fracture Signup and view all the answers

What term describes the concentric layers of intercellular substance that surround the Haversian canal?

Lamellae Signup and view all the answers

Which type of fracture is caused by repetitive trauma?

Stress fracture Signup and view all the answers

Which of the following classifications is used for open fractures?

Gustilo-Anderson Classification Signup and view all the answers

Which type of bone is characterized by having length greater than width?

Long bones Signup and view all the answers

In bone architecture, what structure comes directly after the medullary canal?

Endosteum Signup and view all the answers

What is a common complication of a supracondylar fracture?

Volkmann’s ischemic contracture Signup and view all the answers

Which type of fracture involves the atlas and is characterized as a burst fracture?

Jefferson’s fracture Signup and view all the answers

Which classification is used for femoral neck fractures?

Garden Classification Signup and view all the answers

Which type of bone is cuboidal in shape and has lengths almost equal to its width?

Short bones Signup and view all the answers

Which type of fracture is classified as Grade 3 in the Salter-Harris classification?

Fracture involving epiphyseal plate and epiphysis Signup and view all the answers

What is the primary role of osteoclasts in bone physiology?

Resorption of bone material Signup and view all the answers

What percentage of bone composition is made up of organic materials?

30% Signup and view all the answers

Which type of bone formation involves a gradual transformation of connective tissue to bone?

Membranous ossification Signup and view all the answers

In the Salter-Harris classification, what does Grade 4 involve?

Fracture involving the epiphysis and metaphysis Signup and view all the answers

What is the primary structural component of the inorganic part of bone composition?

Hydroxyapatite Signup and view all the answers

What differentiates a complete fracture from an incomplete fracture?

Complete fractures involve total discontinuity of the bone. Signup and view all the answers

How do mesenchymal cells contribute to bone development during endochondral ossification?

They form a cartilage template that is replaced by bone. Signup and view all the answers

Which fracture is characterized by an interruption in blood supply that may lead to avascular necrosis (AVN)?

Femoral neck fx Signup and view all the answers

What angle of angulation is indicated for the gutter splint in a clavicular fracture?

40° Signup and view all the answers

Which type of fracture is described as an avulsion fracture of the iliac wing?

Duverney’s fx Signup and view all the answers

What is the typical maximum weight for skin traction using adhesive rubber tips?

5-6 lbs Signup and view all the answers

Which fracture is specifically noted for a stress fracture of the 2nd metatarsal?

March fx Signup and view all the answers

What defines osteosclerosis in skeletal diseases?

Regions of increased bone density Signup and view all the answers

What is a key feature of osteopetrosis?

A 'bone in a bone' radiographic appearance Signup and view all the answers

Which of the following conditions is defined as a failure of a fracture to heal within the expected timeframe?

Delayed union Signup and view all the answers

What does a DEXA scan primarily assess?

Bone mineral density for osteoporosis Signup and view all the answers

What term refers to the unsatisfactory alignment of bone healing after a fracture?

Malunion Signup and view all the answers

Which type of traction allows for minimal movement while using screws and nails for fixation?

Skeletal traction Signup and view all the answers

Which of the following conditions can indicate the necessity for amputation?

Congenital anomaly associated with excessive growth Signup and view all the answers

What distinguishes major amputations from minor amputations?

Major amputations are proximal to the MCP and MTP joints Signup and view all the answers

Which type of amputation allows the use of prosthetics designed specifically for the upper extremity?

Cineplastic amputation Signup and view all the answers

In the context of osteoporosis, an individual with a bone mass density between -1.00 and -2.00 SD is classified as having:

Osteopenia Signup and view all the answers

Which of the following types of amputation involves thorough removal through a joint?

Disarticulation amputation Signup and view all the answers

Study Notes

Bone Structure and Classification

Bone is a highly specialized connective tissue with cells calcified in an organic osteoid matrix.
Salter-Harris Classification categorizes epiphyseal plate fractures into five grades based on which parts of the bone are affected.
- Grade 1: Incomplete fracture through the epiphyseal plate.
- Grade 2: Involves the epiphyseal plate and a triangular segment of the metaphysis.
- Grade 3: Involves the epiphyseal plate and the epiphysis.
- Grade 4: Involves the epiphyseal plate, the epiphysis, and the metaphysis.
- Grade 5: Crushed epiphyseal plate.

Embryological Development of Bone

Membranous ossification involves the gradual transformation of connective tissue into bone via an osteoid matrix, primarily in facial bones and the cranial vault.
Endochondral ossification occurs when mesenchymal cells transform into cartilage, forming long bones, spine, and ribs.

Bone Cells and Composition

Osteoblasts are responsible for bone formation, while osteoclasts facilitate bone resorption.
Normal bone health requires a balance of activities between osteoblasts and osteoclasts.
Bone consists of approximately 30% organic material (collagen type 1) and 70% inorganic material (hydroxyapatite, phosphate, and carbonate), with water comprising about 10%.

Types of Fractures

Fractures are classified as incomplete or complete based on the nature of bone breakage.
Open fractures involve communication with surrounding tissues and may present with a wound, while closed fractures do not.
Various fracture types include:
- Transverse: Right angle along the shaft.
- Oblique: Diagonal angle along the shaft.
- Comminuted: Bone is crushed into multiple fragments.
- Spiral: Caused by torsional forces, heals fastest.

Fractures in Different Body Regions

Common upper extremity fractures include supracondylar fractures near the elbow joint, often leading to Volkmann’s ischemic contracture.
Lower extremity fractures include femoral neck fractures, which can interrupt blood supply, risking avascular necrosis (AVN), and various others such as intertrochanteric and trimalleolar fractures.

Bone Healing Anomalies

Delayed union: Failure of fractures to heal within typical timeframes (3-12 weeks for upper extremity, 12-18 weeks for lower extremity).
Malunion: Fractured bones heal in an unsatisfactory alignment.
Osteosclerosis: Dense regions in bone, exemplified by conditions like osteopetrosis, characterized by "bone in a bone" appearance due to ineffective osteoclastic activity.

Osteoporosis

Defined by a bone mass density 2.5 standard deviations below normal; osteopenia is a less severe mid-point.
Known as a "silent disease" due to lack of symptoms until fracture occurs; assessed using Dual Energy X-ray Absorptiometry (DEXA).

Amputation

Amputation involves the removal of a body part, either congenital or acquired.
Types include:
- Major: Above the MCP and MTP joints.
- Minor: Below the MCP and MTP joints.
- Disarticulation: Amputation through a joint.
Indications for amputation include vascular disease, infections, trauma, tumors, or congenital anomalies.

Cineplastic: Designed for upper extremity prosthetic use.
Krukenberg: Separation of the radius and ulna to form a pinching mechanism.

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Description

This quiz focuses on fracture and bone disorders, specifically examining the Salter-Harris classification. Participants will explore the types of fractures associated with the epiphyseal plate and metaphysis. Ideal for students in medical or health sciences, this quiz tests knowledge on fundamental bone structures and classifications.