Fracture Download

[Beverly Zielonko]

LaurenCastiello is a board certified adult-gerontology primary care nurse practitioner. Prior to becoming a registered nurse, she worked in diabetes research at Joslin Diabetes Center in Boston. Lauren has done nurse practitioner clinical practicums focusing on the adolescent, adult, and geriatric populations in internal medicine, long-term care, and outpatient oncology/bone marrow transplant.

Amanda is a freelance health and medical education journalist, editor, and copywriter. She has worked on projects for pharma, charities, and agencies, and has written extensively for patients, healthcare professionals, and the general public.

Jon is a writer from California and now floats somewhere on an island in the Mediterranean. He thinks most issues can be solved by petting a good dog, and he spends plenty of time doing so. Time not spent at his desk is probably spent making art or entertaining humans or other animals.

Bone healing is a natural process that, in most cases, will occur naturally. Therefore, treatment typically focuses on providing the injured bone with the best circumstances for healing, and ensuring optimal future function.

For the natural healing process to begin, a doctor will reduce the fracture. This involves lining up the ends of the broken bones. In smaller fractures, a doctor can do this by manipulating the affected area externally. However, in some instances, this may require surgery.

Fractures can take several weeks to several months to heal, depending on their severity. The duration is contingent on which bone has become affected and whether there are any complications, such as a blood supply problem or an infection.

Moreover, levels of estrogen, which plays a role in bone health, drop substantially during menopause. This makes calcium regulation more difficult and increases the risk of osteoporosis and fractures.

The body can repair most fractures, but medical intervention will usually be necessary to keep the broken bones in place. These interventions can range from external casts and splints to surgical screws and plates.

The most common treatment for a fracture is for you to wear a cast or a splint. This will keep your bone from moving while it heals. How long you need to wear it will depend on the type of fracture and which bone is affected. But it's often for several weeks. Your provider will let you when you can get it off.

For the clinical risk factors a yes or no response is asked for. If the field is left blank, then a "no" response is assumed. See also notes on risk factors.

The risk factors used are the following:

A special situation pertains to a prior history of vertebral fracture. A fracture detected as a radiographic observation alone (a morphometric vertebral fracture) counts as a previous fracture. A prior clinical vertebral fracture or a hip fracture is an especially strong risk factor. The probability of fracture computed may therefore be underestimated. Fracture probability is also underestimated with multiple fractures.

These risk factors appear to have a dose-dependent effect, i.e. the higher the exposure, the greater the risk. This is not taken into account and the computations assume average exposure. Clinical judgment should be used for low or high exposures.

RA is a risk factor for fracture. However, osteoarthritis is, if anything, protective. For this reason reliance should not be placed on a patient's report of 'arthritis' unless there is clinical or laboratory evidence to support the diagnosis.

Although bones are rigid, they do bend, or give, somewhat when an outside force is applied. However, if the force is too great, bones will break, just as a plastic ruler breaks when it is bent too far.

The severity of a fracture usually depends on the force that caused the break. If the bone's breaking point has been exceeded only slightly, the bone may crack rather than break all the way through. If the force is extreme, such as that caused by an automobile crash or gunshot, the bone may shatter.

If the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates down to the broken bone, the fracture is called an open fracture. This type of fracture is particularly serious because once the skin is broken, infection in both the wound and the bone can occur.

Your doctor will do a careful examination to assess your overall condition, as well as the extent of the injury. They will talk with you about how the injury occurred, your symptoms, and your medical history.

The most common way to evaluate a fracture is with X-rays, which provide clear images of bone. Your doctor will likely use an X-ray to verify the diagnosis. X-rays can show whether a bone is intact or broken. They can also show the type of fracture and exactly where it is located within the bone.

A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.

In this type of operation, the doctor places metal pins or screws into the broken bone above and below the fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position while they heal.

During this operation, the doctor first repositions (reduces) the bone fragments into their normal alignment and holds the bones together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the center of the bone.

Fractures take several weeks to several months to heal, depending on the extent of the injury and how well you follow your doctor's advice. Pain usually stops long before the fracture is solid enough to handle the stresses of normal activity.

The Colles fracture is defined as a distal radius fracture with dorsal comminution, dorsal angulation, dorsal displacement, radial shortening, and an associated ulnar styloid fracture. The term Colles fracture is often used eponymously for distal fractures with dorsal angulation. These distal radius fractures are often caused by falling on an outstretched hand with the wrist in dorsiflexion, causing tension on the volar aspect of the wrist, causing the fracture to extend dorsally. Colles fractures require medical management to ensure proper healing. Colles fractures require multiple aspects of the healthcare team for each patient to allow for optimal care of each patient. This activity outlines the evaluation, treatment, and management of Colles fractures and explains the interprofessional team's role in caring for this condition.

Objectives:Identify the etiology and epidemiology of Colles fractures.Outline the appropriate history, physical, and evaluation of a patient with a Colles fracture.Review the treatment and management options available for Colles fractures.Describe interprofessional team strategies for improving care coordination and communication to advance Colles fracture management to improve patient outcomes.Access free multiple choice questions on this topic.

Named after Abraham Colles, who first described a distal radius fracture in 1814 at the Royal College of Surgeons in Dublin, the Colles fracture is one of the most common fractures encountered in orthopedic practice representing 17.5 % (one-sixth) of all adult fractures presenting to the emergency department.[1][2] The Colles fracture is defined as a distal radius fracture with dorsal comminution, dorsal angulation, dorsal displacement, radial shortening, and an associated ulnar styloid fracture.[3][4] The term Colles fracture is often used eponymously for distal fractures with dorsal angulation.[5] These distal radius fractures are often caused by falling on an outstretched hand with the wrist in dorsiflexion, causing tension on the volar aspect of the wrist, causing the fracture to extend dorsally.

The Colles fracture is most commonly caused by a fall, landing on an outstretched hand with the wrist in dorsiflexion. This condition is also known as a "fall on outstretched hand injury," referred to by the acronym "FOOSH injury." The severity of the injury is usually determined by the position of the wrist when injured as well as the amount of force of the trauma. Tension on the volar aspect of the wrist causes bending and compressive forces. As a result of these forces through the wrist, dorsal displacement and comminution occur.

Distal radius fractures occur in people of all ages and, more often, in females. Distal radius fracture has a bimodal distribution in young athletes from high-energy injuries, as in sporting activities and motor vehicle accidents, and the elderly from low-energy trauma. In pediatrics, fractures often occur around the time of puberty due to low bone mineralization. Interestingly, ages 19 to 49 years old make up the least common age group for these injuries.[6]

Osteoporosis associated with aging increases the risk of these fractures in elderly individuals and also increases the risk in women, who are more commonly affected by osteoporosis.[7] Osteoporosis is a predictor of subsequent fragility fractures, especially in women older than 50 years old. Ideally, a distal radius fracture in women older than 50 years of age should indicate a DEXA scan to assess bone quality.

Distal radius fracture can be associated with multiple other injuries, such as distal radioulnar joint injury (DRUJ), Triangular fibrocartilage injury (TFCC), scapholunate, and lunotriquetral ligament injuries. An associated radial styloid fracture would indicate a high-energy mechanism of injury.

Radiographs are usually the mainstay of evaluating, diagnosing, and initially managing these injuries. PA and lateral views should be taken at a minimum to assess these injuries. These radiographs help distinguish the type of injury among different types of forearm fractures to narrow down and make a diagnosis.[9] (Media 4 & 5 ) for AP and lateral radiographs of a typical Colle's fracture,

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