Which type of fracture would have a linear fracture that occurs in a straight line across the bone?
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A broken thighbone, also known as a femur fracture, is a serious and painful injury. The femur is one of the strongest bones in the body, and a break or fracture in the femur bone is often caused by severe injury such as trauma sustained in a motor vehicle accident. Symptoms of a femur fracture include severe pain, swelling, tenderness, physical deformity and often, the inability to walk. Treatment for a femur fracture often includes setting and immobilizing the leg, and in severe cases, surgery may be required to ensure proper healing. Types of Femur FracturesFemur fractures vary based on the type of injury that was sustained, the way the bone was fractured and the location of the fracture. The femur shaft is divided into three parts and the location of injuries may include:
In addition, femur fractures may be categorized by the type of injury, which may include:
Diagnosis of a Femur FractureA femur fracture is diagnosed after a physical examination of the leg as well as imaging tests that may include X-rays or CT scans. Imaging tests allow the physician to identify the exact location of the fracture. Treatment of a Femur FractureTreatment for femur fracture may vary based on the type and location of the break and may often include:
A displaced fracture may require the broken bones to be realigned, prior to splinting of casting of the leg. Depending on the degree of displacement, surgical or nonsurgical methods may be used to manipulate the bones back into position. Severe or multiple fractures may require external fixation, which uses an outer metal rod and pins to hold the bone or bones in place until they heal. Internal fixation devices, including plates, rods or screws, may also be used to maintain proper position of the femur during healing. During the healing phase, physical therapy is recommended to restore normal muscle strength, range of motion, and flexibility. Complete recovery from a femur fracture commonly takes about 4 to 6 months. Additional Resources
Definition[edit | edit source]A fracture is a discontinuity in a bone (or cartilage) resulting from mechanical forces that exceed the bone's ability to withstand them.[1] Fractures can occur in a variety of methods:
Location[edit | edit source]Type of Bone Fractured[2]
Types of Bone Fracture[edit | edit source]In general, there are many different classification systems used for fractures which fall within a set number of patterns:[2]
Pathophysiology of Bone Healing[edit | edit source]The pathophysiological sequence of events that occur following a fracture for bone healing can be divided into three main phases[2][4][5]
Phase 1 - Inflammatory Phase (Hours - Days)[edit | edit source]Immediately at the time of fracture, the space between the ends of the fracture is filled with blood, forming a heamatoma. This prevents additional bleeding and provides structural and biochemical support for the influx of inflammatory cells. The inflammatory reaction results in the release of cytokines, growth factors and prostaglandins, all of which are important in healing. The fibroblasts, chondroblasts and the ingrowth of capillaries is then infiltrated by fibrovascular tissue. This forms a matrix for bone formation and primary callus. Phase 1 takes approximately a week, forming a primary callus which is non-mineralized.[2] This is not readily visible on radiography. Phase 2 - Reparative Phase (Days - Weeks)[edit | edit source]Over the next few weeks, this primary callus is transformed into a bony callus by the activation of osteoprogenitor cells. These cells lay down woven bone which stabilises the fracture site. [2] Soft callus is organised and remodelled into hard callus over several weeks. Soft callus is plastic and can easily deform or bend if the fracture is not adequately supported. Hard callus is weaker than normal bone but is better able to withstand external forces and equates to the stage of "clinical union", i.e. the fracture is not tender to palpate or with movement. This can be seen on radiographs within 7-10 days after injury. Phase 3 - Remodelling Phase (Months to Years)[edit | edit source]The remodelling phase is longest phase and may last several years. [2] This phase represents the gradual formation of compact cortical bone with greater biomechanical properties. This allows for the reduction of the width of the callus. During remodelling, the healed fracture and surrounding callus responds to activity, external forces, functional demands and growth. Bone (external callus) which is no longer needed is removed and the fracture site is smoothened and sculpted. Remodelling can result in almost perfect healing, however, where alignment of the fracture site is not perfect, a residual deformity may remain.[1] [6] Complications[edit | edit source]Many of the aforementioned fracture types can also go on to have additional complications (and many associated soft tissue injuries). See Fracture Complications
[10] Clinical Features of Fracture[edit | edit source]Clinical features vary depending on the cause of injury, nature and the patients level of consciousness. These features are :
When Is Fracture Healed[edit | edit source]The average time for bone healing is about 6-8 weeks, but can varies depending upon many factors; Local Factors
Treatment and Prognosis[edit | edit source]The basics of fracture healing rely on alignment and immobilisation. Alignment may or may not be necessary depending on the degree of displacement, the importance of correct alignment (e.g. index finger vs rib), and the patient (e.g. professional athlete vs debilitated elderly). Immobilisation can be achieved in a variety of ways, depending on the location, morphology of the fracture, and device of fixation
Fixation Devices[edit | edit source]Stress Sharing Devices[edit | edit source]It allows micromotion between the two fractured sites and partial transmission of load. This promotes secondary bone healing with callus formation (a relatively rapid bone healing). For example; intramedullary nail, casts, rods. Stress Shielding Devices[edit | edit source]The stress at the fracture site is transmitted through the shielding device therefore, there is no motion at the fracture site. This promotes primary bone healing without callus formation (slower than the healing with callus formation). For example; compression plate[13][14]. Role of Physiotherapy[edit | edit source]The physiotherapist’s role is to identify the root cause of the problem and select appropriate treatment techniques to help patient's return to their desired activities of daily living. As with any physiotherapy session, conducting a patient assessment is crucial. The problem-oriented medical record (POMR) system is based on a data collection system that incorporates the acronym SOAP:
The treatment provided is largely dependent on the problems identified during your initial assessment. may include a mixture of the following: Examples of early treatment include;
References[edit | edit source]
What type of fracture occurs straight across the bone?Transverse: The break goes in a straight line across the bone.
What type of fracture has a horizontal fracture line?Transverse: A transverse fracture has a horizontal fracture line.
What is linear displaced fracture?Linear fracture: When a bone breaks parallel to the long axis of the bone, it is called a linear fracture. Displaced fracture: Here, the bone breaks into several fragments, making the bone lose alignment, giving rise to a displaced fracture.
What are the 4 types of fractures?Although there are many types of bone fractures, there are four main categories a fracture usually falls under: displaced, non-displaced, open and closed.
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