Patho 305

1. Fractures & Complications

2. Fracture

3. Healing Process
1. Hematoma
 cortical bone fracture results in torn blood vessels
within haversian system
2. Granulation
 clotting at fracture site
3. Pro callus
 avascular bone replaced by living bone via
resorption & bone deposition
4. Callus formation (splint)
 new bone formation at edges of periosteum
5. Remodeling
 replacement of mature lamellar bone

4. Healing Process (Cont.)

5. Soft-Tissue Healing After Trauma
 Disruption of circulatory & lymphatic systems;
hemorrhage, fluid loss, cell death
 Norepinephrine
 Vessel constriction
 Serotonin & platelets
 Prolong vasoconstriction
 Histamine
 Vasodilation
 Increased permeability of venules

6. Bone Healing Complications
 Infection
 Delayed healing
 delayed union, malunion, or nonunion
 Fat emboli
 Osteoarthritis
 Soft tissue complications
 Musclespasm
 Neurovascular injury
 Compartment syndrome

7. Bone Infection- Osteomyelitis
 Hematogenous osteomyelitis
 Infection
(Staph aureus) elsewhere in body-
introduced into blood then bone
Etiology
 Burns, CA tumor necrosis, sinus, periodontal or
pressure ulcer infection
 Direct infection rt
 openfracture, penetrating wounds, surgical
contamination, or prostheses insertion

9. Compartment Syndrome
 Vessels & nerves lie between muscles
(compartment) & compressed
 reduces capillary flow
 muscle & nerves ischemic
Etiology
 External compression- casts
 Decreased internal space
 IVinfiltration
 Crush injuries / bleeding/ tissue swelling

10. Acute Compartment Syndrome
S&S Complications
 Pain  Permanent loss of
 Paresthesia/paralysis function
 Pallor  Limb contracture
 Pulselessness  Necrosis
 Poikilothermia