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Kin 3K03: Sports Injuries (Fractures Summary)

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Krista M Baker

Sports Injuries: Kin 3K03 FRACTURES Bone Anatomy • Minerals + Collagen - Calcium and Phosphorus - Hardness of bone which allows absorption of compressive forces • Cortical - Resists bending, twisting • Cancellous - Orientation of the honeycomb - Cushion; shock absorption • Periosteum - Fibrous membrane - But doesn’t cover articular surfaces, only shaft of bone (attach site for tendons/ligaments) - Highly innervated, therefore very painful when fractured. - Continuous with a) Blood vessels b) Nerves c) Collagen of tendons, ligaments Fracture Classification 1. Displaced/Non-displaced - Fragments of bone are displaced - Non-displaced can become displaced easily 2. Compound (open)/Simple (closed) - Fracture of bone & skin (bone may have cut skin open) 3. Pattern/Shape - Spiral, transverse, oblique - Compression (mostly in vertebrae), impacted (another bone drives into cancellous part) - Comminuted (multiple pieces of bone), hairline (crack right through, non-DP) - Avulsion (piece of bone gets ripped off by attached ligament/muscle) 1. Spiral fracture - In long bones usually (femur) 2. Transverse - Bending of the bone 3. Oblique - Diagonal, compression on one side 4. Butterfly - bending + compression at same time Fracture Care o Speed is NOT your priority, unless it is an emergency situation! - Manage it slowly with care so it becomes stabilized, unless patient goes into shock (compromised ABC’s) o Most cases are NOT emergencies (unless shock, open fracture, femur, skull or pelvis fractures And then… Sports Injuries: Kin 3K03 - Complications are uncommon but can occur - Infection (signs include pus, redness, fever… usually appear after exposure) 1. Compartment Syndrome  Bone can bleed into compartment, expanding walls. Once walls stretch to their maximum, the blood/fluid will compress smaller structures (arteries, veins, nerves) = local ischemia (tissue death)  Bleed in tibia usually goes to anterior compartment,↑pressure, blocking off blood supply = tissue death Recognition -more pale due to compromised blood supply/return -red/purple below -tight, shiny skin -impaired sensation distally -distal pulse? May be absent… -pain↑in compartment -loosen the splint, to reduce pressure! 2. Deep Vein Thrombosis (DVT)  Large venous blockage (blood comes in but not out)  Dislodged blood clot  Lower extremity fractures  Post-immobilization, non-acute Recognition - Achy, swollen, red limb - Oral contraceptives may↑risk
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