fracture in the arm

fracture in the arm

1. first aid of fractures

   • 1. Stop bleeding 2. Avoid moving the affected area 3. Cool the affected area 4. Treat the patient's shock 5. Call the ambulance

2. A fracture is a break in the continuity of a bone or cartilage.

   • common causes: falls, car accidents, direct blow, pathological
     • pathological causes: osteoporosis, low BMD
   • signs and symptoms: pain, bleeding, numbness, swelling and tenderness, limitation of movement

3. types of bone fractures

   • Salter-Harris Fractures
     • Fractures that involve the epiphyseal plate alone or in combination with a part of the bone.

4. brachial plexus

   • the sets of nerves supplying the shoulder, upper and lower hand
   • bone fractures can affect the nerves near the fracture
     • eg: wrist drop, the radial nerve is affected
       • physiotherapy for wrist drop
         • wrist flexion and extension stretch, supination, grip strengthening
     • eg: surgical neck fractures can cause damage to the axillary nerve

5. Management of Bone Fracture

   • Stop any bleeding immobilization
   • put a Plaster casts or plastic functional braces
     • cast types :
       • plastic, synthetic, splint (half cast), cast brace
     • Cast complications
       • Compartment syndrome
       • pressure sores
       • Thermal Injuries
       • Dermatitis
       • Joint stiffness
   • fracture may require surgery, metal plates inserted and physiotherapy

6. anatomy of the arm

   • + the radius and ulna

7. Fracture healing

   • direct (primary) healing
   • Indirect (secondary) healing
   • steps :
     • acute inflammation
     • Mesenchymal stem cell (MSc) recruitment
     • Callus formation
     • Neo-angiogenesis
     • Resorption and replacement of soft cartilaginous callus by hard callus
     • Remodeling of bone

8. Sensory Neurons

   • 5 main types
     • photoreceptors
     • chemoreceptors
     • mechanoreceptros
     • thermoreceptors
     • nociceptors (pain)

9. Neurological examination of the upper limbs

   • used to assess
     • Tone, Reflexes, Power and Sensory function
   • examines the shoulder, elbow and wrists

10. radiography and x-rays

    • types : X-rays and fluoroscopy
    • it detects :
      • fractures. dislocation, subluxation

11. Psychological Complications after a bone fracture

    • Adjustment Disorder (Situational Depression)
    • Acute stress disorder/ Post-traumatic stress disorder
    • Depression and anxiety
    • limiting participation in physical activities
    • Ways to Cope
      • an exercise that does not put undue stress on your healing limb
      • seek support from family member/care giver
      • online support groups

12. Bone Tissue

    • specialized hard type of C.T., with calcified extra-cellular matrix
    • rich blood supply
    • Dynamic( constantly changes shape
    • covered all around my the bone membrane called the periosteum
      • periosteum has a v.rich blood supply + provides stem cells for bone repair and growth
    • endosteum: lines the bone marrow
    • Bone Cells
      • Osteoprogenitor cells
        • Undifferentiated mesenchymal cells
      • Osteoblasts
        • The stem cells of the bones
      • Osteocytes
        • mature bone cells
      • Osteoclasts
        • bone destroying cells

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