A collection of useful words
or
what the doctor really meant when he said ;

Proximal.
Nearest the trunk of the body or point of origin of the limb.
Diaphyseal.
Relating to the shaft of a long bone.
Distal.
The extremity or distant part of the limb.
Malleolar.
Bony prominences such as either side of the ankle joint.
Humerus.
Upper bone of the arm.
Radius and Ulna.
Lower two bones of the arm.
Femur.
Upper bone of the leg.
Tibia and Fibula.
Lower two bones of the leg.
Bone diagrams
Corticotomy.
A cut through the outer hard shell of a bone that completely encircles it but does not sever the internal blood supplies and the like. This enables the bone to be distracted allowing growth of new bone at the corticotomy site.
Distraction.
The action of stretching a bone about a corticotomy site, seperating the ends such that an area is created for new bone to form and grow.
Contraction.
The action of compressing a union between bone ends to stabilise the union and facilitate healing.
Osteotomy.
The cutting of bone usually by saw or chisel.
Endosteal.
Relating to the endosteum or layer of cells lining the inner surface of the bone in the central (medullary) cavity.
Periosteal.
A thick membrane which covers all the bone except where there is cartilage. It consists of two layers, one of which forms the new bone (osteogenic) and the other which carries blood vessels and nerves.
Pronation. - of the forearm. [SEE CROSS UNION ]
rotation of the forearm in such a way that the palm of the hand faces backward when the arm is in the anatomical position, or downward when the arm is extended at a right angle to the body.
Supination. - of the forearm. [SEE CROSS UNION ]
rotation of the forearm in such a way that the palm of the hand faces foreward when the arm is in the anatomical position, or upward when the arm is extended at a right angle to the body.
Serous
Relating to, containing, or producing serum or a substance having a watery consistency. Seen in wounds, usually a brown/reddish clear fluid that forms within the wound site.
Fracture Types
Transverse Fracture
Transverse Fracture

Transverse fractures are usually the result of a direct blow or pure angular force being applied to the bones.
The resultant shape of the bone ends helps transverse fractures stay in alignment more easily than those of other fractures where the resultant ends do not locate so readily.

Spiral Fracture
Spiral (or Oblique) Fracture

Spiral (or oblique) fractures are usually the result of a twisting moment being applied about the long axis of the bone. For example the foot being held trapped whilst the leg twists about it. This is as opposed to a sideways moment or bend which results in a transverse fracture.
The x-ray of a fracture caused by a twisting motion may result in an x-ray indicating an oblique fracture. In practice this type of fracture is very rare and is more often a misinterpretation of the x-ray information of a spiral fracture.
Damage to the bone ends makes it more difficult to align and balance the bones making for an unstable union. Bone spikes may cause damage to soft tissue, nerves and blood supply. The spikes may break free to form 'Butterfly' fragments

Comminuted Fracture
Comminuted Fracture

The term Comminuted fracture is applied to one where there is splintering of the bone ends. This results in a situation where exact reconstitution or reconstruction is difficult or impossible. This situation is usually caused in cases of direct trauma.

[Ilizarov note.

The Ilizarov technique has olived wires which can be used in the reconstitution of spiral fracture butterfly fragments and comminuted fractures if the fragments are not too numerous or small.].

Faulty Fracture Unions
Cross union
Cross Union

A cross union occurs when two adjacent bones become linked by callus formation. This is a version of mal-union (see below)
If this occurs within the forearm bones (Radius & Ulna) there is a loss of Pronation and Supination (which see above).

Mal-union
Mal-Union

This refers to a union of a bone which is often mechanically sound but in the wrong position. This may not be as bad as it sounds depending on the degree of displacement within the union.
If, however the fracture ends/fragments are pulled apart by the action of opposing muscle groups, a functional result from a mal-union is unlikely.


TRAUMA TERMINOLOGY

With grateful acknowledgement to King's College Hospital, London. November 1999

Crepitus
The grating sound caused by the friction of the two ends of fractured bone.
Colles fracture
This type of fracture produces the "dinner fork" deformity.
Complicated fracture
Surrounding tissues are damaged in this type of fracture.
Osteomylitis
Active infection of the bone, usual cause heamatogenous, can be secondary to trauma.
Stress fracture / March Fracture
This injury does not occur after a single injury but after repetitive strain.
Transverse / Oblique fracture
This horizontal fracture is caused by an angulation force.
Callus formation
This is the third stage of bone healing.
Compound fracture
Loss of continuity of bone with exposure to the outside environment.
Skin traction
Non-invasive form of conservative treatment for fractures and dislocation.
Avascular necrosis
Death of bone due to lack of blood supply.
Volkmann's contracture.
Atrophy and fibrosis occurring in the muscles due to an impaired blood supply.
Delayed Union
The fracture takes longer than normal to unite.
Degloving Injury
Where skin has been removed by shearing forces.
Delayed union
This occurs when fracture fragments are still freely mobile after three or four months after injury.
Incomplete fracture
An example of this type of fracture is "greenstick".
Avulsion fracture
This may be caused by a sudden violent contraction tearing away a portion of bone.
External fixator
Rigid anchorage of bone fragments with metal bars and transfixtion pins.
Sudek's atrophy
This is caused by prolonged disability after fracture or other injuries of their limbs. It is probably an abnormality of the sympathetic nervous system. Usually resolves can take up to two years.
Compartment syndrome
The increase in pressure within the muscles may cause an ischemia in this type of complication
Arterial obstruction
Interruption of the blood supply, clinical symptoms Of the ischaemic limb; extreme pain, cold skin, a poor capillary return, absence of pulse distal to injury, parathesia and ultimately paralysis.
Remodeling
The final stage of bone healing.
Plaster of Paris
This is made from Calcium Sulphate or Gypsum
Impacted
One end of the broken bone is driven into the other causing shortening.
Reduction
Restoration of the displaced fracture fragments to their correct anatomical position.
Intracapsular fracture
Fracture within the capsule of a joint.
Fat embolus
Complication caused by globules released from a fractured long bone.
Cross union
This may occur in the forearm when the two adjacent bones become linked by new bone.
Non-union (Hypertropic)
The fracture does not unite at any stage, but some attempt is made and there is an abundance of callus around the bone end.
Non-union (Atrophic)
Little of no attempt is made at union callus formation


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