Ulnar bone fracture pathophysiology: Difference between revisions
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== Mechanism == | == Mechanism == | ||
The ulnar fracture is caused by a fall on the outstretched hands with the wrist in dorsiflexion position. The form and severity of this fracture depends on the position of the wrist at the moment of hitting the ground. The width of this mentioned angle affects the localization of the fracture. Pronation, supination and abduction positions leads the direction of the force and the compression of carpus and different appearances of injury. | The ulnar fracture is caused by a fall on the outstretched hands with the wrist in dorsiflexion position. The form and severity of this fracture depends on the position of the wrist at the moment of hitting the ground. The width of this mentioned angle affects the localization of the fracture. Pronation, supination and abduction positions leads the direction of the force and the compression of carpus and different appearances of injury<ref name="pmid30332871">{{cite journal |vauthors=He HY, Zhang JZ, Wang XW, Liu Z |title=[Acumed intramedullary nail for the treatment of adult diaphyseal both-bone forearm fractures] |language=Chinese |journal=Zhongguo Gu Shang |volume=31 |issue=9 |pages=803–807 |date=September 2018 |pmid=30332871 |doi=10.3969/j.issn.1003-0034.2018.09.005 |url=}}</ref><ref name="pmid27707565">{{cite journal |vauthors=Casagrande DJ, Morris RP, Carayannopoulos NL, Buford WL |title=Relationship Between Ulnar Variance, Cortical Bone Density, and Load to Failure in the Distal Radius at the Typical Site of Fracture Initiation |journal=J Hand Surg Am |volume=41 |issue=12 |pages=e461–e468 |date=December 2016 |pmid=27707565 |doi=10.1016/j.jhsa.2016.08.021 |url=}}</ref>. | ||
* Open fracture: The ulnar bone breaks and pierces the skin also the ligament, muscle, and tendon damage, may be affected. | * Open fracture: The ulnar bone breaks and pierces the skin also the ligament, muscle, and tendon damage, may be affected. | ||
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* Galeazzi fracture: The ulnar fracture extends through an area of the bone, causing the bone to bend on the other side. | * Galeazzi fracture: The ulnar fracture extends through an area of the bone, causing the bone to bend on the other side. | ||
==Pathophysiology== | ==Pathophysiology<ref name="pmid27620542">{{cite journal |vauthors=Guss MS, Kaye D, Rettig M |title=Bennett Fractures A Review of Management |journal=Bull Hosp Jt Dis (2013) |volume=74 |issue=3 |pages=197–202 |date=September 2016 |pmid=27620542 |doi= |url=}}</ref><ref name="pmid27886684">{{cite journal |vauthors=Hopkins CM, Calandruccio JH, Mauck BM |title=Controversies in Fractures of the Proximal Ulna |journal=Orthop. Clin. North Am. |volume=48 |issue=1 |pages=71–80 |date=January 2017 |pmid=27886684 |doi=10.1016/j.ocl.2016.08.011 |url=}}</ref>.== | ||
Its known that the ulnar bone fracture in normal healthy adults can be caused due to the high-energy trauma (e.g., motor vehicle accidents), sport related injuries, falling from height. But it should be noted that the most important Risk factors for insufficiency fractures is chronic metabolic disease such as steoporosis, osteopenia, eating-disordered behavior, higher age, prolonged corticosteroid usage, female gender, lower BMI, history of a recent falling, and prior fracture<ref name="pmid30332871">{{cite journal |vauthors=He HY, Zhang JZ, Wang XW, Liu Z |title=[Acumed intramedullary nail for the treatment of adult diaphyseal both-bone forearm fractures] |language=Chinese |journal=Zhongguo Gu Shang |volume=31 |issue=9 |pages=803–807 |date=September 2018 |pmid=30332871 |doi=10.3969/j.issn.1003-0034.2018.09.005 |url=}}</ref><ref name="pmid27707565">{{cite journal |vauthors=Casagrande DJ, Morris RP, Carayannopoulos NL, Buford WL |title=Relationship Between Ulnar Variance, Cortical Bone Density, and Load to Failure in the Distal Radius at the Typical Site of Fracture Initiation |journal=J Hand Surg Am |volume=41 |issue=12 |pages=e461–e468 |date=December 2016 |pmid=27707565 |doi=10.1016/j.jhsa.2016.08.021 |url=}}</ref>. | |||
* The pattern of bone fracture and severity of injury depends on variety of factors such as<ref name="pmid27454628">{{cite journal |vauthors=Kim JK, Kim JO, Koh YD |title=Management of Distal Ulnar Fracture Combined with Distal Radius Fracture |journal=J Hand Surg Asian Pac Vol |volume=21 |issue=2 |pages=155–60 |date=June 2016 |pmid=27454628 |doi=10.1142/S2424835516400075 |url=}}</ref>: | |||
** Patients age | |||
** Patients Weight | |||
** Patients past medical history specifically any bone diseases affecting the quality of bone (such as osteoporosis, malignancies) | |||
** Energy of trauma | |||
** Bone quality | |||
** Position of the specific organ during the trauma | |||
* The below-mentioned processes cause decreased bone mass density <ref name="pmid28988738">{{cite journal |vauthors=Alfaraj DN, Vilke GM |title=Tripartite Fracture of the Ulnar Sesamoid Bone of the Thumb |journal=J Emerg Med |volume=53 |issue=5 |pages=758–759 |date=November 2017 |pmid=28988738 |doi=10.1016/j.jemermed.2017.08.020 |url=}}</ref: | |||
** [[Autophagy]] is the mechanism through which [[Osteocyte|osteocytes]] evade [[oxidative stress]]. | |||
** The capability of [[autophagy]] in cells decreases as they age, a major factor of [[Ageing|aging]]. | |||
** As [[Osteocyte|osteocytes]] grow, viability of cells decrease thereby decreasing the bone mass density. | |||
== References == | == References == | ||
<references /> | <references /> | ||
Latest revision as of 07:45, 11 April 2019
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Ulnar bone fracture Microchapters |
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Ulnar bone fracture pathophysiology On the Web |
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American Roentgen Ray Society Images of Ulnar bone fracture pathophysiology |
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Risk calculators and risk factors for Ulnar bone fracture pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;
Overview
Ulnar Fracture usually classified according to the level of fracture, the pattern of the fracture, the degree of displacement, the presence or absence of comminution or segment bone loss, and whether it is open or closed. Each of these factors may have some bearing on the type of treatment to be selected and the ultimate prognosis.
Mechanism
The ulnar fracture is caused by a fall on the outstretched hands with the wrist in dorsiflexion position. The form and severity of this fracture depends on the position of the wrist at the moment of hitting the ground. The width of this mentioned angle affects the localization of the fracture. Pronation, supination and abduction positions leads the direction of the force and the compression of carpus and different appearances of injury[1][2].
- Open fracture: The ulnar bone breaks and pierces the skin also the ligament, muscle, and tendon damage, may be affected.
- Closed fracture: The ulnar bone do not cut the skin. However, injury to the soft tissues around the joint may occur.
- Comminuted fracture: In a comminuted ulnar fracture, the ulnar bone is broken into three or more pieces.
- Displaced fracture: The ulnar bone may fragment at the point of breakage and gets misaligned.
- Greenstick fracture: A greenstick ulnar fracture means that the ulnar bone is cracked, but not broken all the way through.
- Metaphyseal fracture: With this type, the ulnar fracture is confined to the upper/lower part of the shaft, but does not affect the growth plate.
- Buckle (or torus) fracture: A buckle ulnar fracture, also known as a torus ulnar fracture, occurs when one side of the ulnar bone is compressed or buckled, without fracturing the other side.
- Monteggia fracture: A fracture fracture type that affects both sides of the forearm.
- Galeazzi fracture: The ulnar fracture extends through an area of the bone, causing the bone to bend on the other side.
Pathophysiology[3][4].
Its known that the ulnar bone fracture in normal healthy adults can be caused due to the high-energy trauma (e.g., motor vehicle accidents), sport related injuries, falling from height. But it should be noted that the most important Risk factors for insufficiency fractures is chronic metabolic disease such as steoporosis, osteopenia, eating-disordered behavior, higher age, prolonged corticosteroid usage, female gender, lower BMI, history of a recent falling, and prior fracture[1][2].
- The pattern of bone fracture and severity of injury depends on variety of factors such as[5]:
- Patients age
- Patients Weight
- Patients past medical history specifically any bone diseases affecting the quality of bone (such as osteoporosis, malignancies)
- Energy of trauma
- Bone quality
- Position of the specific organ during the trauma
- The below-mentioned processes cause decreased bone mass density <ref name="pmid28988738">Alfaraj DN, Vilke GM (November 2017). "Tripartite Fracture of the Ulnar Sesamoid Bone of the Thumb". J Emerg Med. 53 (5): 758–759. doi:10.1016/j.jemermed.2017.08.020. PMID 28988738.</ref:
- Autophagy is the mechanism through which osteocytes evade oxidative stress.
- The capability of autophagy in cells decreases as they age, a major factor of aging.
- As osteocytes grow, viability of cells decrease thereby decreasing the bone mass density.
References
- ↑ 1.0 1.1 He HY, Zhang JZ, Wang XW, Liu Z (September 2018). "[Acumed intramedullary nail for the treatment of adult diaphyseal both-bone forearm fractures]". Zhongguo Gu Shang (in Chinese). 31 (9): 803–807. doi:10.3969/j.issn.1003-0034.2018.09.005. PMID 30332871.
- ↑ 2.0 2.1 Casagrande DJ, Morris RP, Carayannopoulos NL, Buford WL (December 2016). "Relationship Between Ulnar Variance, Cortical Bone Density, and Load to Failure in the Distal Radius at the Typical Site of Fracture Initiation". J Hand Surg Am. 41 (12): e461–e468. doi:10.1016/j.jhsa.2016.08.021. PMID 27707565.
- ↑ Guss MS, Kaye D, Rettig M (September 2016). "Bennett Fractures A Review of Management". Bull Hosp Jt Dis (2013). 74 (3): 197–202. PMID 27620542.
- ↑ Hopkins CM, Calandruccio JH, Mauck BM (January 2017). "Controversies in Fractures of the Proximal Ulna". Orthop. Clin. North Am. 48 (1): 71–80. doi:10.1016/j.ocl.2016.08.011. PMID 27886684.
- ↑ Kim JK, Kim JO, Koh YD (June 2016). "Management of Distal Ulnar Fracture Combined with Distal Radius Fracture". J Hand Surg Asian Pac Vol. 21 (2): 155–60. doi:10.1142/S2424835516400075. PMID 27454628.