Basics of Tissue Injury Ch. 2 Athletic Training for Student Assistants

Objectives Explain the various types of tissue injury Explain tissue Repair and Healing Explain various bone injuries Explain bone repair and healing

Soft Tissue Injuries Contusion Abrasion Laceration Puncture Incision Amputation Avulsion Contrecoup Sprain Strain

Contusion Called Bruise A closed wound that bleeds under the skin

Abrasion The scraping off of a layer/s of skin May or may not bleed depending on how many layers are removed

Laceration Jagged, irregular opening in the skin Caused by a non cutting object such as a wall or pole

Puncture Occurs when a pointed object enters the body through force Object such as a nail or tack

Incision Open wound made by a cutting object such as a scalpel. Rarely seen in athletics

Amputation An open wound in which part of the body is completely torn away

Avulsion The partial tearing away of a body part. Can happen when a ring get caught in a basketball hoop.

Contrecoup Injury that occurs on the opposite side of the initial injury Usually occurs in the brain as the head hits against an un yielding surface Example: the posterior part of the skull makes contact with the ground and the brain hits the anterior part of the skull.

Sprains and Strains Sprain – A wound that bleeds internally and that does damage to the Ligaments Strain – A wound that bleeds internally and that does damage to the Tendons or muscles

Stages of Soft Tissue Healing Stage I : Acute Inflammatory Stage II: Repair Stage III: Remodeling

Stage I: Acute Inflammatory Inflammatory response phase When a body part is injured cells in the area die There is an increase in blood flow to the area This brings cells and chemicals needed for the healing process Phagocytes: Specialized cells that engulf and eat up the dead cells Leukocytes: infection-fighting white blood cells Platelets: Carry blood-clotting materials Lasts as long as four days

Stage II: Repair Fibroblastic Repair Phase The injured area is now filled up with blood, cells, and chemicals to help rebuild the area. Fibroblasts begin to build up scar tissue around the injured area. This stage lasts six weeks to as long as three months depending on extent of injury

Stage III: Remodeling Maturation-Remodeling Phase This is the body’s way of building tissue strength in tendons, ligaments, and muscles to be able to withstand the stress that is put on them by activity and exercise. Can take as long as three years to complete

Injury Videos http://www.csmfoundation.org/Educational_Lower_Extremity.html

Bone Injuries Dislocations Fractures

Dislocation Articulation – where two bone come together (joint) A Dislocation occurs when a force displaces a bone so that the ends no longer match up

Fractures Avulsion Stress Spiral Longitudinal Compression Oblique Comminuted Greenstick Transverse Depressed Blowout Pathological Epiphyseal

Avulsion Fracture When a tendon or ligament pulls so hard that it pulls off a piece of the bone. Common with sprains, strains, and dislocations

Stress Fractures Also know as a fatigue fracture Occurs as an overuse injury with repetitive stress Can not be seen by an x-ray at first

Spiral Fractures A torsional force along the length of the bone causes this type of fracture Looks similar to a stripe on a candy cane

Longitudinal Fracture Fracture that runs the length of the bone Usually occurs by an impact

Compression Fracture Occurs when opposing forces are applied to the bone at the same time Happens often in the spine

Oblique Fracture Diagonal fracture across a bone Takes longer to heal in a weight bearing bone due to the fact that it does not stay in place very well

Comminuted Fracture Happens when a bone is crushed into smaller pieces Can happen by blunt force trauma

Greenstick Fracture When the bone bends and only fractures half way through it is called a greenstick fracture Happens mainly in adolescents

Transverse Fracture Travels across the bone, perpendicular to the bone Cause by an impact that is perpendicular to the bone

Depressed Fractures Usually occurs in the skull from a direct impact This impact makes an indention in the skull

Blowout Fracture Occurs when an eye is pushed hard backwards and down into the eye socket Small bones under the eye are crushed and embedded into the eye muscles

Pathological Fracture A disease process like a bone tumor can weaken the bones so that a little stress will fracture them Improper nutrition and eating disorders are the most common cause among adolescent athletes

Epiphyseal Fracture Fracture of the epiphseal or growth plate Occur mainly in the long bones of adolescent athletes Do not occur in adults

Bone Healing Stage I: Acute Stage II: Repair Stage III: Remodeling

Stage I: Acute Bleeding occurs in the area Osteoclasts begin to “Eat” the debris or reabsorb it to the body Osteoblasts begin to add new layers to the outside of the bone tissue Continues for about four days

Stage II: Repair Osteoclasts and osteoblasts continue to regenerate bone A bony splint (fibrous callus) forms The fibrous callus is transformed into a sleeve of hard callus bone The process of turning callus into bone starts at about week three and continues for about three months

Stage III: Remodeling Takes several years to complete Callus is reabsorbed and replaced with a fibrous cord of bone that is formed around the fracture site If a bone never heals it is called a nonunion fracture Nonunion fractures are common in the scaphoid bone of the wrist