2.  Fractures are generally classified as: - Open - where there is a wound exposing the fracture site, or the bone is protruding from the skin. - Closed - where the bone has fractured but has no obvious external wound. Complicated - which may involve damage to associated vital organs and major blood vessels as a result of the fracture.

3.  Fractures may be caused a number of ways:  Direct force; where sufficient force is applied to cause the bone to fracture at the point of impact  Indirect force; where force or kinetic energy, applied to a large, strong bone, is transmitted up the limb, causing the weakest bones to fracture

4.  Spontaneous or spasm-induced; where fractures are associated with disease and/or muscular spasms

5. pale, cool, clammy skin rapid, weak pulse pain at the site tenderness loss of power to limb associated wound and blood loss associated organ damage nausea deformity

6.  An open fracture is one in which the fractured bone penetrates the skin  This is an important distinction because when a broken bone penetrates it required immediate treatment  An operation is often required to clean the area of the fracture

7.  Caused by high energy injuries such as  Car crashes  Falls  Sport injuries

8.  A closed fracture is a broken bone that does not penetrate the skin  It will need for more immediate treatment  There are more often problems associated with healing compare to a fracture that is open to skin

9.  High impact sports injuries  Traumatic, forceful and unnatural movements  Overuse - prolonged long-distance walking or running  Falls  Accidents  Osteoporosis  Tumors growing near the bone

10. Common treatment for fracture are:  Braces  Casts  Medication  Injection for pain relief  Often surgery will take place when other treatment fail to relief pain

11. 1. Reactive Phase i. Fracture and inflammatory phase ii. Granulation tissue formation 2. Reparative Phase iii. Callus formation iv. Lamellar bone deposition 3. Remodeling Phase v. Remodeling to original bone contour

12.  Stage where the fracture healing start with the bleeding, tenderness and swelling  It is a very complex symphony of cellular changes modulated by cytokines, which are protein chemical messenger  Usually Stage I is the first few days to few weeks

13.  This is the stage where the fracture get “healed”, that is the bone ends become joined and stabilized  It is a very complex cellular symphony modulated by cytokines just like Stage I  The cells of the body that are capable of changing into bone cells  This stage starts within a week and continues for months

14.  This is the final stage where the body changes the wake bone material into strong bone material  The body will remodel the fracture callus down to normal sized bone  The cell density increase, the collagen reorient along the lines of stress and the bone material itself increases in strength  This stage continues for many months to few years in adults

15.  Infection  Poor nutrition

16. 1.How are fractures causes? 2.What are the two main types of fractures? 3.What are the phases of fracture healing? 4.What are the signs and symptoms of open fracture? 5.What are the signs and symptoms of closed fracture?