Basics of Tissue Injury

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

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

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

4. Contusion • Called Bruise • A closed wound that bleeds under the skin

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

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

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

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

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

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

11. 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.

12. 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

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

14. 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 I: Acute Inflammatory

15. 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

16. 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

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

23. Bone Injuries • Dislocations • Fractures

24. 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

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

26. 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

27. 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

28. 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

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

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

31. 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

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

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

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

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

36. 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

37. 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

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

39. Bone Healing • Stage I: Acute • Stage II: Repair • Stage III: Remodeling

40. 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

41. 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

42. 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