1- Treatment options for fractures- SA

Question 1

Give 4 options of fracture healing

Answer 1

Intramedullary pin & cerclage wire
Plating (+compression)
Intramedullary nail
External fixator
Pin & tension band

Question 2

What is the most widely used method of fracture fixation? & which force is it good at counteracting?

Answer 2

Intramedullary pin = good at counteracting bending force

Question 3

Increasing an intramedullary pins diameter results in?

Answer 3

A disproportionate increase in strength/stiffness = strong at preventing bending

Question 4

How does retrograde placement of the IM pin differ to normograde?

Answer 4

Retrograde = enters the proximal fragment distally

Normograde = pin is placed from proximal end of the proximal fragment

Question 5

What 2 forces does the IM Pin achieve poorly? & What can be added to prevent these?

Answer 5

Rotation & axial compression
Add an external fixator
(Transverse fracture)

Question 6

What is a external fixator?

Answer 6

Series of pins are placed through the skin & connected to a connecting bar (external to the body)
Counteracts all forces applied to a fracture- especially if used in combo with IM pin

Question 7

List 2 complications of external fixators

Answer 7

Pins prone to infection
Discharge
Requires frequent examinations
Re-application of loose pins
May require staging down
Several follow up radiographs

Question 8

Describe the difference between a locking or non-locking plate

Answer 8

Non-locking = requires plate to adhere to the screws by friction
Locking = Thread in the plate where the screw engages

Question 9

List 3 types of bone plates

Answer 9

Buttress plate
Neutralisation plate
Compression plate

Question 10

What force of plates prone too? & what can be used to prevent this?

Answer 10

Bending = IM pin

Question 11

Define avulsion fracture

Answer 11

separation of a bone fragment at the attachment point of a tendon or ligament
Produced by distraction forces generated externally

Question 12

2 methods to treat avulsion/tension fractures

Answer 12

Lag screw = produces rigid fixation
Tension band = produce a compressive force

Question 13

T/F Avian bone healing is rapid

Answer 13

True

Question 14

What do you need to consider when choosing a treatment option for fractures

Answer 14

by fracture type and forces that will be applied

Question 15

What are the primary physiologic forces that act on a normal bone

Answer 15

axial compression
tension
bending
torsion

Question 16

What is bending

Answer 16

when a limb is placed at an angle to the ground, or there is asymmetrical muscle contraction

Question 17

What is torsion

Answer 17

when the body changes direction with leg planted on ground

Question 18

what is an intramedullary pin not good at counteracting

Answer 18

poor at axial compression unless the bone column is reinstated