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MSK > 5- common fractures > Flashcards

5- common fractures Flashcards

1
Q

what are examples of lower limb fractures? and basic pt about what each one is or what causes? (5)

A
  1. ankle = usually inversion injury with rotational force
  2. tibial shaft fracture = spiral, transverse, oblique, comminuted (high energy), open fractures
  3. tibial plateau = break bone & damage cartilage on top of tibia. high energy
  4. femoral shaft fractures - high energym major trauma
  5. pelvic fractures - remember more than 1 break always
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2
Q

what is classification of ankle fracture?

A

weber classification = ABC

  • C is highest up fibula, A right at medial malleolus
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3
Q

what is general conservative management for fractures?

A

cast or moon boot or collar&cuff (proximal humerus fracture)

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4
Q

what are operative managements of fractures?

A
  • open reduction internal fixation (ORIF)
  • intramedullary (IM) nailing
  • arthroplasty (replacement)
  • K wires (pins)
  • tension band wiring
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5
Q

what are treatment (sort of just like basic) for lower limb fractures - ankle, tibial shaft, tibial plateau, femoral, pelvic?

A
  • ankle - cast, moonboot, ORIF
  • tibial shaft - above knee cast, IM nailing (better for adults)
  • tibial plateau - above knee cast, ORIF, knee replacement
  • femoral shaft - IM nailing (unless very young kids then cast)
  • pelvic binder at A&E, conservative or operative
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6
Q

what lower limb fractures have higher risk of compartment syndrome?

A

compartment syndrome = super high pressure in compartment, need fasciotomy

tibial shaft & tibial plateau have high risk (tibial shaft has associated risk of neurovascular injury of popliteal structure/common peroneal nerve )

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7
Q

what is importance of horizontal beam x-ray for tibial plateau?

A

when lying flat the fat, bone marrow & blood can settle and can see fluid level

  • proves fracture is there even if can’t see with naked eye x-ray so MRI next step
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8
Q

what are examples of upper limb fractures?

A
  1. distal radius fracture
  2. forearm fractures - often fracture to both radial & ulnar
  3. olecranon fractures
  4. humerus shaft fractures
  5. proximal humerus fractures
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9
Q

what are the 3 subtypes of distal radius fractures

A
  1. colles fractures = broken piece of radius points backwards (dorsal displacement) - fall on outstretched hand
  2. smiths fractures = broken piece of radius points forward (volar displacement)
  3. barton’s fractures = fracture dislocation of radiocarpal joint
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10
Q

what are the monteggia & galeazzi fracture dislocations of forearm?

A

Galeazzi = has Radial fracture & Ulnar displacement
Monteggia = has Ulnar fracture & Radial displacement

GRUESOME MURDER

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11
Q

what is nightstick fracture?

A

type of forearm fracture where isolated fracture of ulna - like if protect arm over body. usually mid diaphysis from direct blow

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12
Q

what is treatment of olecranon fractures?

A

tension band wiring or ORIF or cast

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13
Q

what upper limb fracture is very forgiving?

A

humeral shaft fracture - big malalignment not big deal as doesn’t limit function

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14
Q

what upper limb fractures have big risk of nerve injury?

A
  • humeral shaft fracture = radial nerve (wrist drop)
  • proximal humerus = axillary nerve (regimental patch)
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15
Q

what are early local complications of fracture?

A
  1. compartment syndrome
  2. vascular injury
  3. nerve injury
  4. skin necrosis
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16
Q

what are early systemic complications?

A
  1. hypovolaemia
  2. fat embolism
  3. acute respiratory distress syndrome (ARDS)
  4. systemic inflammatory response syndrome (SIRS)
  5. multi-organ dysfunction syndrome
17
Q

what is late local complications?

A
  • stiffness, loss of function
  • post traumatic arthritis
  • non union or malunion
  • volkmann’s ischaemic contracture (permanent flexion of wrist & fingers - claw)
  • CRPS (neurological pain syndrome)
  • osteomyelitis
  • avascular necrosis
18
Q

what are late systemic complications of fracture?

A

DVT or PE

19
Q

what is hypertrophic non-union fracture healing?

A

mechanical problem, too much movement at fracture site, abundant callus response but failure union. infection can result in atrophic or hypertrophic nonunion

20
Q

what are osteoclasts main function?

A

bone resorption

MSK (33 decks)

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