Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Clinical approach to fractures > Flashcards

Clinical approach to fractures Flashcards

1
Q

What aspects of a history may suggest a fracture?

A
  • History of injury
  • Tenderness of bone
  • Deformity of bone
  • Pain with remote force
  • Abnormal mobility
  • Patient will protect and support limb/part of body
  • Fracture from fall from standing height suggests pathological fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What rule is used when ordering a radiograph?

A
  • Rule of 2
  • 2 joints: affected joint and one above/one above and one below
  • 2 angles: AP and lateral
  • 2 separate occasions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you describe a fracture/radiograph?

A

1) Demographics of patient details
2) Date of radiograph
3) Orientation of image
4) Mechanism of injury as described by patient
5) Talk about fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you include when talking about a fracture on a radiograph?

A
  • Anatomical location
  • Compound of closed (and GA class if relevant)
  • Type of fracture
  • Intra- or extra-articular
  • Deformities (displacement, angulation, rotation)
  • Soft tissue and neurovascular status
  • Other medical conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 4 R’s of fracture management?

A

Resus, reduction, restriction (stabilisation), rehab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What part of ATLS contains fracture resus and why?

A
  • Secondary survey
  • Fractures not immediately life threatening, so assess primary survey first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the initial management of fractures?

A
  • Give analgesia
  • Assess NV status and document
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the definitive management of fractures?

A
  • Wound debridement (if any)
  • Fixation in theatre
  • Internal fixation avoided in open fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 6A’s of open fracture management?

A
  • Analgesia
  • Assess NV status and document
  • Anti-sepsis
  • Anti-tetanus
  • Alignment and splinting
  • Antibiotics (broad spectrum)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the cornerstone of open fracture fixation?

A
  • Early debridement of foreign material and devitalised tissue
  • Irrigate wounds with 6L saline
  • Cover wounds with dressing
  • External fixation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should fractures be reduced?

A
  • All displaced fractures should be reduced unless no proven benefit (e.g. clavicular fractures)
  • Anatomical reduction particularly important on articular surfaces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What must be done to check success of fracture reduction?

A

Check alignment of fracture with pre- and post-reduction X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 2 possible methods for fracture reduction?

A
  • Closed-manipulation
  • Open/surgical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Closed reduction/manipulation?

A
  • Done under LA, regional, or GA
  • Aims to realign fractur and may involve traction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the indications for closed reduction/ manipulation?

A
  • Low energy undisplaced fractures
  • Fractures in cancellous bone (kids)
  • Phalangeal or metacarpal fractures
  • Fractures that don’t require anatomical reduction (e.g. clavicular and most humeral fractures)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is restriction of a fracture?

A
  • Fixation of fracture site that reduces strain on bone
  • This allows easier healing and greater chance bone remains aligned
17
Q

Where should fixation be done?

A
  • At a site that allows movement once restriction is removed
  • E.g. where ligaments aren’t too tight
18
Q

What are the methods for restriction?

A
  • Non-rigid (e.g. slings or elastic support)
  • Crutches
  • Splints
  • Plaster
  • Functional brace
  • Continuous traction
  • External fixation
  • Internal fixation
19
Q

What are some complications of PoP casting?

A
  • Compartment syndrome
  • Pressure sores (particularly malleolus, dorsum of foot, distal ulna at wrist)
  • Skin blistering
  • Hair follicle/sweat gland dermatitis from staph infection
20
Q

When is external fixation most useful?

A
  • Open fractures
  • Fractures with burns
  • Fractures with tissue loss
21
Q

Rehabilitation (4 R’s of fracture management)?

A
  • Immobility causes reduced muscle mass and joint stiffness
  • Therefore earlier mobilization reduces morbidity later
  • Methods include physiotherapy, occupational therapy and social services
22
Q

What are the pros and cons of external fixation?

A
  • Pro’s: minimally invasive, and versatile
  • Con’s: risk of pin tract infection, and has higher rates of mal-alignment
23
Q

When are external fixations used?

A
  • Open fractures
  • Closed fractures with extensive soft tissue damage
  • Fractures with burns
24
Q

What are the2 types of internal fixation?

A

Intramedullary and extramedullary

25
Q

Intramedullary internal fixation?

A
  • Nails and wires inserted into the bone and held in place with pins
  • Used in LL diaphyseal fractures and UL fractures
  • Very good union rate and low complication rate
26
Q

Extramedullary internal fixation?

A
  • Main form is plating
  • Used in metaphyseal, articular, and UL diaphyseal fractures
  • Achieve high degree of fixation but has higher complication rate

MSK (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions