common fractures Flashcards by Amy Hollis

what are some common lower limb and pelvis fratures?

Ankle fractures
Tibial Shaft Fractures
Tibial Plateau fractures
Femoral Shaft Fractures
Pelvic Fractures

How well did you know this?

Not at all

Perfectly

how do ankle fractures commonly occur?

inversion injury with rotational force applied to the foot

How well did you know this?

Not at all

Perfectly

what is the classification of ankle fractures?

Weber A, Weber B, Weber C

How well did you know this?

Not at all

Perfectly

what would you classify a fracture in the blue area?

Weber A fracture (below joint line- stable)

How well did you know this?

Not at all

Perfectly

what would you classify a fracture in the green area?

Weber B fracture

How well did you know this?

Not at all

Perfectly

what would you classify a fracture in the purple area?

Weber C fracture (above joint line- unstable)

How well did you know this?

Not at all

Perfectly

management of ankle fractures?

conservative:
-cast or mono boot

operative:
-open reduction internal fixation (ORIF)

How well did you know this?

Not at all

Perfectly

what do tibial shaft fractures increase risk of?

compartment syndrome

How well did you know this?

Not at all

Perfectly

what type of tibial shaft fractures are there?

Spiral
Transverse
Oblique
Comminuted

How well did you know this?

Not at all

Perfectly

management for tibial shaft fracture?

conservative:
-above the knee cast

operative:

IM nailing
open reduction internal fixation

How well did you know this?

Not at all

Perfectly

what causes tibial plateau fracture?

in young- high energy injuries

in old- low energy injuries in osteoporotic bone

How well did you know this?

Not at all

Perfectly

what are risks associated with tibial plateau fracture?

neurovascular injury of popliteal structure/common perineal nerve
compartment syndrome

How well did you know this?

Not at all

Perfectly

what type of fracture are soft tissue injuries of knee joint structures associated with?

tibial plateau fracture

How well did you know this?

Not at all

Perfectly

management for tibial plateau fracture?

conservative:
-above knee cast

operative:

Open Reduction Internal Fixation (ORIF)
External Fixator
Delayed Total Knee Replacement

How well did you know this?

Not at all

Perfectly

management for femoral shaft fracture?

conservative:
-not typically used

operative:

IM nail
plate fixation: ORIF

How well did you know this?

Not at all

Perfectly

what is management for pelvic fractures?

initial= pelvic binder

conservative

operative

How well did you know this?

Not at all

Perfectly

what are common fractures of upper limb?

Distal Radius Fractures
Forearm Fractures
Olecranon Fractures
Humeral Shaft Fractures
Proximal Humeral Fractures

How well did you know this?

Not at all

Perfectly

what is a common cause of distal radius fracture?

FOOSH

Fall on outstretched hand

How well did you know this?

Not at all

Perfectly

what are the different distal radius fractures?

Colles
Smiths
Bartons fractures

How well did you know this?

Not at all

Perfectly

what are Colles distal radius fracture?

Colles fracturesare common extra-articular fractures of the distal radius that occur as the result on an outstreteched hand. Consists of a fracture of the distal radial metaphyseal region with dorsal angulation and impaction, but without the involvement of the articular surface.

How well did you know this?

Not at all

Perfectly

what are smiths distal radius fracture?

Smith fractures, are fractures of the distal radius with associated volar angulation of the distal fracture fragment(s). Classically, these fractures are extra-articular transverse fractures and can be thought of as areverse Colles fracture.

How well did you know this?

Not at all

Perfectly

what are Barton distal radius fractures?

Barton fractures extend through the dorsal aspect to the articular surface but not to the volar aspect . There is usually associated dorsal subluxation/dislocation of the radioocarpal joint.

management for distal radius fracture?

conservative:
-cast/splint

operative:
-ORIF/MUA + K-wires/Ex-fix

if there is a fracture in the radius there is usually a fracture in the ulna.

True or False?

True

Usually if there is a fracture of one bone, often there is an injury of the other

what are examples of forearm fracture patterns?

Monteggia Galeazzi fracture dislocations Nightstick fracture

what is a Monteggia fracture?

Monteggia fracture-dislocations consist of a fracture of the ulnar shaft with concomitant dislocation of the radial head.

what is Galeazzi fracture?

Galeazzi fracture-dislocations consist of a fracture of the distal part of the radius with dislocation of the distal radioulnar joint and intact ulna

what's a nightstick fracture?

Nightstick fractures are isolated fractures of the ulna - typically transverse and located in the mid-diaphysis and usually resulting from a direct blow. It is a characteristic defensive fracture

management of forearm fractures?

conservative: -cast operative: -ORIF

what is an olecranon fracture?

common injury from falling onto the elbow

management of olecranon fracture?

conservative: -cast Operative: - tension band wiring/ORIF - plate fixation

what risks does a humeral shaft fracture have?

radial nerve

what causes humeral shaft fracture?

-direct trauma to the arm

what is a humeral shaft fracture?

fall resulting in oblique, or spiral fractures in the humeral bone

what is the management for humeral shaft fractures?

conservative: - humeral brace/U slab cast - IM nail/ORIF plate fixation

what is a proximal humerus fracture?

common injury to humerus, typically low energy of osteoporotic bone from a fall

risk associated with proximal humerus fracture?

damage to axillary nerve

what is the management for proximal humerus fracture?

conservative: -collar + cuff Operative: -ORIF/replacement

what's 1st degree nerve injury?

neurapraxia

what is neuropraxia?

Temporary conduction block / demyelination | Should resolve within 28 days

what is 2nd degree nerve damage?

axonotmesis

what is axontmesis?

Nerve cell axon dies distally from point of injury = Wallerian degeneration Structure of nerve (endoneurial tubes) intact Regenerates at 1mm per day

what is 3rd degree nerve damage?

neurotmesis

what is neurotmesis?

Nerve transected – rare with # or dislocation | No recovery without surgery

what is malunion?

fracture has healed in non anatomic position

how does malunion present?

Pain Stiffness Loss of Function Deformity

what is non union?

when the fracture doesn't heal

what increases chances of atrophic non union?

``` Poor blood supply to fracture site Fracture gap too big and no movement Systemic disease Smoking Medicines – steroids, NSAIDs, bisphosphonates infection!! ```

what increases chances of hypertrophic non union?

- Too much movement at fracture site - Abundant callus response but failure union -Infection

what are the two ways in which fractures may heal and what is more common?

-primary or secondary secondary bone healing occurs in majority of fractures

when would primary bone healing occur?

-in minimal fracture gap (less than 1mm hairline fracture)

describe primary bone healing

-bones bridge the gap with new bone from osteoblasts

describe secondary bone healing?

- fracture occurs - haematoma occurs with inflammation from damaged tissue - macrophages and osteclasts remove debris and resorb the bone ends - granulation tissue forms from fibroblasts and new blood vessels - chondroblasts form cartilage (SOFT CALLUS) - osteoblasts lay down bone matrix (type 1 collagen) - calcium mineralisation produces immature woven bone (HARD CALLUS) - remodelling occurs with organisation along lines of stress into lamellar bones fracture---->swelling ---->soft callus (2-3 weeks)----> hard callus (6-12 weeks)--> remodelling