Brainscape's Knowledge GenomeTM

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


See full index

Orthopaedic Medicine > common fractures > Flashcards

common fractures Flashcards

1
Q

which 2 X-ray views are usually taken to ix a fracture

A

coronal and saggital

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

what is a tomogram

A

a view of a slice through a part of the body

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

what will an U/S show following a fracture

A

accumulation of fluid (especially blood)

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

describe radioisotope scanning in ix of a fracture

A
  • radioactive substance injected into bloodstream
  • the substance ends up in bones because it attaches to phosphate molecules which are actively taken up by bone
  • the more metabolically active the bone is the faster it will take it up
  • therefore the areas of unusual metabolic activity (the fracture sites) can be seen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when would radioisotope scanning be used?

what bone in particular is it commonly used to ix?

A

if there is clinical doubt about whether or not there is a fracture

scaphoid

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

spiral fractures - a lot or little soft tissue damage?

A

usually little

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

fractures are described in terms of the ? fragment in relation to the ? fragment

A

distal

proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describing fractures

A 
which bone
open or closed
where on the bone 
shape (spiral, oblique, transverse)
how many fragments (simple, comminuted)
position of distal fragment (displacement, angulation, rotation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describing fracture angulation

A

anterior, posterior, varus, valgus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

traction may be used early in tx to relieve what?

A

muscle spasm (which is a major component of post fracture pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

a femoral fracture will cause how much blood loss?

A

between 2 and 3 units

one unit is about 450ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

major pelvic fractures are associated with what type of bleeding? how much blood could be lost?

A

major venous bleeding from pelvic plexuses

up to 6 units may be lost

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

vast majority of wounds should be left open or closed?

A

left open (if any doubt about closure causing tension on the skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe a functional brace

A

accurate fit so needs to be fitted after swelling and pain have settled
hinges allow joint movement in one direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

modern casting materials

A

glass fibre and polyurethane resin combinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when is external fixation advantageous

A

high energy fractures associated with soft tissue damage where access is needed for secondary surgery/skin grafting means internal fixation is not ideal (also because of risk of ischaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when is internal fixation used

A

where a high degree of accuracy is required or other methods fail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

types of internal fixation

A

apposition
inter fragmentary compression
inter fragmentary compression plus onlay device
inlay device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is used in apposition

A

k wires

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is usually used in inter fragmentary compression

A

screws

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

in which type of bone is inter fragmentary compression particularly valuable

A

cancellous bone around joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what do onlay devices usually consist of

A

a plate of metal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is worse for disruption of natural bone healing - inlay or onlay devices?

A

onlay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

are inlay devices useful around joints?

A

no because they are relatively inaccurate at restoring anatomical position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how does traction work in holding a fracture in reduction

A

the pull of a weight stimulates muscles to contract which holds the bones in position

26
Q

in static traction what is the pull applied against? example?

A

another part of the body

e.g. Thomas splint - pull applied against a ring which presses against the pelvis

27
Q

when is balanced traction used?

A

when static traction is in danger of causing damage to a part of the body through pressure

28
Q

when is dynamic traction used

A

when joints are still permitted to move, but by means of pulleys, the pull is still maintained along the line of the broken bone

29
Q

for long term dynamic traction, what is preferred - strapping stuck onto the skin or a pin inserted through the bone?

A

pin

30
Q

stages of bone healing

A

first 2 weeks - swelling
2-6 weeks - callus forming
6-12 weeks - bone forming
1-2 years - remodelling has taken place and the bone returns to normal

31
Q

bone heals in the presence of what type of movement?

A

micro movement directed along the long axis of the bone at right angles to the break

32
Q

will bones heal as normal if there is no movement?

A

no, it will be slow and by a different process which does not involve natural external callus formation

33
Q

bones fixed rigidly will heal slowly. this is most marked in

a) long bones
b) cancellous bone

A

a) long bones

34
Q

what type of fixation is particularly valuable in high velocity injuries

A

external fixation

35
Q

is fixation indicated in pathological fractures?

A

yes

36
Q

Internal fixation leads to early/delayed mobility but fast/slow healing ? ?

A

internal fixation leads to EARLY mobility but SLOW healing

37
Q

commonest cause of bone infection in the western world

A

surgery!

38
Q

if a fracture is held stable but there is infection, will it unite?

A

yes

39
Q

if an unstable fracture becomes infected what will be required?

A

stabilisation by external fixation followed by surgical wound cleansing and later bone grafting

40
Q

when is fat embolism typically seen

A

following a long bone fracture in a man under 20

41
Q

symptoms of fat embolism

A

rapid and shallow breathing
mild confusion
may have rash on chest and neck

42
Q

other name for compartment syndrome

A

Volkmann’s ischaemia

43
Q

can compartment syndrome occur without fracture

A

yes

44
Q

in compartment syndrome is the distal pulse usually normal?

A

yes

45
Q

what is found in abundance in the kidneys of people who die from renal failure following massive soft tissue injury

A

myoglobin

46
Q

why does early mobilisation following fracture prevent renal stone formation

A

thinning bone releases calcium which can cause renal stones

47
Q

if left to heal naturally how long will upper and lower limb fractures take to heal?

A

upper - 6 weeks

lower - 12 weeks

48
Q

once growth ceases is the rate of union age dependent?

A

no

49
Q

non union is most common in which bone

A

tibia

50
Q

timescale when we would generally class a fracture as non union in a) per limb b) lower limb

A

a) upper limb - 10 weeks

b) lower limb - 20 weeks

51
Q

what may be added to stimulate union

A

bone graft (autologous)

52
Q

children have a great capacity to remodel mal united fractures, but what type of deformity will they not be able to remodel

A

rotary

53
Q

what may arrest bone growth

A

fracture breaching the germinal layer of the epiphyseal growth plate

54
Q

when is dynamic traction particularly useful

A

treatment of fractures of the femur where splintage to involve the hip joint is impractical

55
Q

what is the main problem with traction

A

the injured person must remain in bed which prolongs hospital stay and makes nursing difficult

56
Q

describe fat embolism in detail - onset, symptoms, management …

A

onset within 2-5 days from injury
mild confusion, rapid shallow breathing, rash on chest/neck
early dx important followed by high % oxygen, chest physio, maybe steroids

57
Q

name 6 early complications caused by fracture

A 
blood loss
compartment syndrome
renal failure
infection
soft tissue injury
fat embolism
58
Q

name 5 complications that may result from fracture treatment

A 
plaster disease (skin sores, stiffness, muscle wasting)
immobility 
infection
compartment syndrome
renal stones
59
Q

Why may arthritis develop following fracture

A

if the fracture goes through the joint then the surfaces will no longer be congruent
a very angulated fracture will put uneven forces on the joint

60
Q

causes of delayed/non union

A 
excess movement 
too little movement 
infection 
poor bloody supply
soft tissue interposition 
excessive traction
intact adjacent bone

Orthopaedic Medicine (5 decks)

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