Conservative Fracture management Flashcards
What are the 4 stages of fracture management?
- Resuscitate
- Reduce
- Retain
- Rehabilitate
What are the main forms of reduction of a fracture?
- Open reduction
- Closed manipulation
- Traction
When may open reduction be required?
When anatomical reduction is necessary - e.g. inta-articular fractures) or associated neurovascular damage
When may closed reduction be regarded as the best option?
For extra-articular fractures where accurate reduction can be achieved
What are methods for retaining a fracture in its reduced position?
- External fixation
- Internal fixation
- Conservative immobilisation
When would external fixation be used to retain a fracture in its reduced position?
- Contaminated open wound
- Severe open fractures
- Severe associated soft tissue injury
When would internal fixation be used to retain the position of a fracture following reduction?
- Comminuted or displaced fractures
- Intra-articular fractures
- Bones not able to be reduced by other methods
- Associated joint incongruity
What are the main forms of intramedullary internal fixation?
- K-wires
- Intramedullary nails
What are the main forms of extramedullary internal fixation?
Plates and screws
How would you conservatively manage a C-spine fracture?
Cervical collar/traction
How would you conservatively manage a pelvic fracture?
- If stable - none necessary
- Immediate management - pelvic binder
How would you conservatively manage a proximal humerus fracture?
Collar and cuff
How would you conservatively manage a midshaft humeral fracture?
Collar and cuff, and U-slab/functional humeral brace
How would you conservatively manage a distal/olecranon/epicondylar humeral fracture?
Above elbow backslab/cast
How would you conservatively manage a colles fracture?
Colles backslab - below elbow backslab with wrist flexed and ulnar deviated
How would you manage a Smith’s fracture?
Below Elbow backslab/cast with wrist extended
How would you conservatively manage manage a volar Barton’s fracture?
Above elbow backslab/cast
How would you conservatively manage an ulnar fracture?
Above elbow backslab/cast
How would you conservatively manage a fracture of the scaphoid?
- Futuro splint +/- thumb extension
- Tumb spica splint/cast - If definite fracture
How would you conservatively manage a fracture of any other carpal of the hand except the scaphoid?
- Below elbow backslab/cast
- Volar/dorsal forearm splint
How would you conservatively manage a bennet’s fracture?
Bennet’s Cast
How would conservatively manage a fracture of 4th/5th metacarpals?
- Ulnar gutter splint
- Volar/dorsal forerarm slab/splint
How would you conservatively manage a fracture/fractures of the 2nd/3rd metacarpals?
- Radial gutter splint
- Volar/dorsal forearm slab/splint
How would you conservatively manage a patella fracture?
- Above knee backslab
- Leg cylinder cast
- Hinge brace
- Cricket brace
How would you conservatively manage a tibial plateau fracture?
- Hinge brace
- Above knee back-slab/cast - non-weight bearing
How would you conservatively manage a tib/fib fracture?
Above knee back slab/cast
How would you conservatively manage a bi/trimalleolar fracture?
Non weight bearing
- Below knee backslab/cast
How would you conservatively manage a metatarsal fracture?
Weight bear as tolerated
- Stiff soled shoes
- Walking boot
How would you conservatively manage fractures of the proximal or mid palages of the hand?
- Buddy tape
- Ulnar/radial gutter splint
- Dorsal/volar finger splints
How would you conservatively manage someone with a distal phalanx fracture?
- U-shaped splint
- Mallet finger splint - if mallet fracture
