Cortext Week 5 Flashcards
Name some early local complications of joint replacement
Infection, dislocation, instabirlity, fracture, nerve injury, ischaemia, DVT
Name some early general complications of joint replacement?
Hypovolaemia, shock, acute renal failure, MI, ARDS, PE, chest infection, urine infection - 0.2 % of death
Name some late local complications of joint replacement?
Loosening, infection, fracture, implant breakage, pseudotumour formation
What is Kellers procedure for?
Hallux valgus
What is a sequestrum ?
A dead fragment of bone
What is the term for new bone forming around the area of necrosis?
Involucrum
Why are children prone to osteomyseltis?
Metaphyses of long bones have abundant tortuous vessels with sluggish flow which can accumulate bacteria
What can children develop, which is a subacute osteomyelitis with a more insidious onset and where the bone reacts by walling off the abscess with a thin rim of sclerotic bone?
Brodies abscess
In chronic osteomyelitis - where does it commonly occur and what causes it?
Axial skeleton - from haematogenous spread pulmonarym urinary infections and discitis. TB can cause it.
What is acute osteomyelitis treated with>
Best guess IV antibiotics
How is chronic osteomyelitis usually treated?
With surgery
What three types of patients are at particular risk of osteomyelitis of the spine - most commonly lumbar?
Diabetics
IV drug users
Immunocompromised patients
What condition presents with insidious onset back pain which is constant and unremitting, paraspinal muscle spasm, spinal tenderness and fever?
Osteomyelitis
What investigations should be done for osteomyelitis of spine?
MRI, blood cultures and consider endocarditis
How is osteomyelitis of spine treated?
high dose IV antibiotics after CT guided biopsy
What does glasgow coma score of 8 or less imply?
Loss of airway control
What type of bone healing occus where there is minimal fracture gap (less than 1mm) and the bone simply bridges the gap with new bone from osteoblasts. It also occurs with hairline fractures and when they are fixed with compression plates and screws?
Primary bone healing
What bone healing occurs when there is a gap at the fracture site that needs to be temporarily filled to act as scaffold for new bone to be laid down?
Secondary bone healing
What bone healing involves an inflammatory response with recruitment of pluropotential stem cells?
Secondary
When does a soft callus usall form?
After 2nd to 3rd week
When does a hard callus usually form?
After 6-12 weeks
What can severely impair fracture healing?
Smoking
What occurs due to excessive movement at fracture site with abundant hard callus formation but too much movement to give the fracrure no chance to bridge?
Hypertrophic non-union,
What fracture comes from a pure bending force?
transverse
What fracture comes with shearing force from fall?
Oblique - can be fixed with screw
What are fractures with 3 or more fragments?
Comminuted
What fracture occurs when thebone is fractured in two places?
Segmentalk - long rods and plates
What can extra-articular unstable diaphyseal fractuyres be fixed with?
ORIF
What nerve can be affected in anterior dislocation of shoulder?
Axillary
What nerve can be affected in a humeral shaft fracture?
Radial
What can hypertrophic non-union occur due to?
Instability and excessive motion
What can atrophic non-union occur due to?
Rigid fixation with fracture gap and lack of blood supply
Name some fractures with poor blood supply?
Scaphoid waist, distal clavicle, subtrochanteric fractures of femur and Jones fracture of fifth metatarsal
