FN: Fracture Management

Question 1

4 R’s

Answer 1

Resusitation
Reduction
Restriction
Rehabilitation

Question 2

Open fractures 6 As

Answer 2

1. Analgesia: M and M
2. Asses: NV status, soft tissues, photograph
3. Antisepsis: wound swab, copiuos irrigation, cover with betadine-soaked dressing
4. Alignment: align fracture and splint
5. Anti-tetanus: check status (boaster lasts 10 yrs)
6. Antibiotics: Fluclox 500 mg IV/IM and benpen 600mg IV/M
   OR augmentin

Question 3

Classification system of open wounds

Answer 3

Gustillo classification

Question 4

Gustillo 1

Answer 4

Wound <1cm in length

Question 5

Gustillo 2

Answer 5

Wound >1 cm with minimal soft tissue damage

Question 6

Gustillo 3

Answer 6

Extensive soft tissue damameg

Question 7

Most dangerous complication of open fractures

Answer 7

1. Clostridium perfringes
2. Wound infection sna dgas gangrene
3. ± shock and renal failure
4. Management: debride, benpen and clindamycin

Question 8

Reduction methods

Answer 8

Manipulation/closed reduction
Traction
Open reduction (and internal fixation)

Question 9

Restriction methods

Answer 9

Non-rigid - slings/elastic supports

2. Plaster - POP/back slab
3. Functional bracing - joints free to move but bone shafts supportewd in cast segments
   Continours traction e.g. collar and cuff
4. Ex fix - pin wires adn external frame
5. Internal fixation - pins, plates, screws and IM nails (increased stability)

Question 10

Rehabilitation

Answer 10

Physio
OT
Social services to aid with home and food