Fracture Flashcards
what is a fracture
partisal or complete interurptiuon of the continuity of the bone
what is a dislcoation/subluxation
complete or partial disrutpion in the continuity of a jopint
what is a fracture disolaction?
fracture associated with a dislocation
describe the apporach in asessing a patient with a fracture?
Mechanims of injury
high energy?
ABCDE
physiology of patient (age)
associated comorbdiites
what is an open fracture?
inside out or outside in
bone fragemtns communite with outside
what makes open fractures high risk?
higher risk of contamination (infection)
generally high energy truama
more soft tissue injury
delated healing/nonn union
soft tissue cover required
describe the approach to open Fractures
- wound care
- pain manegement
- imaging (plane X-rays generally
-
reduction, immobilisation- most important
- conservative (plaster or splint)
- operation (fixation)
- early movement
what Xray rules shoul we follow for fractures ?
hint- (2…2….2…)
2 view (anteriro posteriro AP- lateral)
2 bones (make sure both are visiible)
2 joints (above and below fracutre)
what are the clinical features of a fracture?
pain
deformity
bone creptius
abnormal mobility
associated tissue injurty
neurovascular compromise
what should we consider when classifying a fracture (7 things)
Grwoth plate invovlemetn (skeletally mature vs immature)
anatomy (location)
extent (complete vs incomplete)
orientation (trnavers, oblique, spiral)
displacement
frgamentation (comminated /segmental)
soft tisssue (open or closes)
why might a children fracture we difficult to see on an xray?
children have evry thick periosteum (bone that hasnt calcified yet)
stronger than actual bone
perisotreal disruption (still a fracutre)- Buckle fracture
what is a complete vs incomplete fracture
what type of force causes a spiral fracture?
torque/ rotating force applied along the axis of the bone
what is more signficant intra-articular or extra arctiular fracture?
Intra-articular fracture (involving a joint more significant)
joint is lined by articular cartilage - this needs normal blood supply
if there is a dislocation of the intra articulaf fracutre can die fast f not realligned
What do we need to remember when looking at fracutres in children?
Growth plates!
dont mistake for fractures
epiphyseal plate
What are red flags in fractures for pathology pre-exsiting in the bone?
walking and bone break
not normal to happen
large fractures require large force
tumour? metastasis from otuside the bone
Elderly- osteoporososis (kyphotic defomrity)
what are the serious complications of fractures ot be aware off?
compartment syndrome
infection (ctastrophic in bones)
long term (stiffness, arhtritis, instability, noon union- avascualar necosis)
general (DVT/PE)
what kind of fracture causes growth arrest?
in children if there isna fraxture and the growht plate is damaged
rest of growth plate may stop too complete- disproportionate lenght of limbs
what is avascualr necorsis? where is it come
what will it lead to?
AVN/ non union fracutre
common in scaphoid in the hand
doesnt heal the fracture- lack of blood supply causes necorsis
lead to post trsauamtic arthritis
management for open fractures?
