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Y2 Finals > Fracture > Flashcards

Fracture Flashcards

1
Q

What are the causes of fractures

A
  1. Overuse during repetitive activities (running & jumping)
  2. Physical force
  3. Osteoporosis
  4. Ca
    (osteoporosis & Ca will cause spontaneous fracture)
    (    pathological fracture means the bone will just break if you hit it with mild strength)
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2
Q

What are the modifiable risk factors of fracture

A
  1. Decreased vitamin D
  2. Smoking
  3. Alcohol
  4. Glucocorticoid used (will decrease bone mass)
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3
Q

What are the non-modifiable risk factors of fracture

A
  1. Increased age
  2. Congenital disorder (osteoporosis imperfecta)
  3. Malabsorption problems (for Ca & Vit D)
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4
Q

What are the signs and symptoms of fracture

A
  1. Localised pain
  2. Swelling
  3. Bruising
  4. Misaligned (e.g. external rotation)
  5. Shortened
  6. Deformities
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5
Q

What to do when a leg is externally rotated

A

Require open surgery immediately & urgently to prevent cut off of blood supply

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6
Q

How to tell if a patient’s leg is shortened

A

Let patient lie supine and look at position of foot (*if patient is in pain, do not need to see the length of the leg)

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7
Q

What to assess when you meet a patient with fractures

A
  1. Assess positioning of limbs
  2. Check for swelling
  3. Check for crepitus
  4. Check for deformity
  5. Check for skin integrity
  6. Check for pain/inflammation
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8
Q

What should you do when a patient with fractures come in with pain & inflammation

A

Immobilise & send pt to X-ray (*do not do PE first)

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9
Q

What kind of fractures are there

A
  1. Transverse
  2. Longitudinal
  3. Oblique
  4. Spiral
  5. Comminuted
  6. Impacted
  7. Green stick
  8. Stress
  9. Avulsion fracture of patella
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10
Q

Who is green stick fractures most likely seen in

A

Children - can be sign of child abuse (bone only crack but not separated)

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11
Q

What kind of fractures are simple fractures

A

Oblique, Greenstick, Spiral, Transverse, Longitudinal

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12
Q

What kind of fracture is a comminuted fracture

A

Complex multiple fracture - related to dislocation

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13
Q

What is a complete fracture

A

A fracture that breaks through entire bone, becoming shorter & completely displaced

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14
Q

What is a incomplete fracture

A

A fracture with only buckles & cracks

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15
Q

What kind of fracture is it when skin is broken/penetrated due to extensive trauma like RTA

A

Open/compound fracture

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16
Q

What is kind of fracture is it when skin is not broken

A

Closed/simple fracture

17
Q

What kind of fracture is it when the fragments of a fracture are aligned and in position

A

Non-displaced fracture

18
Q

What kind of fracture is it when bone ends are separated

A

Displaced fragment/fracture

19
Q

What kind of fracture is it when it involves a flat bone and fragments fog below level of bone surface

A

Depressed fracture

20
Q

How many X-rays should be taken for a normal fracture

A

2 - AP & L

21
Q

How many X-rays should be taken for a fracture near the joint

A

3 - AP, L & PA

22
Q

What kind of test should be done for fractures that are small/occult/non-displaced in areas where it is difficult to visualise

A

CT/MRI

23
Q

What should the doctor do if fracture is suspected but cannot be visualised by X-ray/MRI/CT

A

Immobilise it and take another X-ray 1-2 weeks later

24
Q

What markers indicate inflammation

A

CRP & ESR (CRP for acute inflammation)

25
Q

What are the healing stages for fractures

A
  1. Haematoma formation
  2. Soft callus formation
  3. Hard callus formation
  4. Bone remodeling
26
Q

What is the treatment plans for fracture

A
  1. Rest & Immobilise affected limb
  2. Removable splint/cast
  3. Reduction of displaced fractures
    • closed reduction (no surgery)
    • open reduction (with surgery; internal & external fixture)
27
Q

What is the management for fractures

A
  1. Reduction (to restore normal anatomical position if possible & prevent potential NV compromise/iscahemia to distal limb)
  2. Immobilisation (reduced fracture to be maintained in proper alignment)
  3. Ice, elevate, Immobilise affected limb
  4. Cast, splint, braces
  5. Surgery
  6. Internal fixation
  7. External fixation
  8. Bone grafting
  9. Electrical bone stimulation
  10. Abx prophylaxis for open/compound fracture OR tentanus prophylaxis, pain & rehab of soft tissue structures
28
Q

What is the nursing management of fractures

A
  1. Pain management (pharm & non pharm: ice, pursed lip breathing, music therapy)
  2. Ensure properly Immobilise & elevated on pillow
  3. Monitor for NV compromise (colour, tempt, cap refill, peripheral pulse, oedema, movement, sensation, pain)
  4. Assist to ambulate to bathroom
  5. Inform that PT will work with patient post-opt to promote healing process
29
Q

What are the complications of fractures

A
  1. Damage around structures by broken ends of the bone (bleeding blood vessels, altered sensation in nerves, tear to muscle/tendon)
  2. Compartment syndrome
  3. Fat metabolism from long bone fracture travel up to heart, leg and brain
  4. Bone deformity
  5. Joint stiffness/instability
  6. Contracture (muscle & tendon become shorter and ROM limited)
30
Q

What complications can happen to a Immobilised patient with fracture

A

DVT (+ve Homan’s sign) & pressure injury

Y2 Finals (10 decks)

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