Fracture Assessment Flashcards
What is an open fracture?
Fractured bone exposed to environmental contamination via disrupted soft tissue covering.
Open fractures can lead to severe complications due to contamination.
What are the grades of the Gustilo-Anderson Open fracture classification System? (6)
- Grade 1: open fracture with wound < 1cm
- Grade 2: open fracture with wound >1cm with minimal soft tissue damage/flaps/avulsions
- Grade 3: open fracture with extensive soft tissue damage
- 3a: adequate soft tissue covering despite extensive soft tissue injury
- 3b: extensive soft tissue loss, periosteal stripping, bone exposure, often massive contamination
- 3c: open fracture with arterial injury requiring repair
This classification helps in determining treatment and prognosis.
What are the types of incomplete cortical disruption fractures? (3)
- Fissure
- Greenstick
- Depression (skull/nasal cavity)
Incomplete fractures are characterized by partial breaks in the bone.
What are the types of complete cortical disruption fractures?
- Simple (2 fragments)
- Comminuted (3+ fragments, fracture lines will interconnect)
- Segmental (3+ fragments, intact column in between the 2 fractures)
What ways in which a distal fragment can be displaced relative to the proximal fragment?
- Medial/Lateral
- Cranial/Caudal
- Proximal/Distal
Displacement describes the position of the distal fragment relative to the proximal fragment.
What does the Fracture Assessment Score (FAS) evaluate?
- Biological assessment
- Biomechanical assessment
FAS helps in determining the ideal type of fracture repair.
What factors are assessed in fracture repair? (4)
- Apparatus
- Alignment
- Apposition
- Activity
Comprehensive assessment is crucial for successful healing.
What are the types of plates used in fracture repair?
- DCP (Dynamic Compression Plate)
- LC-DCP (Limited Contact Dynamic Compression Plate)
- LCP (Locking Compression Plate)
Each type of plate has specific advantages and disadvantages regarding soft tissue preservation and stability.
which situations are best approached with an open reduction (3)?
- Articular fractures
- Anatomically reconstructable fractures
- Comminuted fractures treated by major segment alignment and cancellous bone graft
Open reduction allows for direct visualization and alignment of fracture fragments.
Types of fractures best treated with CLOSED REDUCTION? (2)
- Nondisplaced or incomplete fractures
- Comminuted fractures treated by major segment alignment using bridging osteosynthesis
Closed reduction is less invasive and is used when fractures are not displaced.
Times when Anatomic Reconstruction is used (3)?
- Articular fractures
- Single fractures
- Fractures with one to three large fragments
Anatomic reconstruction aims to restore the original anatomy of the bone for optimal function.
Grade open fracture, wound <1cm
Grade 1
Name of grading system for open fractures
Gustilo-Anderson Open Fracture Classification system
Grade open fracture 10cm wound with major soft tissue damage, bone exposure
grade 3b
Grade open fracture 10cm wound, arterial bleeding
Grade 3c
Grade open fracture 2cm wound, minimal soft tissue damage
Grade 2
Grade open fracture, wound 10cm but no big flaps or arterial bleeds
Grade 3a
Types of Complete Simple Fractures (3)
Transverse
Oblique (2x)
Spiral
Differentiating between short and long oblique
Long oblique length is 2 x diameter of bone at that level
Long obliques can be treated with…
cerclage wires or lag screws (may need multiple + neutralisation plate)
Definition of comminuted fracture
3 or more fragments, interconnected fracture lines
Grade open fracture 10cm wound, bone exposed, artery bleeding
grade 3c
name of open fracture grading system
Gustilo-Anderson Open Fracture classification system
Grade open fracture <1cm open wound
Grade 1
