Fracture complications

Question 1

What are some early local complications of fracture?

Answer 1

• Compartment syndrome
• Vascular injury and distal ischaemia
• Nerve injury
• Skin necrosis

Question 2

What are some early systemic complications of fracture?

Answer 2

Hypovolaemia
Fat embolism

Question 3

What are some complications that can arise due to fat embolism in fracture?

Answer 3

• ARDS - Acute respiratory distress syndrome
• SIRS - Systemic Inflammatory response syndrome
• Multi-organ dysfunction syndrome

Question 4

What are the 3 degrees of nerve injury in fracture?

Answer 4

1st - Neurapraxia
2nd - Axonotmesis
3rd - Neurotmesis

Question 5

What is neurapraxia?

Answer 5

This is temporary conduction block that should resolve in around 28 days

Question 6

What is Axonotmesis?

Answer 6

This is death of the distal nerve cell axon (Wallerian degeneration), which will begin to regenerate at 1mm per day

Question 7

What is neurotmesis?

Answer 7

Full transaction of a nerve, requiring surgery

Question 8

What are some late, localised complications of fracture?

Answer 8

• Stiffness
• Loss of function
• Post-traumatic arthritis
• Malunion (Don’t heal in correct way)
• Chronic regional pain syndrome
• Osteomyelitis
• Avascular necrosis
• Volkmann’s ischaemia contracture

Question 9

What is Volkmann’s ischaemia contracture?

Answer 9

Shortening of flexor tendons showing an abnormal hand

Question 10

What are some late systemic complications of fracture?

Answer 10

DVT
PE