Fracture complications

Question 1

what are some immediate complications due to fractures ?

Answer 1

neurovascular damage

visceral damage

Question 2

what are some early complications due to fractures ?

Answer 2

compartment syndrome
infection
fat embolism could lead to ARDs

Question 3

what are some late complications due to fractures ?

Answer 3

problems with union 
AVN (avascular necrosis)
growth disturbance 
myositis ossificans (bone formation inside muscle at sites of haematomas)
regional pain syndromes

Question 4

state some general complications of fractures ?

Answer 4

tissue damage 
- infection, haemorrhage 
anaesthesia 
- anaphylaxis, aspiration 
prolonged bed rest 
- chest infection, pressure sores, DVT, PE

Question 5

what are the three types of nerve damage ?

Answer 5

neuropraxia
axonotmesis
neurotmesis

Question 6

what does axillary damage result in ?

Answer 6

weak abduction

Question 7

what does ulnar damage result in ?

Answer 7

claw hand

Question 8

what does radial damage result in ?

Answer 8

wrist drop

Question 9

what does hip and knee dislocation result in ?

Answer 9

foot drop

- sciatic and fibular nerves

Question 10

what is Rhabdomyolysis?

Answer 10

Rhabdomyolysis is the breakdown of damaged skeletal muscle. Muscle breakdown causes the release of myoglobin into the bloodstream. Myoglobin is the protein that stores oxygen in your muscles. If you have too much myoglobin in your blood, it can cause kidney damage.

Question 11

what can compartment syndrome cause ?

Answer 11

increased pressure in muscle compartment, less difference between venous and arterial pressure so muscle becomes ischaemic which leads to rhabdomyolysis and Acute tubular necrosis (ATN) which causes AKI (acute kidney injury)
can even cause fibrosis

Question 12

what contracture can result from compartment syndrome ?

Answer 12

Volkmann contracture
- is a permanent shortening of forearm muscles, usually resulting from injury, that gives rise to a clawlike deformity of the hand, fingers, and wrist. It is more common in children.

Question 13

what is the presentation of compartment syndrome?

Answer 13

pain doesn’t match clinical findings
pain on passive muscle stretching
warm, erythematous, swollen

Question 14

what is the treatment of compartment syndrome ?

Answer 14

elevate limb
remove all bandages and cast
fasciotomy

Question 15

what are the consequences of AVN ?

Answer 15

bone becomes soft and deformed

→ pain, stiffness and OA.

Question 16

what does an Xray show of AVN?

Answer 16

sclerosis and deformity.

Question 17

name some common sites where AVN occurs?

Answer 17

femoral head, scaphoid, talus

Question 18

what is Pellegrini-Stieda disease?

Answer 18

Calcification of the superior attachment of MCL @

the knee following traumatic injury

Question 19

what is complex regional pain syndrome type 1 ?

Answer 19

Complex disorder of pain, sensory abnormalities, abnormal blood flow, sweating and trophic changes in superficial or deep tissues.
 No evidence of nerve injury.

Question 20

what is the presentation of complex regional pain syndrome type 1 ?

Answer 20

NOT traumatised area that is affected: affects a
NEIGHBOURING area.
 Lancing pain, hyperalgesia or allodynia
 Vasomotor: hot and sweaty or cold and cyanosed
 Skin: swollen or atrophic and shiny.
 NM: weakness, hyper-reflexia, dystonia, contractures

Question 21

what can be a complication from type 5 salter harris fractures ?

Answer 21

growth arrest