Fracture description and radiographic assessment of fracture healing Flashcards

1
Q

Describe articular fractures

A

fracture involves the joint surface
all require rigid internal fixation to maintain articular surface to try and prevent severe OA

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2
Q

what is the diaphysis

A

Diaphysis is the shaft of the bone- the cortex is thick and bone strong

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3
Q

what is the metaphysis

A

Metaphysis is the transition from the physis or growth plate to the diaphysis
generally the bone is softer here

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4
Q

what is the epiphysis

A

the ends of the bons - are covered with articular cartilage making up the joint

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5
Q

what system do we use to treat physeal fractures

A

Salter Harris system - there are 5 fracture types described

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6
Q

Describe the aims of management of Salter Harris fractures

A

aim to maintain normal bone growth of the bone resulting in a limb of normal length without angular limb deformities

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7
Q

what are closed fractures

A

the skin is intact

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8
Q

what are open fractures

A

the skin overlying the fracture is broken

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9
Q

Describe a type 1 open fractures

A

small wound <1cm
little contamination
treat as a closed fracture

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10
Q

Describe a type 2 open fracture

A

extensive wound >1cm
communicating with the fracture

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11
Q

Describe a type 3 open fracture

A

very extensive soft tissue damage and fractured bones are seen protruding through the skin

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12
Q

Describe comminuted fracture

A

consists of at least 3 fragments

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13
Q

what may you need to use to fix a comminuted fracture

A

if not re-constructable- use buttress plate or external fixator to bridge the area of comminution

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14
Q

Describe a avulsion fracture

A

when a distractive force results in the fracture and also tends to bring about a loss of reduction

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15
Q

Describe how to repair avulsion fractures

A

need to overcome the distractive forces can use a lag screw or tension band to do this
this converts the distractive forces into compressive ones

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16
Q

what do pathological fractures originate from

A

from weakening of the bone by a pathological process e.g. neoplasia

17
Q

List 5 factors that affect bone healing

A

age of patient
comorbidities
nature of fracture
stability and appropriateness of the repair
post-op management

18
Q

what is primary bone healing

A

when there is bone to bone healing

19
Q

what is secondary bone healing

A

where there is intervening callus formation

20
Q

What does primary bone healing need

A

intimate contact of the bone ends under compression
needs application of bone plate and extensive dissection and manipulation of soft tissue

21
Q

describe how secondary bone healing works

A

does not require accurate reduction of the fracture
could just use an external fixator