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Y4 final checklist_ SURGERY > Fracture extra > Flashcards

Fracture extra Flashcards

1
Q

How long do the features of lower limb take to heal?

A. in adults

B. in children

A

A. Adults → 12 weeks

B. Children → 6 weeks

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2
Q

How long do fractures of upper limb take to heal?

A. In adults

B. In children

A

A. Adults → 6 weeks

B. Children → 3 weeks

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3
Q

What’s MRI is used for in terms of fracture?

A

MRI → to assess spinal injury; soft tissues; muscles

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4
Q

What’s CT used to assess in terms of fracture?

A
  • visceral injury in pelvic fracture
  • visceral injury in lower rib fracture
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5
Q

What air in the tissue on the imaging may indicate?

A
  • open wound
  • fracture
  • visceral injury
  • infection
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6
Q

How would you fix articular and comminuted long-bone fracture under ORIF e.g. ankle fracture?

A

Plate and screws

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7
Q

The method used to fix long bone (femur, tibia, humerus) fractures?

A

Intramedullary nail

* it allows early mobilisation

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8
Q

The method used to fix foot, wrist and hand fractures?

A

Kirschner (K) wires

* wires are inserted percutaneously and can be placed under tension

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9
Q

Phases of fracture healing (3) just name

A
  1. Inflammatory phase
  2. Reparative phase
  3. Remodelling phase
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10
Q

What happens in the inflammatory phase of fracture healing?

A
  1. Inflammatory 2. Reparative 3. Remodelling

Inflammatory phase:

  • first 24-72 hrs
  • fracture → bleeding → swelling
  • cytokines are released
  • this all stimulate repair mechanism
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11
Q

What happens in the reparative phase of fracture healing? (2)

A
  1. Inflammatory 2. Reparative 3. Remodelling

Reparative phase → depends on stability of the fracture:

  • healing by callus in unstable fractures: occurs between 4-8 weeks; necrotic bone is reabsorbed and weak woven bone is laid down (it’s a precursor for highly organised and strong bone)
  • healing by primary bone healing in stable fractures: contact healing can occur when two ends are in direct contact
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12
Q

What happens in the remodelling phase of fracture healing?

A
  1. Inflammatory 2. Reparative 3. Remodelling

Remodelling phase:

  • starts 8-12 weeks after the fracture
  • ends of the repair phase
  • continues for years
  • strong lamellar bone replaces woven bone
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13
Q

Management of clavicular fracture (2)

A

Conservative → for uncomplicated fracture:

  • broad arm sling for 3 weeks
  • analgesia

*bump forms in the healed bone

Reduction with ORIF → needed if the fracture is open or if there s neurovascular compromise

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14
Q

Fracture of which part of the neck of the humerus is more dangerous?

A

The anatomical neck of humerus → risk of avascular necrosis

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15
Q

What’s the difference between dislocation and subluxation?

A
  • Dislocation → complete loss of contact between the articular surfaces of a joint
    • Subluxation → partial loss of contact
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16
Q

What’s the main complication of an anterior shoulder dislocation?

A

Axillary nerve injury (Regimental badge area)

It supplies: Teres minor, teres major and deltoid

17
Q

Name (3) methods to reduce dislocated shoulder

A

A. Kocker’s method

B. Hippocratic method

C. traction/countertraction

18
Q

Treatment of acromioclavicular joint subluxation/dislocation

A
  • often occur in rugby players

Treatment:

  • sling with strapping over joint
  • ORIF - occasionally to repair the ligament
19
Q

Classification of a fracture around the elbow and management (4)

A
  • radial head → undisplaced fractures (support bandage) + immobilisation; displaced (ORIF)
  • supracondylar → Mx depends on a fracture pattern
  • olecranon → ORIF and K-wires
  • Condylar:
  • medial epicondylar → ORIF + K-wires
  • lateral epicondylar → ORIF (if significant discplacement)
20
Q

Possible complications of condylar fractures (4)

A
  • growth arrest (in children)
  • mal-union
  • stiffness
  • ulnar nerve palsy
21
Q

Types of humeral mid-shaft fractures (2)

A

Both are fracture-dislocation

  • Galeazzi
  • Monteggia
22
Q

Management of Galeazzi and Monteggia fractures-dislocations

A

ORIF with plates and/or intramedullary nail

23
Q

(4) Types of distal radius fractures (just name)

A
  • Colle’s fracture
  • Smith’s fracture
  • Chauffeur’s fracture
  • Barton’s fracture
24
Q

Colle’s

  • what is this
  • management
  • complications
A

Colle’s

  • fracture that occurs 2.5 cm from a distal end of the radius + dorsal angulation
  • classic dinner fork deformity

Management: reduction of fracture under regional anaesthesia + plaster backslab for 6 weeks + X ray

Complications: Carpal tunnel syndrome, mal-union, stiffness, rupture of extensor pollicis longus

25
Q

Smith’s

  • what is this
  • management
A

Smith’s

*reverse of Colle’s

  • anterior angulation of radius + tilt

Management: manipulation under anaesthesia and plaster casts for 6 weeks

26
Q

Barton’s fracture

  • what is this
  • management
A

Barton’s fracture

  • intra-articular fracture of a wrist → hand and distal radius displace proximally

Management: Usually ORIF

27
Q

What’s Chauffeur’s fracture?

A

Fracture of the radial styloid

28
Q

What’s needed to assess a suspected scaphoid fracture (imaging wise)

  • management
A

4 radiographic views → but the fracture may still not be visible

*therefore fracture is assumed if there is a tenderness in the anatomical snuffbox area

Management:

  • scaphoid plaster (from elbow to knuckles)
  • repeat X ray in 2 weeks (bone scan may be needed if still cannot identify fracture)
  • if it shows the fracture → plaster on for 8 further weeks
  • if fracture not united at 12 weeks → internal fixation needed
29
Q

What’s Bennet’s fracture?

  • cause
  • management
A

Bennet’s

Fracture of first metacarpal extending into carpometacarpal joint

Cause: blow ti the point of the thumb

Management: unstable → should be reduced

if it fails → percutaneous pin inserted

30
Q

Management of metacarpal and pharyngeal injuries (2)

A

examples: punching, fighting
* most managed by closed reduction (if necessary) + immobilisation with splinting to the neighbouring finger
* unstable fractures or multiple metacarpal involvement → percutaneous K - wire

31
Q
A

Y4 final checklist_ SURGERY (25 decks)

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