Fracture - Late local complications Flashcards
What is Chronic Regional Pain Syndrome?
An exaggerated pain response after injury
What is the main cause of Chronic Regional Pain Syndrome (CRPS)?
It can be caused by a peripheral nerve injury (Type 2), but often occurs without nerve injury (Type 1)
What are the typical symptoms of Chronic Regional Pain Syndrome?
(1) Constant burning or throbbing pain
(2) Allodynia (sensitivity to normally non-painful stimuli)
(3) Chronic swelling
(4) Stiffness
(5) Painful movement
(6) Skin colour changes
What is the first-line treatment for lower back pain?
NSAID
A 31-year-old man presents with tingling in his right hand with loss of grip strength. He is diagnosed with carpal tunnel syndrome. He subsequently undergoes carpal tunnel release surgery.
Two months after the operation, he presents with pain in the ipsilateral forearm, excruciating to even light touch. The arm also feels hot and sweaty at times.
Examination shows the skin to be shiny around the area. What is the most likely diagnosis?
Complex regional pain syndrome
What pharmacological treatments are used to manage Chronic Regional Pain Syndrome?
- Analgesics
- Antidepressants eg, amitriptyline
- Anticonvulsants eg, gabapentin
- steroids
What are the four stages of fracture healing?
- Inflammation
- Ossification (soft callus formation)
- Ossification (hard callus formation)
- Bone remodelling
What are the two types of ossification?
Endochondral ossification and membranous ossification
At which stage of fracture healing is woven bone converted into lamellar bone?
stage 4 - bone remodelling
After injury, bone tissue will first replicate and grow, later remodelling according to the forces acting on it. A teenager fell off his bike 2 weeks ago, fracturing his distal radius, and wants to know when his wrist will have healed and be strong enough for him to risk doing some sports again.
What type of bone will most likely first form at the site of the fracture?
Woven, trabecular
