Fracture Management

Question 1

Greenstick fracture

Answer 1

incomplete fracture in which the bone is bent

Question 2

Transverse fracture

Answer 2

fracture at a right angle to the bone’s axis

Question 3

Oblique fracture

Answer 3

the break has a curved or sloped pattern

Question 4

Comminuted fracture

Answer 4

the bone fragments into several pieces

Question 5

Impacted fracture

Answer 5

ends are driven into eachother

Question 6

Ottawa ankle rules

Answer 6

xray required only if pain in melleolar zone and bone tenderness at A, B and inability to weight bear

Question 7

Ottawa knee rules

Answer 7

xray only required for knee injuries with age over 55, isolated tenderness of the patella, tenderness at head of the fistula, inability to flex at 90 degrees, inability to weight bear both immediately and in the casualty department

Question 8

Drawer Test

Answer 8

used to detect ruptures of the cruciate ligaments in the knee and the instability of the ankle
If the tibia pulls forward or backward more than normal, the test is considered positive – torn ACL

Question 9

ORIF

Answer 9

Open 
Reduction 
Internal
Fixation 
- method of surgically repairing a fractured bone

Question 10

External Fixation

Answer 10

immobilising bones to allow a fracture to heal

accomplished by placing pins or screws into the bone on both sides of the fracture

Question 11

linear skull fractures

Answer 11

breaks cranial bone resembling a thin line, without splintering, depression or distortion of the bone

Question 12

depressed skull fractures

Answer 12

some sort of the bone may get depressed into the brain and damage the brain from inside and a person can lose consciousness

Question 13

Basilar skull fractures

Answer 13

breaks the bone at the base of the skull and requires more force to be caused than cranial vault fractures

Question 14

Systemic complications of casts

Answer 14

deep vein thrombosis leading to pulmonary embolism

Question 15

immediate local complications of casts

Answer 15

produces constructing effect on the limb and most of it is well located but a moderate constriction will produce compression of veins, damming blood and causing swelling, discomfort or pain and a blue colour in the skin and under nails

Question 16

Impaired arterial supply in casts

Answer 16

a pale skin which is cool and without a palpable pulse indicates that the arterial supply is disrupted
splitting the cast may relieve the arterial compression

Question 17

delayed local complications in casts

Answer 17

plaster sores cause burning, itching and stabbing pain
heat and swelling of the digits, increased warmth over a localised area, localised odour and visible pus or staining of the cast

Question 18

Causes of complications in casts

Answer 18

poor technique when padding
local cast breakdown with skin irritation due to poor care
foreign bodies may easily slip between the cast and the skin
scratching at minor irritation with metal implements may cause trauma or infection
plaster soakage leads to skin damage and infection

Question 19

nerve damage in casts

Answer 19

loss of power, tingling and numbness distal to the cast are signs of impaired nerve function
cause may be direct compression by bone ends or plaster pressure, indirect compression of oedematous tissue or tourniquet effect, or reduced blood flow