Fracture management

Question 1

What are the components of long bones?

Answer 1

Diaphysis - shaft
Metaphysis - beside and around growth plate
Epiphysis - growth plate

Question 2

What is the progression in secondary bone healing?

Answer 2

1. Haematoma - gap fills with granulation tissue
2. Soft callus - filled in by cartilage
3. Bone - hard callus (enchondral ossification)
4. Remodelling

Question 3

When is traction used for fracture management?

Answer 3

In children and adults unsuitable for surgery

Question 4

Why is it essential to reduce and internally fix a displaced intra-articular fracture?

Answer 4

To prevent post-traumatic OA

Question 5

How can a femoral shaft fracture cause Acute respiratory distress syndrome?

Answer 5

Fatty globules from bone marrow enter venous circulation and travel to the lungs

Question 6

What patients can be managed with a Thomas splint for a femoral shaft fracture?

Answer 6

Young children

Question 7

What can be done for a fracture which cannot be operated on due to extensive soft tissue injury and swelling?

Answer 7

External fixation

Question 8

Internal fixation is the preferred management option of proximal humeral fractures (T/F)

Answer 8

False

-operative and conservative management both have poor outcomes and result in stiffness

Question 9

Most humeral shaft fractures are managed non-operatively (fixation) (T/F)

Answer 9

True

Question 10

Olecranon (Ulna) fractures tend to be ________ fractures from triceps contraction

Answer 10

avulsion

Question 11

What is Galeazzi fracture?

Answer 11

Radial fracture with dislocation of distal Radio-ulnar joint

Question 12

What is Monteggia fracture?

Answer 12

Ulnar fracture with dislocation of the radial head

Question 13

What complications can arise from Distal radius fracture?

Answer 13

Median nerve compression
Extensor pollicis longus rupture
Loss of grip strength

Question 14

What is the common mechanism of distal radius fracture (collie’s farcture)?

Answer 14

FOOSH

falling on outstretched hand

Question 15

In Collie’s fracture, the radius is displaced in the_______ direction

Answer 15

dorsal

Question 16

Smith’s fracture is a distal radius fracture which results in it displacing in the _____ direction

Answer 16

volar (anterior)

Question 17

What nerve is commonly damaged in humeral shaft fracture? What is the clinical sign?

Answer 17

Radial nerve

Wrist drop

Question 18

What nerve is commonly affected in anterior shoulder displacement? What is the clincal sign?

Answer 18

Axillary nerve

badge patch numbness

Question 19

Neuropaxia is __ degree nerve injury. There is a temporary ______ ________ associated with demyelination. It should resove within a _____

Answer 19

1st degree

temporary conduction block

month

Question 20

Axonotmesis is __ degree nerve damage. What happens to the nerve cell axon?

Answer 20

2nd degree injury

Axon dies distal to point of injury
-regenerates 1mm/day

Question 21

Neurotmesis is a __ degree nerve injury. The nerve is _____ and requires ______

Answer 21

3rd degree

cut

surgery