Fracture Management

Question 1

What are the 3 things involved in fracture management

Answer 1

Reduce - Hold - Rehabilitate

Question 2

Why do we reduce a fracture

Answer 2

Tamponade bleeding at the fracture site

Reduction in traction on the surrounding tissues => less swelling

Reduce traction of traversing nerves => reduce risk of neuropraxia

Reduction of pressure of traversing blood vessels => restoring blood supply

Question 3

What needs to be done before a fracture can be reduced

Answer 3

Analgesia of the affected region either by oral/ regional blockade

Question 4

What is meant by hold in the general principles of fracture management

Answer 4

Hold refers to immobilisation of the fracture

Question 5

What are the most common ways to hold a fracture

Answer 5

Splint

Plaster casts

Question 6

What is important to remember in the first 2 weeks when applying a plaster cast

Answer 6

Must not be circumferential in the first 2 weeks as need to have space for swelling to occur

If this is not done, pts are susceptible to compartment syndrome

Question 7

When should a plaster cross both the joint above and below the fracture

Answer 7

When there is axial instability

Question 8

If there is no axial instability, how should the cast be applied

Answer 8

Must cover the fracture and the joint immediately distal to it

Question 9

When may you need to thromboprophylax the patient

Answer 9

If the patient will be immobilised in a cast and is NWB

Question 10

What does rehabilitate refer to

Answer 10

Intensive period of physiotherapy post getting out of the cast