Fracture Management

Question 1

What are the four steps of fracture management?

Answer 1

1. Anatomic reduction (realignment) of fracture fragments.
2. Stabilisation of fragments using splinting/cast/surgery.
3. Maintaining neurovascular supply.
4. Encourage early rehabilitation.

Question 2

What are the types of traction methods and who are they used for?

Answer 2

1. Skin traction - adhesive strapping to attach a load to the limb.
2. Skeletal strapping - fixed (weight on pulley), balance (limb weight balanced against load), gallows (buttocks rise above head, children under 2)
3. Commonly used in children

Question 3

What are the indications for open reduction internal fixation?

Answer 3

1. Failed conservative management
2. Two fractures in one limb
3. Bilateral identical fractures
4. Intra-articular fractures (joint involved)
5. Displaced unstable fracture
6. Open fracture

Question 4

What are the four methods of internal fixation?

Answer 4

1. Plates
2. Screws
3. Intramedullary nails - centre of long bones
4. K wires - closed reduction and percutaneous/internal fixation

Question 5

What is external fixation used for and how is it performed?

Answer 5

1. Good for burnt skin and open fractures

2. Pins/wires placed away from zone of injury then inserted into bones directly