Fracture Management Workshop

Question 1

What are the three types of hip fracture?

Answer 1

Subcapital
Intertrochanteric
Subtrochanteric

Question 2

Which type of hip fracture is intracapsular?

Answer 2

Subcapital

Question 3

What sign on X-ray indicates a subcapital hip fracture?

Answer 3

Interrupted Sheratons line

Question 4

How is a intracapsular hip fracture treated?

Answer 4

Total hip replacement In mobile patients (higher risk of dislocation)
Hemiarthroplasty in less mobile patients

Question 5

Which types of hip fracture are extracapsular?

Answer 5

Intertrochanteric

Subtrochanteric

Question 6

How are extracapsular hip fractures treated?

Answer 6

Internal fixation with compression or dynamic hip screw

Question 7

Which hip fracture has the risk of avascular necrosis?

Answer 7

Subcaptial

Question 8

What are the risks associated with displaced femoral shaft fractures?

Answer 8

Fat embolism

Question 9

What is the initial management of a femoral shaft fracture?

Answer 9

Analgesia- femoral nerve block

Thomas splint to stabilise + minimise blood loss/fat embolism

Question 10

What is the definitive treatment of a femoral shaft fracture?

Answer 10

IM nailing

Question 11

Who is most susceptible to a distal femur fracture?

Answer 11

Patients with osteoporosis who fall onto a flexed knee

Question 12

How are extra-articular distal femur fractures managed?

Answer 12

Not distal- IM nail

Distal- plate + screws

Question 13

How are intra-articular (knee) distal femur fractures managed?

Answer 13

Anatomical reduction, rigid fixation, Plate + screws

Question 14

How to proximal tibia fractures happen?

Answer 14

High energy injuries in young patients (usually valgus stress)
Low energy in osteoporotic bone

Question 15

What are the complications of high energy proximal tibia fractures?

Answer 15

Compartment syndrome

Neurovascular injury e.g foot drop caused by damage to peroneal nerve

Question 16

How is an intra-articular proximal tibia fracture managed?

Answer 16

Total knee replacement often required

Question 17

How is an extra-articular proximal tibia fracture managed?

Answer 17

Plates + screws or external fixation if substantial soft tissue swelling

Question 18

How do tibial shaft fractures occur?

Answer 18

Bending (transverse fracture)
Rotational energy (spiral fracture)
Compressive force from deceleration (oblique fracture)
Combination of these forces/high energy (comminuted fracture)

Question 19

What criteria merits non-operative management in a tibial shaft fracture?

Answer 19

Up to 50% displacement and 5% angulation in any plane

Question 20

What is the operative management for tibial shaft fractures?

Answer 20

IM nailing

Question 21

What is an intra-articular distal tibial fracture called?

Answer 21

Pilon fracture

Question 22

How are pilon fractures treated?

Answer 22

Surgical emergency- Internal fixation

Question 23

How long does the tibia take to heal?

Answer 23

16 weeks

Question 24

How is a distal fibular fracture with no medial fracture or rupture of deltoid ligament treated?

Answer 24

Walking cast or splint for 6 weeks

Question 25

How is a distal fibular fracture with rupture of the deltoid ligament treated?

Answer 25

Open reduction internal fixation with plates and screws

Question 26

How might a deltoid ligament rupture be suspected?

Answer 26

Bruising and tenderness medially

Question 27

If there is talar shift how is a distal fibular fracture managed?

Answer 27

Anatomic reduction and rigid internal fixation

Question 28

How are bimalleolar fractures managed?

Answer 28

Open reduction internal fixation with plates and screws