Fracture Management Workshop Flashcards
What are the three types of hip fracture?
Subcapital
Intertrochanteric
Subtrochanteric
Which type of hip fracture is intracapsular?
Subcapital
What sign on X-ray indicates a subcapital hip fracture?
Interrupted Sheratons line
How is a intracapsular hip fracture treated?
Total hip replacement In mobile patients (higher risk of dislocation)
Hemiarthroplasty in less mobile patients
Which types of hip fracture are extracapsular?
Intertrochanteric
Subtrochanteric
How are extracapsular hip fractures treated?
Internal fixation with compression or dynamic hip screw
Which hip fracture has the risk of avascular necrosis?
Subcaptial
What are the risks associated with displaced femoral shaft fractures?
Fat embolism
What is the initial management of a femoral shaft fracture?
Analgesia- femoral nerve block
Thomas splint to stabilise + minimise blood loss/fat embolism
What is the definitive treatment of a femoral shaft fracture?
IM nailing
Who is most susceptible to a distal femur fracture?
Patients with osteoporosis who fall onto a flexed knee
How are extra-articular distal femur fractures managed?
Not distal- IM nail
Distal- plate + screws
How are intra-articular (knee) distal femur fractures managed?
Anatomical reduction, rigid fixation, Plate + screws
How to proximal tibia fractures happen?
High energy injuries in young patients (usually valgus stress)
Low energy in osteoporotic bone
What are the complications of high energy proximal tibia fractures?
Compartment syndrome
Neurovascular injury e.g foot drop caused by damage to peroneal nerve
How is an intra-articular proximal tibia fracture managed?
Total knee replacement often required
How is an extra-articular proximal tibia fracture managed?
Plates + screws or external fixation if substantial soft tissue swelling
How do tibial shaft fractures occur?
Bending (transverse fracture)
Rotational energy (spiral fracture)
Compressive force from deceleration (oblique fracture)
Combination of these forces/high energy (comminuted fracture)
What criteria merits non-operative management in a tibial shaft fracture?
Up to 50% displacement and 5% angulation in any plane
What is the operative management for tibial shaft fractures?
IM nailing
What is an intra-articular distal tibial fracture called?
Pilon fracture
How are pilon fractures treated?
Surgical emergency- Internal fixation
How long does the tibia take to heal?
16 weeks
How is a distal fibular fracture with no medial fracture or rupture of deltoid ligament treated?
Walking cast or splint for 6 weeks
How is a distal fibular fracture with rupture of the deltoid ligament treated?
Open reduction internal fixation with plates and screws
How might a deltoid ligament rupture be suspected?
Bruising and tenderness medially
If there is talar shift how is a distal fibular fracture managed?
Anatomic reduction and rigid internal fixation
How are bimalleolar fractures managed?
Open reduction internal fixation with plates and screws
