Fractures (1)

Question 1

Types:
What is a Stable?

What is a Compound?

What is a Pathological?
→ How can this occur?
→ What are the main cancers that metastasise to bone?

Answer 1

➊ Sections of bone remain in alignment at the fracture

➋ Skin is broken, and bone is exposed to air

➌ Bone breaks due to abnormalities within the bone e.g. tumour, osteoporosis or paget’s disease of the bone
→ With minor trauma or spontaneously w/o hx of trauma
→ Prostate, Renal, Thyroid, Breast, Lung

Question 2

What are the principles of its management?

How is it managed?

Answer 2

➊ • Reduction (open/closed) of fracture
• Stabilise to allow healing to occur

➋ • Analgesia
• Simple fractures - Reduce the fracture and apply plaster cast
• Complex fractures – NBM and taken to surgery

Question 3

What are the early complications that can occur?

What are the late complications that can occur?

Answer 3

➊ • Delirium
• Compartment syndrome (more common in long bone fractures)
• Fat embolism
‣ Fat globules from a fracture are released into circulation, which may obstruct blood flow
‣ Can cause a SIRS, resulting in fat embolism syndrome
‣ Operating early reduces the risk of this
• VTE due to immobility

➋ • Slow healing
• Maligned healing
• Avascular necrosis (death of bone)
• Osteomyelitis
• Arthritis
• Chronic pain