Fractures

Question 1

General complications

Answer 1

• Haemorrhage and shock
• Infection
• Muscle damage → rhabdomyolysis

Prolonged Bed Rest:
• Chest infection, UTI
• Pressure sores and muscle wasting
• DVT, PE
• ↓ bone mass density

Question 2

Late complications

Answer 2

• Problems with union
• AVN
• Growth disturbance
• Post-traumatic osteoarthritis
• Complex regional pain syndromes
• Myositis ossificans

Question 3

Early complication

Answer 3

• Compartment syndrome
• Infection
• Fat embolism → ARDS

Question 4

Nerve palsy with Anterior shoulder dislocation or humeral surgical neck fracture

Answer 4

Axillary nerve

• weak abduction
• muscle bulk wasting
• regimental badge sign

Question 5

Nerve palsy with # humeral shaft

Answer 5

Radial nerve

- wrist drop

Question 6

Nerve palsy with elbow dislocation

Answer 6

Ulnar nerve

- claw hand

Question 7

Nerve palsy with hip dislocation

Answer 7

Sciatic nerve

- foot drop

Question 8

Nerve palsy with # neck of fibula or knee dislocation

Answer 8

Common peroneal nerve

- foot drop

Question 9

Causes of delayed or non union

Answer 9

• Ischaemia: poor blood supply or AVN
• Infection
• ↑ interfragmentary strain
• Interposition of tissue between fragments
• Intercurrent disease: e.g. malignancy or malnutrition

Question 10

3 bones with retrograde blood supply

Answer 10

femoral head
scaphoid
talus

Question 11

Salter Harris Classification

Answer 11

I - epiphysis fracture 
II - diaphysis involvement
III - metaphysis involvement 
IV - both metaphysis and diaphysis involvement 
V - crushed injury

Question 12

Which medications inhibit fracture healing

Answer 12

NSAIDs
Steriods
DMARDs
Immunosuppressive agents

Question 13

Stages of wound healing

Answer 13

1. Haematoma formation
2. Soft callus - granulation tissue
3. Hard callus
4. Remodelling