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Orthopaedics > Fractures > Flashcards

Fractures Flashcards

1
Q

See picture 2. Name types of fractures.

A

Memo in album.

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2
Q

How is fracture displacement described?

A 
LARA
Length
Angulation
Rotation
Apposition/translation
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3
Q

Name 5 basic steps of how fractures heal.

A
  1. Haematoma
  2. Inflammation
  3. Callus formation
  4. Consolidation
  5. Remodelling
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4
Q

What is an acetabular #

A

Femoral head driven into pelvis

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5
Q

4 types of acetabular fractures

A
  1. Anterior column #
  2. Posterior column
  3. Transverse
  4. Combination
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6
Q

What is an anterior column acetabular fracture (3)

A

Runs through ant acetabulum- separates a segment between ASIS and obturator foramen.
Uncommon, good prognosis
Doesn’t involve weight bearing of acetabulum.

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7
Q

Where is posterior column acetabular #

A

Run upwards from obturator foramen to sciatic notch.

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8
Q

What injury is usually associated with or causes a posterior column acetabular #?

A

Posterior hip dislocation

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9
Q

Possible complication of posterior column acetabular #

A

Injury sciatic nerve

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10
Q

Rx post column acetabular #

A

ORIF

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11
Q

What is transverse acetabular #

A

Uncomminuted # running transversely through acetabulum. Separates ilium above from ischium and pubis below

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12
Q

transverse acetabular # rx

A

Easy to reduce. ORIF.

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13
Q

What is combined or complex acetabular #

A

Combination of ant and post column and transverse acetabular #
Usually in value roof of acetabulum
Poor prognosis. V difficult to reduce.

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14
Q

How treat acetabular fractures in general? (4)

A

Resus ATLS
Reduce dislocation if present
Maintain reduction with traction, (10kg/10% body weight)
Definitive rx delayed until pt fit for sx. DON’T DELAY MORE THAN 7 DAYS!

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15
Q

Contra-indications for surgery to acetabular # (4)

A
  1. Severly comminuted complex #
  2. Lack sx expertise
  3. Lack of blood transfusion service
  4. Associated abdominal injuries requiring a laparotomy/bladder repair.
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16
Q

Are acetabular # usually treated surgical or non-surgical?

A

Non-surgical
ORIF preferred mostly, but due to many contraindications due to associated injuries and high R complications, it’s not done commonly in practice.

17
Q

5 complications of acetabular #

A
  1. Sciatic nerve injury
  2. Sepsis
  3. AVN femoral head
  4. Osteoarthritis
  5. Shock
18
Q

Which structure is at risk in posterior column acetabulum fracture?

A

Superior gluteal NV bundle

19
Q

Usual treatment supracondylar fracture?

A

Closed reduction and percutaneous pinning (crpp) except type 1 Gartland(immobilise 3 weeks )
Adults orif

20
Q

Mechanism of injury supracondylar fracture?

A

Fall on outstretched hand mostly

<4% flexion injury

21
Q

Usual demographic of supracondylar fracture?

A

One of most common fractures in paeds, age 5-7

22
Q

!!! Which 3 nerves and artery are of concern in supracondylar fracture?

A
  • Anterior interosseous nerve neuropraxia (branch of median n !) - most common (can’t flex IPJ of thumb and DPJ of index - can’t do ok sign)
  • radial nerve palsy - close second (inability to extend wrist, MCPJ, thumb IPJ)
  • ulnar nerve palsy seen with flexion type injury patterns, but far less common

Radial artery

23
Q

How is displacement of fracture described?

A

In terms of distal fragment

24
Q

Name 10 early local complications of fractures

A

Skin
• skin necrosis
• fracture blisters
Open wound

Muscle
• compartment syndrome
• tendon injury

Nerve
• neuropraxia
• axonotmesis
• neuronotmesis

Vessels:
• arterial injury

• infection

25
Q

Name 10 early systemic complications of fractures

A
  • Haemorrhagic shock
  • fat embolism syndrome
  • ARDS
  • sirs
  • multiple organ failure syndrome
  • DvT
  • pe
  • pressure sores
  • tetanus
  • sepsis
26
Q

Name 10 late complications of fractures

A
  • Delayed Union
  • non union
  • mal union
  • avascular necrosis
  • growth disturbance
  • osteoarthritis
  • joint stiffness
  • complex regional pain syndrome
  • heterotopic ossification
  • osteomyelitis
27
Q

Name 10 complications of #nonunion

A 
• Conversion to open #
• neuro vascular compression
• limb length discrepancy
. Deformity
. Unstable limb
• weak, pain, loss of function
• bone atrophy
• osteoarthritis
• bone hypertrophy
• malignancy
28
Q

How long do # of lower and upper limb take to heal in children?

A

• Upper limb: 3 weeks

. Lower limb: 6 weeks

29
Q

How long do # of lower and upper limb take to heal in adults?

A

Upper: 6 weeks
Lower: 12 weeks

30
Q

What is a Colles # (7)

A 
ColleD
• distal radius #
• dorsal displacement
• dorsal angulation
• dinner fork deformity on arm
. From fall on outstretcheD hand - dorsal flexion
• common in elDerly (osteoporosis)
•Rx closeD reDuction and cast

Orthopaedics (20 decks)

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