Fractures Flashcards
What is a compound fracture?
is when the skin is broken and the broken bone is exposed to the air. The broken bone can puncture through the skin.
What is stable fracture?
What the bones are still alignment at the fracture
What is a pathological fracture? What can cause them?
when a bone breaks due to an abnormality within the bone e.g. tumour (prostate, breast, thyroid, lung, renal); OP; Pagets
What are the different types of #s?
Transverse
Oblique
Spiral
Segmental (two complete fractures creating different segments)
Avulsion
impacted
Comminuted (breaking into multiple fragments)
Compression fractures (affecting the vertebrae in the spine)
complete (bones completely separated)
displaced (out of alignment)
What is a Colle’s fracture?
Transverse fracture of the distal radius of the wrist –> this causes an upwards displacement of the bone creating a “dinner fork deformity”
What causes a Colle’s fracture?
Falling onto outstretched hand normally (FOOSH)
How does a scaphoid # present? What commonly causes them?
scaphoid is below the base of the thumb - may be tender in the anatomical snuffbox. Commonly a FOOSH causes
What should you beware of in a scaphoid fracture?
Has a retrograde blood supply - only one direction - if blood supply cut off in # = avascular necrosis
What bones are at risk of avascular necrosis?
scaphoid bone femoral head humeral head talus navicular fifth metatarsal of foot
What is the Weber classification for?
The lateral malleolus (distal fibula) and in relation to the tibiofibular syndemosis (fibrous join between tibia and fibula)
Summarise pelvic ring fractures
The pelvis forms a ring - so if you # one part another will (like a polo mint)
Need to think about blood loss (blood on the floor, 4 more)
What imaging is used for fractures?
XR in two views!
What are the principles of # mx?
1) mechanical alignment - closed reduction (manipulate) OR open reduction in surgery
2) Relative stability so can heal e.g. casts, k wires, plates, nails etc.
ALSO:
- Analgesia
- VTE prophylaxis
- pre-op assess
What are potential complications of a #?
- damage local structures
- haemorrhage
- compartment syndrome
- fat embolism
- VTE
What are potential complications of a #?
- damage local structures
- haemorrhage
- compartment syndrome
- fat embolism
- VTE
- avascular necrosis
- arthiritis
- CRPS
- malunion/ nonunion
- infection
What is a fat embolism?
Where a # of a long bone results in fat globules being released into the circulation which become lodged in the blood vessels
What is the criteria for evaluated a fat embolism and what is the major criteria?
Gurd’s criteria!!
Resp distress, petechial rash, cerebral involement
What can hip #s be categorised as?
Intra vs extra capsular #
What is potentially the worst kind of hip # and why?
Intracapsular as the head of the femur has a retrograde blood supply from the femoral artery - if the # damages this blood supply then avascular necrosis
What is an intra vs extra capsular fracture?
Intra = break involving capsule of hip, proximal to the intertrochanteric line
What classification is used for intra-capsular fractures? Explain
Garden classification 1 - incomplete and non-displaced 2 - complete and non-displaced 3 - partial displacement 4 - fill displacement
What is the management for displaced vs non-displaced fractures?
non-displaced = blood supply okay and can treat with internal fixation
displaced = blood supply disrupted so hemiarthoplasty or total hip replacement
What are the indications for hemiarthoplaty vs total hip replacement
hemiarthorplasty = replace head of femur - for pts with limited mobility
total hip replace = head of femur and acetabulum (socket) replaced - for pts who walk independently and fit
What are the two different types of extracapsular fractures and how are they managed?
Interochanteric fractures - occur between the greater and lesser trochanter –> manage with dynamic hip screw
Subtrochanteric fractures - occur in the proximal shaft of the femur - treated with an intramedullary nail
