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Orthopaedics > fractures > Flashcards

fractures Flashcards

1
Q

compound fracture

A

skin is broken and broken bone exposed to air

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2
Q

stable fracture

A

sections of bone remain in alignment at fracture

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3
Q

pathological fracture

A

bone breaks due to abnormality within bone

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4
Q

comminuted fractures

A

breaks into multiple fragments

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5
Q

salter-harris fracture

A

growth plate fracture

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6
Q

types of fracture more common in kids

A

greenstick

buckle

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7
Q

colles fracture

A

transverse fracture of distal radius

causing distal portion to displace posteriorly (upwards)

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8
Q

colle’s fracture deformity

A

dinner fork deformity

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9
Q

colle’s fracture usual mechanism

A

FOOSH

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10
Q

scaphoid fracture usual mechanism

A

FOOSH

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11
Q

key sign of scaphoid fracture

A

tenderness in anatomical snuffbox

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12
Q

scaphoid bone blood supply

A

retrograde - blood vessels supply blood from only one direction

fracture can result in loss of blood supply –> avascular necrosis and non-union

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13
Q

which key bones have vulnerable blood supply

A 
scaphoid
femoral head
humeral head
talus 
5th metatarsal
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14
Q

what can happen if bones with vulnerable blood supply are fractures

A

avascular necrosis, impaired healing and non-union

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15
Q

what do ankle fractures involve

A

lateral malleolus (distal fibula) or medial malleolus (distal tibia)

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16
Q

ankle fractures: weber classification

A

describe fractures of lateral malleolus

described in relation to distal syndemosis (fibrous joint) between tibia and fibula

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17
Q

The Weber classification defines fractures of the lateral malleolus as: Type A

A

below ankle joint

will leave syndemosis intact

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18
Q

The Weber classification defines fractures of the lateral malleolus as: Type B

A

at level of ankle joint

syndemosis will be intact or patially torn

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19
Q

The Weber classification defines fractures of the lateral malleolus as: type C

A

above ankle joint

syndemosis will be disrupted

20
Q

when is surgery more likely to be required for ankle fracture

A

if syndemosis is distrupted by fracture

need to regain good joint stability and function

21
Q

pelvic ring fractures

A

when one part of pelvic ring fractures another part will also fracture (think of breaking a polo mint)

22
Q

pelvic fractures often lead to…..

A

significant intra-abdo bleeding

can lead to shock and death to need emergency resus and trauma management

23
Q

why do pelvic # cause intra-abdo bleeding

A

either due to vascular injury or from cancellous bone of pelvis

24
Q

causes of pathological fractures

A

tumour
osteoporosis
Paget’s disease

25
Q

common sites of pathological #

A

femur

vertebral bodies

26
Q

main cancers that metastasise to bone

A 
Prostate 
renal 
thyroid 
breast 
lung
27
Q

fragility fractures

A

occur due to weakness in bone, usually osteoporsos

often occur w/o approp trauma needed to break bone

28
Q

how can patient’s risk of fragility fracture be predicted

A

FRAX tool

29
Q

bone mineral density can be measured using a

A

DEXA scan

30
Q

1st line medical treatment for reducing risk of fragility fractures

A

calcium + vitamin D

bisphosphonattes

31
Q

how to bisphosphonates work

A

interfere with osteoclasts - reduce their activity and prevent reabsorption of bone

32
Q

bisphosphonate side effects

A

reflux + oesophageal erosions
atypical fractures
osteonecrosis jaw
osteonecrosis external auditory canal

33
Q

what’s an alternative to bisphosphonates

A

denosumab - monoclonal antibody which blocks osteoclast activity

34
Q

imaging

A

X-ray (2 views always required)

CT

35
Q

principles of # management

A
  1. mechanical aligment

2. relative stability

36
Q

principles of # management: mechanical aligment

A

closed reduction - via manipulation of limb

open reduction - via surgery

37
Q

principles of # management: relative stability

A

provide stability to give time for healing to occue

fix bone in correct position whilst it heals

38
Q

various ways bones can be fixed

A

external cast
IM wires, nails
screws, plates

39
Q

possible early complications

A 
damage to local structures
haemorrhage 
compartment syndrome
far embolism 
VTE
40
Q

possible long-term complications

A 
delayed union 
malunion 
non-union 
avascular necrosis 
infection (osteomyeltitis) 
joint instability 
joint stiffness
contractures
arthritis 
chronic pain 
complex regional plain syndrome
41
Q

fat embolism

A

can occur following fracture of long bone

fat globules are released into circulation following #and can become lodges in blood vessels

42
Q

fat embolism syndrome

A

fat embolisaion can cause systemic inflammatory response

43
Q

when does fat embolism typically present

A

~24-72hrs after fracture

44
Q

Fat embolism: Gurd’s major criteria

A

resp distress
petechial rash
cerebral involvement

45
Q

Fat embolism: Gurd’s minor criteria

A

jaundice
thrombocytopenia
fever
tachycardia

Orthopaedics (30 decks)

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