Fractures Flashcards

1
Q

Fractures may result from…

A
  1. single, highly stressful, traumatic incident (traumatic #)
  2. repetitive stress of normal degree persisting to point of mechanical fatigue (stress #)
  3. normal stress acting on an abnormally weakened bone (pathological #)
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2
Q

What are the fracture types?

A
  • closed/open (simple/compound)
  • complete/incomplete
  • complicated
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3
Q

Describe a closed fracture.

A

Bone doesn’t communicate externally

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4
Q

Describe an open fracture.

A

Fractured bone or penetrating object communicates externally. Greater amount of soft tissue damage and issue of pathogens/infection.

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5
Q

Describe a complicated fracture.

A

Blood vessels, nerves or organs suffer significant damage.

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6
Q

Describe a complete fracture.

A

Bone is completely broken into 2 separate parts.

  • Transverse
  • Oblique
  • Spiral
  • Segmental
  • Avulsion
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7
Q

What is a comminuted fracture?

A

Bone is broken into more than two fragments.

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8
Q

Describe an incomplete fracture.

A

Bone is divided but the periosteum remains in continuity. E.g. greenstick #, compression #, stress #

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9
Q

What is a pathological fracture?

A

Due to a disease:

  • osteoporosis
  • Paget’s
  • infection
  • tumour
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10
Q

What is a physeal fracture?

A

Damage through the growth plate that has long term consequences. Can cause progressive deformity. Harris-Salter classification system used.

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11
Q

What are the symptoms of a fracture?

A
  • swelling, ecchymosis and deformity
  • localized persistent pain
  • marked or total loss of function
  • localized bone tenderness
  • crepitus
  • may be sudden or insidious onset depending on #
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12
Q

How are fractures diagnosed?

A
  • examination and palpation of tender point and surrounding tissue
  • neurovascular assessment
  • radiographs (new # may not show immediately)
  • CT, spiral CT, MRI
  • bone scans
  • ultrasound or vibration
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13
Q

What does fracture management involve?

A

Fracture reduction, immobilisation and rehabilitation

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14
Q

How is a fracture immobilized?

A
  • internal or external fixture
  • splints/casts/strapping and walking aids
  • screws, k-wires, plates
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15
Q

How are fracture rehabilitated?

A

With joint mobilization and exercises.

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16
Q

How are fractures reduced?

A

With an open (surgical) or closed procedure.

17
Q

What further treatment may complicated fractures require?

A
  • antibiotic treatment
  • debridement
  • irrigation
  • dressings
18
Q

How long does a fracture take to heal?

A

A fracture without complications will heal in 6-16 weeks.
Callus visible: 2-3 weeks
Union: 8-12 weeks
Consolidation: 12-16 weeks

19
Q

What osseous complications can arise from fractures?

A
  • osteomyelitis
  • delayed union, non-union or mal-union
  • avascular necrosis
  • joint problems
  • shortening of the bone
  • osteoarthritis
20
Q

What soft tissue complications can arise from fractures?

A
  • nerve or vascular damage
  • compartment syndrome
  • CRPS
21
Q

What is a pilon ankle fracture?

A

of metaphysical area of distal tibia (and sometimes fibula) extending to articular surface.

22
Q

How are pilon ankle fractures classified?

A

RUEDI-ALLGOWER

  1. malleolar # with large posterior plafond fragments
  2. spiral extension #
  3. central compression # w/ or w/o fibula #
23
Q

What is the Lauge Hansen Classification System?

A

A way of classifying ankle fractures by their MOI.

  • Supination/adduction Injuries
  • Supination/external rotation injuries
  • Pronation/Abduction injuries
  • Pronation/External Rotation injuries
24
Q

What is the Weber Classification System?

A

A classifications system for ankle joint fractures.

25
Q

What type of fractures can affect the talus?

A
  • chip/avulsion
  • talar neck
  • taller body
  • talar dome
  • posterolateral process
  • lateral process
  • talar head
26
Q

What can complicated talar fractures?

A

Avascular necrosis as there is no nutrient artery within the talus.

27
Q

What are the complications of calcaneal fractures?

A

Possible permanent disability, residual pain and delayed return to normal function.

28
Q

What are the most common forefoot fractures?

A

Digital #’s.

29
Q

What happens if digital fractures are inadequately treated?

A
  • haelomata
  • contracted digits
  • transverse plane deformities
  • metatarsalgia
30
Q

What is the cause of a stress fracture?

A

Generally overuse or pathological concerns.

31
Q

What are the symptoms of stress fracture?

A

insidious onset, painful over time, decreases with rest

32
Q

What bones in the foot are most commonly affected by stress fracture?

A

Navicular and metatarsals