Fractures Flashcards
A-E assessment of fractures
- Massive haemorrhage
- AW + C spine
- Breathing
- Disability - GCS, neurology, abdo exam
- Exposure - hypothermia treat
Types of fracture
- Open/closed
- Transverse, oblique, spiral, comminuted
Displacement of fractures
- Translation
- Angulation
- Rotation
- Shortening
- Distraction
What is v important in a fracture assessmen?
Neurovasculature assessment
What to ask in a fracture history?
- Mechanism of injury
- Ass injuries
- Pateint demographics
- PMH
What is a greenstick fracture?
Where outer layer - cortex - breaks, reaches middle of bone but doesnt stretch across
Pain ladder fractures
- Paracetemol
- NSAIDs
- Codeine
- Tramadol
- Morphine
What bloods do you do to prep for theatre?
- Paracetemol
- NSAIDs
- Codeine
- Tramadol
- Morphine
How to manage a closed fracture
- Asess NV status
- Assess soft tissue s
- Splint
- Back slab
How to manage an open fracture
- Assess NV status + soft tissues
- Photograph open
- Dess open
- Back slab
- Tetanus booster
- IV antibiotics
- Emergnecy
What criteria is used to classify fractures in children?
SALTER HARRIS
What does Salter Harris criteria measure?
Normal to type V
Association with growth plate
Type I - Straight across
II - Above
III - Lower or Below
IV - Two or Through
V - Erasure of growth plate
Crush
What is compartment syndrome?
Muscle swelling causing compression of nerves and vessels
Restricted blood flow to area
Approach to large joint X ray
Check patient demographic details (Name, DOB and hospital number)
Check type of joint image done (comment on projection of the image)
Check whether entire region has been covered
Is the XR adequate? - over or under exposed
Bone density (normal/ increased or decreased/ lucency)
Look at joint spacing - narrowed, widened, effusion or not
Cortical margins - breech or disruption of cortex Soft tissues - swelling/laceration/presence of gas/debridement/muscle atrophy Bone surface and contours - irregular/smooth/osteochondral defect/osteophytes/erosive Alignment - subluxed/dislocated Artefact - foreign body/loose bony fragment/replacement/resurfacing/metalwork
What is a Weber fracture?
Ankle. Type A, B or C
Why are intrcapsular neck of femur fractures especially concering?
One way blood supply -> avascular necrosis
Blood supply intercapsuarly to femur
Circumflex artery - ligamentum teres
Blood supply intercapsuarly to femur
Circumflex artery - ligamentum teres
What types omf NOFs are there + draw them
Extracapsular
-Intertrochanteric
-Subtrochanteric - under lesser trochanter
Intracapsular or transcerviacl - between femoral head and greater trochanter
Why do hips often fracture in two places? What other structures have this?
Ring strcuture - like a polo
Sacroiliac
Forearm - radius and ulna
Blood on the floor - what are the four more?
Long bones
pelvis
Abdomen
Chest
Head
What is bennetts fracture?
Thumb MCP base intra articular fracture with discplacement
Pain, swell, decreased ROM, instable
Repeat readiography in two weeks
Boxers fracture what is?
5th MCP
What causes boxers fracture?
Direct dorsal blow to hand
Treatment boxers fracture
Conservative - immobilise, buddy strap, reduction, physio
Surgeyr - pin or ORIF
When do surgery for fracture
Displaced, deformity, communition
Symtpoms of scaphoid fracture
Wrist pain with restricted ROM
Tenderness on gripping and wrist extension
Tenderness around anatomical snuffbox
Danger about scaphoid fracture
One way blood supply - if impaired causes necrosis
What is Smiths?
Gay fracture - fall on inward bend wrist
What is colles fracture?
Low energy FOOSH
All the Ds of colles fracture?
Dinner fork deformity
Dorsum
ROM
Anaesthetic block
Who often gets Colles fracture?
Elderly, osteoporotic, postmenopausal
How to assess NV status
Rock, paper, scissors
Pulses, power and sensation
Where are monteggias/galezzis fractures?
Ring structure/galezzis
What is a teribe triad injury elbow?
Elbow dislocation
Coronoid fracture
Radial head fracture
Terrible triad injury knee?
ACL
MCL
Meniscus
