Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine II > Fractures > Flashcards

Fractures Flashcards

1
Q

Define fracture

A
  • defect in continuity of bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define traumatic fractures

A
  • sudden, forceful impact
  • MVA, fall, assault, or abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define pathologic/insufficiency fractures

A
  • osteoporosis
  • nutrient deficiency, age, sex, smoking, proton pump inhibitors, or corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define stress fractures

A
  • change in training frequency, intensity, or volume
  • overtraining, inadequate recovery
  • LE mechanics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe an avulsion fracture

A
  • occurs from tensile load usually from a tendon
  • when under high tension the bone is what is broken and pulled away
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Salter Harris classification of epiphyseal fractures

A
  • Type I: straight through the growth plate
  • Type II: begins in the growth plate then goes through the diaphysis
  • Type III: begins in the epiphysis and goes through the growth plate
  • Type IV: goes through all layers
  • Type V: compression of the growth plate (impaction fracture)
  • Type VI: compression of one side of growth plate
  • Type VII: only goes through the epiphysis
  • Type VIII: only goes through the diaphysis & metaphysis
  • Type IX: tendon coming off of the side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe a closed reduction of fractures

A
  • placing the bone back into place with the used of soft tissue hinge without surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe an open reduction of fractures

A
  • placing the bone back into place through surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe a Galeazzi fracture

A
  • distal radius
  • dislocation of distal radioulnar joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe a Jones fracture

A
  • base of 5th metatarsal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe a Maisonneuve fracture

A
  • fibula
  • a few inches above mortise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe a Monteggia fracture

A
  • proximal ulna
  • dislocation of radial head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe a Nightstick fracture

A
  • midshaft ulna
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe a Piedmont fracture

A
  • radial shaft
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe a Pott’s fracture

A
  • oblique lateral malleolus
  • transverse medial malleolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe a Torus/Buckle fracture

A
  • cortical bone compression type defect without displacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe primary/direct cortical bone healing

A
  • continuity is restored by direct contact & healing of the original cortical tissue
  • requires near perfect reduction, very stable immobilization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe secondary/indirect cortical bone healing

A
  • follows more classic healing response (inflammation, repair, remodeling)
  • facilitated by some motion & some weight bearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe cancellous bone healing

A
  • direct, membranous bone formation
  • occurs quickly but can only cover a few millimeters
  • probably mediated by local stem cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Factors that affect bone healing

A
  • age
  • degree of local trauma
  • degree of bone loss
  • type of bone involved
  • degree of immobilization
  • infection
  • local malignancy
  • radiation necrosis
  • avascular necrosis
  • hormones
  • exercise/modified tension along the line of stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Complications related to bone healing

A
  • delayed union (pathological)
  • slow union (non-pathological)
  • nonunion (fragments do not form into one bone)
  • malunion (fragments heal improperly)
  • pseudoarthrosis (false joint, fibrous union)
  • osteomyelitis (infection)
  • avascular necrosis
22
Q

Complications in adjacent tissues to bone healing

A
  • soft tissue injury
  • arterial injury
  • nerve injury
  • compartment syndrome
23
Q

What are the 5 P’s of compartment syndrome

A
  • Pain
  • Paresthesia (numbness/tingling)
  • Paralysis
  • Pallor (unhealthy pale appearance)
  • Pulselessness
24
Q

Commonly missed fractures on X-ray

A
  • C1-2
  • C6-7
  • vertebral body fractures (osteoporosis)
  • scaphoid
  • radial head
  • femoral neck
  • tibial plateau
  • patella
  • calcaneus
25
Q

Late effect complications related to bone healing

A
  • complex regional pain syndrome (CRPS)
26
Q

Describe complex regional pain syndrome (CRPS)

A
  • grouping of complex painful disorders that develop as a consequence of trauma affecting the extremities with or without an obvious peripheral nerve lesion
  • MOI unclear
  • often associated with surgery
  • very difficult to manage
27
Q

Difference between type I and type II CRPS

A
  • Type I: no nerve injury evident
  • Type II: peripheral nerve injury present
28
Q

Clinical features of CRPS

A
  • pain
  • hyperesthesia
  • tenderness
  • swelling
29
Q

Signs and symptoms of CRPS

A
  • severe pain with hypersensitivity
  • trophic changes : nail, hair, skin, & bone/osteopenia
  • autonomic disturbances
  • functional impairment
30
Q

Describe stage I/acute reversible stage of CRPS

A
  • lasts 3-6 months
  • vasodilation
  • pain & edema are dominant clinical features
  • erythema, hyperhydrosis, rapid nail growth, & warmth
  • early intervention may prevent progression
31
Q

Describe stage II/dystrophic ischemic stage of CRPS

A
  • may lasts 3-9 months
  • vasoconstriction
  • pain (burning) & edema increases
  • brittle nails
  • cold/cyanotic/dry/mottled skin
  • hypersensitivity to cold
  • osteoporosis
32
Q

Describe stage III/atrophic stage of CRPS

A
  • may last years
  • spontaneous recovery often occurs within 18-24 months
  • pain increases or decreases
  • atrophy
  • severe osteoporosis
33
Q

Management of CRPS

A
  • control pain & edema (compression garments, e-stim, elevation, gentle massage, moist heat, or splints)
  • desensitization techniques
  • active movement within pain free range (all pain provoking activities must be eliminated)
  • weight bearing
  • joint mobilization is contraindicated
34
Q

Describe a Colles fracture

A
  • radial fracture with dorsal displacement of the distal fragment & radial shift of the carpal bones
35
Q

What causes greater injury to a Colles fracture

A
  • greater wrist extension at impact generally results in greater injury, possibly including a comminuted fracture
36
Q

Management for a Colles fracture

A
  • ranges from closed reduction (cast or external fixation) to surgical reduction & internal fixation
  • fracture healing takes 5-8 weeks with expected full functional recovery in 4 months
37
Q

Describe a Smiths fracture

A
  • distal portion of radial fracture dislocates palmarly
38
Q

Management of a Smiths fracture

A
  • surgery usually required
  • fracture healing in 5-9 weeks with expected full functional recovery in 6 months to a year
39
Q

Treatment for a Smiths fracture

A
  • While casted: ORM at digits, elbow, & shoulder with the goal to reduce edema & prevent capsular & tendon tightness
  • Cast removed: gentle ROM at thumb & wrist in pain free range & edema control
  • If continued limited ROM: joint mobilizations may need to be incorporated
  • Once full ROM: strengthening exercises can be added
40
Q

What is the most common carpal bone fracture

A
  • scaphoid (60-70%)
  • typically with a history of FOOSH (fall on outstretched hand)
41
Q

Complications related to scaphoid fractures

A
  • non-union or necrosis due to blood flow interruption
42
Q

Scaphoid fracture rehab during immobilization

A
  • primary focus is edema reduction & ROM of the uninvolved distal joints
43
Q

Scaphoid fracture rehab following cast removal/use of thumb spica splint

A
  • wrist exercises that focus on differential gliding of the wrist & finger
  • strengthening with exercise putty, sustained grip activities, & gradual closed chain activities progress to tolerance
  • return to full activity within 12 weeks after cast removal
44
Q

Describe a SLAC (scaphoid lunate advanced collapse)

A
  • disruption of the scapholunate ligament
  • rotary subluxation of the scaphoid, it flexes in a palmar direction
  • abnormal forces from the scaphoid to radius & from capitate to lunate
45
Q

Describe stage I SLAC

A
  • degeneration at radial styloid & distal radial aspect of scaphoid
46
Q

Describe stage II SLAC

A
  • Stage IIA: entire radioscaphoid articulation involved
  • Stage IIB: radioscaphoid & STT joint arthritis
47
Q

Describe stage III SLAC

A
  • radioscaphoid, scaphocapitate, & lunocapitate articulations involved
48
Q

Describe the different surgeries for a SLAC

A
  • Proximal row carpectomy: 60% of normal ROM as compared to opposite wrist & over 90% of normal grip strength
  • Four corner fusion: less than 50% ROM & about 75% grip strength
49
Q

What does a tibial plateau fracture history look like

A
  • high energy trauma
  • ensure no symptoms of compartment syndrome
  • beware that 50% of closed tibial plateau fractures have menisci & collateral ligament tears
50
Q

Symptoms of a tibial plateau fracture

A
  • pain especially with weight bearing
  • swelling
  • decreased flexion ROM
51
Q

Diagnosis of a tibial plateau fracture

A
  • AP (anterior posterior) & oblique X-ray
  • CT may be used after diagnosis to determine surgical approach

Clinical Medicine II (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions