fractures Flashcards
greenstick fracture
doesnt break all the way through
salter harris
break across epiphyseal growth plate
buckle fracture
One side of a bone bends, raising a little buckle, without breaking the other side of the bone.
comminuted
breaks into little pieces
monteggia and galezzi
radial or ulnar break and dislocation
MUGR
gustilo grading
open fracture grading scale type 1 -typ111C
type 1 open fracture
low energy, wound <1cm
type 2 open fracture
moderate soft tissue change, wound 1-10cm
type 3a open fracture
lots of soft tissue damage, not grossly contaminated
type 3b open fracture
periosteal stripping
type 3c open fracture
assoc neurovascular complication
automatic type 3 open fractures
gun shots, farm accident, wound over 10cm, high energy
spiral
due to rotational force
oblique
across
complete stability fractures
transverse
no stability fractures
oblique, spiral, comminuted
potential stability fractures
oblique fractures less than 45 degrees
compound
hits external soft tissue
management of open fractures
tetanus and antibiotic prophylaxis
photograph cover and stabilise
surgical emergency- all within 24 hrs
early and thorough wound excision and toilet
leave skin open
repeat wound review and toilet
stabilise fracture
fasciotomies if risk of compartment syndrome
circulation, neuro and open vs closed check
indications for external fixation
fractures with poor soft tissue conditions inc open fractures
where distraction through fixator may help with fragment reduction
emergency pelvic stabilisation for haemorrhage control
limb reconstruction
complications of external fixation
neurovascular injury
pin tract infection
loss of fracture alignment
joint contractures- stiffening
tardy union
indications of intramedullary nailing
long bone diaphyseal fracture
types of plate
compression- squeeze bone together
neutralisation- resist rotating forces
buttress- stops collapse
strut/bridging- more like external nail, no opening fracture
hip fractures managment
Intracapsular fractures in a patient who is otherwise fit and well, should be managed with internal fixation with hip screws
displaced fractures can be managed by hemi or full arthroplasty
humeral shaft fracture managemnt
Uncomplicated, closed fractures of the humeral shaft often require nothing more than analgesia and conservative management with a basic sling.
causes of pathological fracture
Tumours: Primary, Secondary (metastatic, most common)
Osteoporosis (most common)
Paget’s disease
Hyperparathyroidism
complex fracture features
communited, severely displaced or angulated, intra-articular fracture
capsular fractures of femur treatment
Inter and sub-trochanteric are extra-capsular fractures, Open repair with internal fixation and a dynamic hip screw
if displaced and old then hemiarthroplasty
Mid-shaft fracture of humerus
radial nerve palsy
colles fracture
distal radial fracture with dorsal displacement and angulation of the distal fragment.
smith fracture
distal radius with volar displacement and angulation of the distal fragment.
wrist drop/ unable to extend wrist
hip fracture that is extracapsular signs
pain and inability to bear weight, along with a shortened and externally rotated leg
bruising around the hip joint more commonly occurs with extracapsular fractures as the bleeding is not contained within the capsule.
intertrochanteric fracture is a subtype
