Fractures Flashcards
what is a compound fracture
skin is broken with bone exposed to air
What is a stable fracture
sections of bone remain in alignment
what fractures typically occur in children
Greenstick and buckle fractures
Salter-Harris - as involves growth plates
what is a Colles fracture?
Transverse fracture of distal radius
What fractures are normally caused by FOOSH
Colles
Scaphoid fracture
what is a sign of a scaphoid fracture?
Tenderness in the anatomical snuff box
what is the risk of a scaphoid fracture and why
Avascular necrosis as it as a retrograde blood supply, only one direction so fracture can cut off supply
Which bones are at a risk of avascular necrosis with fractures>?
scaphoid
femoral head
humeral head
Talus
Navicular
fifth metatarsal of foot
what is the Weber classification system?
Defines fractures of the lateral malleolus in relation to syndesmosis which is important for stability of the ankle joint
Type A - below ankle joint , syndesmosis intact
Type B - at Level of ankle joint - syndesmosis will be intact or partially torn
Type C - above ankle joint, syndesmosis will be disrupted
What are risks of pelvic ring fractures?
Can lead to significant intra-abdominal bleeding either due to:
vascular injury
from cancellous bone of pelvis
What are the main cancers that metastasise to the bone
PORTABLE
P - prostate
R - renal
T - thyroid
B - breast
Le - lung
What is FRAX
A tool to predict risk of a fragility fracture over the next 10 years
What does a DEXA scan measure
Bone mineral density
What T score indicates osteoporosis
Less than -2.5
What T score indicates osteopenia
-1 to -2.5
What is a normal T score
More than -1
What are first line treatments to reduce risk of fragility fractures
Calcium and vitamin D
Bisphosphonates
What are side effects of bisphosphonates? How do they work
Interfere with osteoclasts to reduce their activity and prevent reabsorption of bone
SE:
Reflux and oesophageal erosions
Atypical fractures e.g. femoral
Osteonecrosis of the jaw
Osteonecrosis of the external auditory canal
What is an alternative to bisphosphonates
Denosumab
What are initial complications of fractures?
Damage to local structures
Haemorrhage
Compartment syndrome
Fat embolism
VTE
What are long term complications of fractures
Delayed union
Malunion
Non-union - failure to heal
Avascular necrosis
Infection
Joint instability and stiffness
Contractures
Arthritis
Chronic pain
Complex regional pain syndrome
How soon can a fat embolism occur after fracture
24-72 hours
What criteria are used for diagnosis of a fat embolism?
Gurd’s major criteria:
1. Resp distress
2. Petechial rash
3. Cerebral involvement
Minor criteria:
Jaundice
Thrombocytopenia
Feveer
Tachycardia
What is management of fat embolism
Supportive while condition improves
