Brainscape's Knowledge GenomeTM

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


See full index

Year 2- MSK > Fractures > Flashcards

Fractures Flashcards

1
Q

What is the significance of the metaphysis in pediatric bones?

A

The metaphysis connects to the physis (growth plate), which is an area of weakness in children’s bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do ligaments and tendons compare to bones in children?

A

In children, ligaments and tendons are stronger than bones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the key properties of pediatric bones

A

(1) Less dense
(2) More porous
(3) Lower mineral content
(4) Less stiff
(5) Lower bending strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the periosteum in children’s bones affect fracture types?

A

The thick periosteum leads to incomplete fractures like greenstick or torus fractures, and bones tend to bend or bow rather than fully break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the types of fractures specific to pediatric bones?

A
  1. Greenstick fracture
  2. Torus fracture
  3. Plastic deformation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a greenstick fracture?

A

Incomplete fracture where one side breaks, and the other side bends.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a Torus fracture

A

Buckling or creasing of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Plastic deformation?

A

A bone bends and stays bent without an obvious fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why is the growth plate prone to injury in children?

A

The growth plate (physis) is the weakest part of developing bones and is vulnerable to fractures, which can cause growth deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What classification is used for growth plate fractures?

A

Salter-Harris classification - graded from I to V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is class 1 of the Salter-Harris classification?

A

Fracture straight across the physis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is class 2 of the Salter-Harris classification?

A

Fracture through physis and metaphysis, forming a triangular fragment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is class 3 of the Salter-Harris classification?

A

Fracture crosses the physis and exits through the epiphysis

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

What is class 4 of the Salter-Harris classification?

A

Fracture goes through both the physis and metaphysis

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

What is class 5 of the Salter-Harris classification?

A

A crush injury to the growth plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What fractures are suspicious for NAI?

A

Femoral fractures in non-walking children and rib fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the common classification for supracondylar fractures?

A

Gartland classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Type I of Gartland classification

A

Non-displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Type 2 of Gartland classification

A

Displaced with an intact posterior cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Type 3 of Gartland classification

A

Displaced with posterior cortex disrupted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Type 4 of Gartland classification

A

Fully displaced

22
Q

What signs indicate possible vascular compromise in supracondylar fractures?

A
  1. Check radial pulse
  2. Capillary refill
  3. Nerve function
23
Q

Why are children more suitable for conservative fracture treatment?

A

Children’s bones have greater remodeling potential and heal rapidly, so less invasive methods like plaster casts and traction are often sufficient

24
Q

Diaphyseal fractures

A

Flexible nails

25
Q

Metaphyseal fractures

A

K wires

26
Q

Epiphyseal fracture

A

K wires and screws

27
Q

External fixation

A

Reserved for contaminated wounds or severe injuries

28
Q

What is the ‘Fat Pad Sign’ in elbow fractures?

A

Also called the “Sail sign,” it indicates a supracondylar fracture on X-ray due to displaced fat pads around the joint

29
Q

What are the most common types of elbow fractures in children?

A

Supracondylar fractures

30
Q

What is a toddler’s fracture, and how does it present?

A

It is a spiral fracture of the tibia, typically presenting with a child refusing to bear weight.

Initial X-rays may appear normal, but further imaging is required to confirm the diagnosis

31
Q

What are common symptoms of a fracture?

A

(1) Localised tenderness
(2) Swelling
(3) Deformity
(4) Crepitus.

32
Q

What should be assessed in a distal neurovascular exam?

A

Pulses
Capillary refill
Temperature
Colour
Sensation
Motor power

33
Q

Name the nerves assessed in an upper limb neurovascular exam

A

Radial, median, ulnar, axillary

34
Q

Why is non-accidental injury (NAI) important in pediatric fractures?

A

It indicates potential child abuse

35
Q

What is the initial management for a fracture?

A

Clinical assessment
Analgesia (usually IV morphine)
Splinting/traction
Imaging.

36
Q

What imaging methods are commonly used for fractures?

A

X-ray, CT, MRI

37
Q

What is the preferred treatment for unstable extra-articular fractures with soft tissue swelling?

A

Closed reduction with intramedullary nail fixation

38
Q

What is an open fracture?

A

A fracture where the bone breaches the skin and contacts the outside environment

39
Q

What are the two types of open fractures?

A

Inside-out
(bone punctures skin)

Outside-in
(skin is lacerated from external injury)

40
Q

What is the Gustilo classification used for in open fractures?

A

To describe contamination, wound size, ability to close, and presence of vascular injury

41
Q

What is the most common type of infection in open fractures?

A

Polymicrobial

42
Q

What imaging is used to assess open fractures?

A

X-ray with AP and lateral views

43
Q

What is the immediate management of an open fracture?

A

(1) Direct pressure for bleeding
(2) Reduction of dislocation
(3) Removal of debris
(4) Sterile dressing
(5) Stabilization
(6) Neurovascular assessment

43
Q

What antibiotics are given as prophylaxis for open fractures?

A

IV flucloxacillin (gram-positive)

IV gentamicin (gram-negative)

IV metronidazole (anaerobes for soil contamination)

44
Q

When is tetanus vaccine or immunoglobulin given in open fractures?

A

If history is unknown or contaminated injury; give both vaccine and Ig if necessary

45
Q

A 54 year old woman is brought into the emergency department having fallen from a horse. The patient appears to have an isolated injury to her right leg, with no history of head injury or loss of consciousness. On initial assessment, the patient is alert and orientated with a c-spine collar and blocks in place, cardiovascular and respiratory examination is unremarkable. The abdomen is soft and non-tender, a pelvic binder is in place. On full exposure, there is a displaced open fracture of the right tibia and fibula, which is contaminated with soil, there is minimal bleeding. The right dorsalis pedis and posterior pulses are absent and the right foot is pale with reduced sensation. No other injuries are found. Observations show a heart rate of 108, blood pressure of 122/63, respiratory rate of 16, oxygen saturations of 98% on room air, and temperature of 36.4 celsius. IV access is available.

What is the single most important initial management consideration?

A

Reduction of the right lower leg fractures

46
Q

A 7-year-old boy is brought to the emergency department by his mother after falling down, whilst playing at the playground. He fell on an outstretched hand and is now crying of pain in his right forearm. He stopped playing immediately after the fall and refused to use his right hand.
On examination, his right forearm is swollen and bruised. There is some tenderness on palpation of the middle of the forearm. An x-ray is requested and it shows an angulated fracture in the mid-diaphysis of the right radius. The fracture is incomplete as it goes through the cortex on the convex side of a bone that has been bent while the opposite cortex (concave surface) remains intact.

What type of fracture does this describe?

A

Greenstick fracture

47
Q

What is the correct order of fracture healing?

A

Inflammation - soft callus - hard callus - remodelling

48
Q

At which stage of fracture healing is woven bone converted into lamellar bone?

A

Bone remodelling

49
Q

A [Blank] clot forms at the site of a fracture?

A

Fibrin

50
Q

After injury, bone tissue will first replicate and grow, later remodelling according to the forces acting on it. A teenager fell off his bike 2 weeks ago, fracturing his distal radius, and wants to know when his wrist will have healed and be strong enough for him to risk doing some sports again.

What type of bone will most likely first form at the site of the fracture?

A

Woven, trabecular

Year 2- MSK (13 decks)

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