fractures Flashcards
what are the two stages of bone healing?
primary and secondary
what type of fractures does primary healing cause?
hairline fractures
- osteoclasts bridge gap
what are the stages of secondary healing?
- debris removed and bone ends resorbed -> macrophages and osteoclasts
- granulation tissue forms -> fibroblasts
- cartilage formed (soft callus) -> chondroblasts
- bone matrix (enchondral ossification) -> osteoblasts
- calcium mineralisation (hard callus)
what is a segmental fracture?
2+ fractures
what is comminuted fracture?
3+ fragments
what causes and oblique fracture?
force (fall from height)
what causes a spiral fracture?
torsional forces
what causes transverse fractures?
bending
how to tell if a fracture is displaced?
skin doesn’t blanch
lack of sensation
blistering
ischaemia signs
how to check the distal neurovascular status?
distal pulses
numb sole
what are signs of fracture?
tender
can’t bear weight
swelling
deformity
crepitus
what investigations are used?
x-rays (AP and lateral)
CT
MRI
what scan is used for stress fractures?
technetium bone scan
what is the management?
splintage
closed reduction + cast
ORIF + plate/screws
open fracture - IV broad spectrum antibiotics
what are the early local complications?
compartment syndrome, vascular/nerve injury, skin necrosis
what are the early systemic complications?
hypovolaemia
shock
fat embolism
ARDS
