Fractures 2

Question 1

What is an open fracture?

Answer 1

When there is direct communication between the external environment and the fracture. Usually through a break in the skin, not always eg fragments penetrating rectum.

Grading via Gustilo grading. Type 1 - 3C.

Question 2

What is a dislocation, the site and mechanism of the injury usually involved?

Answer 2

Dislocation is a complete joint disruption, subluxation is a partial dislocation, not fully out of joint

Site: anterior shoulder, posterior elbow, posterior hip, anteroposterior knee, lateral ankle

Mechanism: falls, sports/recreational, hyper mobility. Joint pops out of socket.

Question 3

What are the complications of an open fracture?

Answer 3

Infection
Nonunion
Compartment syndrome

Question 4

What are the complications of a dislocation?

Answer 4

Tearing of muscles, ligaments and tendons which reinforce joint
Nerve or blood vessel damage in or around the joint
Susceptibility to reinjury
Fracture

Question 5

How do you manage fractures and dislocations and what are the outcomes?

Answer 5

Fractures:
Primary surgical treatment is debridment/excision and skeletal stabilisation.

Dislocation:
ABCDE trauma assessment.
Reduction, immobilisation and rehabilitation.