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Musculoskeletal > fractures > Flashcards

fractures Flashcards

1
Q

What are some risk factors for fractures

A

smoking, alcohol, malnutrition, impaired vision, osteoporosis

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2
Q

What is the blood supply to the femoral head

A

intramedullary artery of femur shaft, medial and lateral circumflex branches of profounda femoris, artery of ligament teres

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3
Q

Where is an intracapsular fracture

A

in the neck

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4
Q

where is an extra capsular fracture

A

in the trochanteric line roughly

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5
Q

In extra capsular fracture what type of fractures can you get

A

basicervical, intertrochanteric and subtrochanteric

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6
Q

What do you use to treat hip fractures

A

early mobilisation and surgery

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7
Q

How do you treat undisplayed intracapsular fractures

A

screws

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8
Q

How do you treat displaced intracapsular fractures

A

THR or arthroplasty

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9
Q

What happens in primary bone healing?

A

there is a minimal fracture gap, where bone is able to refill it- this would be a hairline fracture, fixation with plates and screws

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10
Q

What is secondary bone healing

A

fracture fills with granulation tissue > soft callus > hard callus = colles fracture

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11
Q

What is the general management?>

A

ABCDE, analgesia, assess- closed/open, neuromuscular status, soft tissue, compartment syndrome, splint age, reduction, non op/ op

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12
Q

What kind of patterns of fractures can you get?

A

angulation, displaced, comminution, stable/ unstable, extra/intraarticular

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13
Q

Which part of the bone displays?

A

The bottom half of the bone

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14
Q

What non op strategies are there?

A

plaster cast, bracing, traction

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15
Q

if minimally displaced what treatment option is besT>

A

splintage

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16
Q

if position is unacceptable, what should you do?

A

reduction

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17
Q

if its an unstable fracture, how do you fix it?

A

operative stabilisation

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18
Q

When should you not perform ORIF?

A

When there is significant swelling

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19
Q

When should internal fixation be used?

A

when displaced intra articular fracture

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20
Q

What does a compartment syndrome require?

A

fasciotomy

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21
Q

is a femoral shaft fracture usually high energy or low energy?

A

high

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22
Q

what are the risks of femoral shaft fracture?

A

ARDS, fat embolism

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23
Q

what is the treatment of femoral shaft fracture

A

resus, analgesia, splint (thomas) unstable- nailing

24
Q

If you have a distal femur fracture what do you use to treat it?

A

plating

25
Q

What type of stress is a proximal tibial fracture likely to cause?

A

valgus stress

26
Q

If it is a high energy proximal tibial fracture with soft tissue damage what procedure should be used?

A

external fixation

27
Q

What is a big risk in a tibial shaft fracture?

A

compartment syndrome

28
Q

How do you treat tibial shaft fracture?

A

plaster, IM nailing, ex-fix

29
Q

What is an intra articular distal tibial fracture called?

A

Pilon fracture

30
Q

Is a distal tibial fracture an emergency?

A

YES 110%

31
Q

Once soft tissue swelling settles, what do you do in a distal tibial fracture?

A

internal fixation

32
Q

What constitutes a stable ankle fracture?

A

isolated distal fibular fracture or medial malleolus

33
Q

talar shift happens from what

A

bimalleolar fractures, distal fibular fracture

34
Q

What age group tend to fracture their proximal humerus?

A

elderly

35
Q

What arteries/ veins are at damage in injury of the proximal humerus?

A

axillary artery, brachial plexus

36
Q

what are you at risk of in proximal humerus fracture

A

AVN/ NON UNION

37
Q

What nerve is at risk in the humeral shaft fractures?

A

radial

38
Q

When is internal fixation used in humeral shaft fractures

A

non union

39
Q

What is the usual treatment of distal humerus fractures?

A

ORIF

40
Q

If the radius is fractured in isolation and a DRUJ dislocation- wha tis this?

A

Galeazzi

41
Q

If the ulna is fractured in isolation suspect a dislocation of the radial head

A

Monteggia

42
Q

How should yu treat both fractured bones of the forearm?

A

ORIF

43
Q

Where does a colles fracture occur?

A

Distal radius

44
Q

What are complications of colles fracture?

A

median neve compression, EPL rupture, CRPS, loss of grip strength

45
Q

What is a smiths fracture?

A

Fall onto back of hand, EXTRA ARTICULAR, unstable ORIF

46
Q

What is a bartons fracture

A

intra articular, \orif

47
Q

What are the three unstable fractures you should treat in polytrauma

A

pelvic, femoral and tibial

48
Q

What are early complications of fractures

A

compartment syndrome, vascular injury, nerve injury and skin necrosis

49
Q

What is 1st degree nerve injury called?

A

Neurapraxia

50
Q

what is second degree nerve block called?

A

axonotmesis- nerve cell dies distally from point of injury

51
Q

What is neurotmesis

A

3rd degree injury, nerve is transcected

52
Q

What tests should you do in nerve injury?

A

nerve conduction studies?

53
Q

What can be early systemic complications?

A

ARDS, SIRS, fat embolism, hypovolaemia

54
Q

What are late local complications

A

DVT, AVN, malunion, nonunion, CRPS

55
Q

What type of medicine can lead to non union

A

steroids, NSAIDS, bisphosphonates

56
Q

Name the biggest late systemic complications

A

PE

57
Q

What things should you assess in a fracture?

A

Open/ closed/ neuromuscular involvement, compartment syndrome, soft tissues.

Musculoskeletal (29 decks)

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