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MSK > Fractures > Flashcards

Fractures Flashcards

1
Q

What type of fracture is this?

What causes this type of fracture?

What are some major complications of this type of fracture?

How should you treat this fracture?

A

Fracture of the femoral shaft

High energy injury (e.g. fall from height/RTA) or can be pathological

Blood loss and hypovolaemic shock, fat embolus causing ARDS

Resuscitation, analgesia, splinting, internal fixation

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2
Q

What specific type of analgesia could be used for femoral shaft fractures?

A

Femoral nerve block

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3
Q

What type of splint can be used for femoral shaft fractures?

Who specifically are they used in? Why?

A

Thomas Splint

Mostly used in kids as their bones heal faster and so they can tolerate how long they use it for

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4
Q

What type of fracture is this?

This type of fracture can be split into two types, what are they?

A

Distal femoral fracture

Intra-articular and extra-articular

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5
Q

How do you treat an intra-articular distal femoral fracture?

A

Anatomical reduction and rigid fixation with plate and screws

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6
Q

How do you treat an extra-articular distal femoral fracture?

A

Can use Thomas splint

If not too distal can nail

If very distal use plating

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7
Q

What type of fracture is this?

How can this type of fracture be caused?

Which direction of stress is this injury associated with?

What scan is useful to determine the personality of these fractures?

Are these fractures intra or extra-articular? What does this cause?

A

Proximal tibial fracture

High energy in young, low energy in old

Valgus stress

CT scan

Intra-articular, high chance of post-traumatic arthritis

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8
Q

What are the principles of treatment of proximal tibial fractures?

A

Anatomical reduction and rigid fixation.

Elevation

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9
Q

What type of fracture is this?

Why should all cases of this type of fracture be monitored overnight?

Are open fractures common here or not?

To what degree of angulation is accepted in this bone?

How good is the affected bone at healing?

Give an example of conservative and operative healing.

A

Tibial shaft fracture

They have a very high risk of compartment syndrome

Open fractures are very common here

5 degrees

Not good, takes a long time (can be up to a year)

Conservative- plaster casting

Operative- IM nailing, plating or external fixation

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10
Q

What is this fracture known as?

Is it intra or extra-articular?

What usually causes it?

How would you treat it?

A

Pilon Fracture

Intra-articular

High energy injury, usually a fall from height

External fixation until soft tissue damage settles and then internal fixation

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11
Q

What type of fracture is this?

What other injuries are usually associated?

What other investigation is usually required?

How would you treat it?

A

Distal tibial fracture

Fractures of spine, pelvis, calcaneus and possibly soft tissue injuries

CT scan

Internal fixation if no soft tissue damage, external fixation if soft tissue damage

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12
Q

What are two examples of ankle fractures which are stable and can be treated conservatively?

A

Isolated distal fibular fractures

Displaced medial malleolus fractures

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13
Q

What are 3 examples of ankle fractures which cause talar shift?

How should you treat fractures with talar shift? Why?

A

Bimalleolar fractures

High malleolar fractures

Distal fibular fracture with deltoid ligament rupture

Treat with ORIF- risk of arthritis

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14
Q

What type of fracture is this?

What causes the majority of these fractures?

What risks are associated?

A

Proximal humeral fracture/Fracture of the surgical neck of humerus

Osteoporosis in the elderly

Brachial plexus, axillay artery/nerve injuries, AVN, non-union

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15
Q

What would be the management of a fracture of the proximal humerus in the following cases…

Elderly patient?

Split into 3 or 4 parts?

Younger patient?

What complications can occur after both conservative or surgical management?

A

Conservative

Arthroplasty

Internal fixation

Stiffness and rotator cuff dysfunction

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16
Q

What type of fracture is this?

What nerve is most likely to be damaged in these injuries and how will it present?

How likely is non-union?

What type of injury normally causes these fractures?

A

Humeral shaft fracture

Radial nerve: wrist drop and numbness in the first dorsal web space

10% no matter the management

Rotational injuries

17
Q

What is the primary treatment for humeral shaft fractures?

When should internal fixation be used instead of this?

What type of internal fixation would usually be used?

A

Bracing

Non-union, high energy, pathological fractures, polytrauma, unable to tolerate brace

IM nails

18
Q

What type of fracture is this?

Is it usually intra or extra articular?

How is it treated?

A

Distal humeral fracture

Intra-articular

ORIF

19
Q

What type of fracture is this?

What causes it?

How is it treated?

When is an exception to this treatment?

A

Olecranon fracture

Fall onto elbow and triceps pulls

Internal fixation

Very low demand

20
Q

What type of fracture is this?

What do these fractures often occur alongside?

What sign should you look for to assess elbow damage?

A

Fracture of the radial head

Elbow dislocations

Fat pad sign

21
Q

How would you treat a radial head fracture in each of the following situations?

Minimally displaced marginal fracture?

Displaced fracture with large fragment blocking movement?

Comminuted fractures?

A

Conservatively

Internal fixation

Excision and possible replacement

22
Q

What type of fracture is this?

A

Monteggia Fracture

23
Q

What type of fracture is this?

A

Galeazzi Fracture

24
Q

Radius fractured, ulnar dislocated at the DRUJ is known as what?

Ulna fractured, radial head dislocated is known as what?

Isolated ulnar fracture is known as what?

A

Galeazzi Fracture

Monteggia Fracture

Nightstick Fracture

25
Q

What is the treatment for…

Fractures of radius and ulna?

Monteggia/Galeazzi fractures?

Isolated ulnar fracture?

A

ORIF

ORIF for fracture, reduction of dislocation

Conservative

26
Q

What type of fracture is this?

What usually causes it?

Is it intra or extra-articular?

Which way does it angulate/displace?

What is the typical deformity associated with these fractures?

A

Colles’ Fracture

FOOSH

Extra-articular

Dorsally

Dinner fork deformity

27
Q

How would you treat the following Colles’ fractures…

Stable, minimally displaced/angluated?

Displaced, simple fracture?

Displaced and communated fracture?

A

Conservatively- POP

Reduction under anaesthesia

Reduction under anaesthesia and ORIF

28
Q

What are 4 complications associated with a Colles fracture?

A

Median nerve compression (acute carpal tunnel)

EPL rupture

Complex regional pain syndrome

Loss of grip strength

29
Q

What causes a Smith’s fracture?

Intra or extra-articular?

Which direction of displacement/angulation?

Stable or unstable?

How do you treat?

A

Fall onto back of hand

Extra-articular

Volar

Unstable

ORIF

30
Q

Is a Barton’s fracture intra or extra-articular?

How is it treated?

A

Intra-articular

ORIF

31
Q

What defines polytrauma?

What are major fractures?

A

More than 1 major fracture

Long bone fractures or pelvic fracture

32
Q

What two fractures pose the biggest risk of blood loss?

What makes up the lethal triad?

A

Pelvic and femoral shaft

Hypothermia, acidosis, coagulopathy

33
Q

In a polytrauma case, what orthopaedic injuries need to be treated as an emergency?

A

Unstable pelvic, femoral or tibial fractures

Open fractures

Fractures with vascular compromise

Compartment syndrome

34
Q

What are 4 early local complications of fractures?

A

Compartment syndrome

Vascular injury (distal ischaemia)

Nerve injury

Skin necrosis

35
Q

What are 3 indications for investigating nerve injury after a fracture?

A

Open fractures

Penetrating injuries

Neuralgic pain

36
Q

What are 5 early systemic complications of a fracture?

A

Fat embolus

Hypovolaemia

SIRS

ARDS

MODS

37
Q

What are some causes of atrophic non-union?

What is the cause of hypertrophic non-union?

A

Lack of blood supply, too big a gap, steroids, smoking, poor nutritional status

Too much movement

38
Q

What causes Volkmann’s Ischaemic contracture?

A

Missed compartment syndrome

39
Q

What are the only fractures which require an x-ray to confirm union?

A

Diaphyseal fractures of long bones

MSK (6 decks)

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