Fractures Flashcards
is primary or secondary bone healing more common?
secondary
what fills in the fracture gap in primary bone healing?
bone
what fills in the fracture gap in secondary bone healing?
granulation tissue THEN cartilage THEN bone
what comprises a “soft callus”?
cartilage
typical path of fracture healing?
haematoma -> soft callus -> hard callus -> remodelling
what fracture complications should you look out for when examining a fracture?
neurovascular problems
soft tissue injury
compartment syndrome
cause of a comminution fracture?
high energy
poor quality bone
treatment for a fit patient with an unstable fracture?
operative stabilisation
treatment for a s imple, minimally displaced fracture that is stable?
conservative management
splint
when should you not do open reduction internal fixation surgery?
high energy fracture,
soft tissue swelling
treatment for a displaced intraarticular fracture?
anatomic reduction and rigid internal fixation to prevent post traumatic OA
when should you consider joint replacement in a peri articular fracture?
risk of non-union,
AVN
treatment for open fractures?
antibiotics
early debridement
operative stabilisation
treatment for compartment syndrome
fasciotomy
operative stabilisation
treatment for vascular injury with fracture?
reduction
stabilisation
reassess circulation
revascularisation
most common cause of a femoral shaft fracture
high energy
pathological
risks for a femoral shaft fracture?
fat embolism
ARDS
treatment for femoral shaft fracture?
resus
analgesia
splintage
if unstable, IM nailing
treatment for an extra articular distal femur fracture?
thomas splint
nail if not too distal,
plating
treatment for an intra articular distal femur fracture?
anatomical reduction
rigid fixation
plate and screws
common cause of proximal tibial fractures?
valgus stress
high energy if young, low energy if old
investigations for proximal tibial fracture?
CT
treatment for proximal tibial fracture?
anatomical reduction
rigid fixation
can you get open fractures with a tibial shaft fracture?
yes, not uncommon
conservative treatment for a tibial shaft fracture?
plaster
operative treatment for a tibial shaft fracture?
IM nailing
plating
what kind of fracture typically is a distal tibial fracture
pilon
what other bone injuries are associated with a distal tibial fracture
spine
pelvis
calcaneus
which fractures are considered to be surgical emergencies?
distal tibial
treatment for distal tibial fracture?
bridging ex fix to allow soft tissues to settle
internal fixation once they have
which ankle fractures are considered stable fractures
isolated distal fibular fracture,
minimally displaced medial malleolus fracture
what ankle fractures are deemed to be unstable?
bimalleolar
who gets proximal humeral fractures?
elderly osteoporotic patients
complications of a proximal humeral fracture?
brachial plexus/ axillary artery injury
AVN
treatment for proximal humeral fracture?
old- conservative
young- internal fixation
usual treatment for an intra articular fracture?
open reduction internal fixation
what kind of fracture is an olecranon fracture usually?
avulsion
how should you treat a comminuted fracture of the radial head?
excise +/- replacement
what injury in what other structure can be suspected if the radius is fractured?
dislocated distal radioulnar joint
what injury in what other structure can be suspected if the ulna is fractured?
dislocation of radial head
treatment if both forearm bones fractured?
ORIF
what is a colles fracture?
extra articular fracture, dorsal angulation, dorsal displacement
what action causes a smiths fracture?
falling onto back of hand
where does a smiths fracture happen?
distal radius
treatment for a smiths fracture?
ORIF
what injuries would come under a polytrauma
long bones +/- pelvis
what fractures tend to cause the most bleeding?
pelvic
femoral shaft
treatment for polytrauma?
skeletal stabilisation
reduced bleeding and fat embolism
what is 1st degree nerve injury called?
neurapraxia
what happens in neurapraxia?
temporary conduction block
what is 2nd degree nerve block called?
axonotmesis
what happens in axonotmesis
nerve cell axon dies distally from point of injury
can 1st or 2nd degree nerve injury repair itself?
both can
treatment for nerve injury that isnt repairing itself?
nerve conduction study then
nerve gafting
tendon transfer
