Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

othopaedics > fractures > Flashcards

fractures Flashcards

1
Q

precipitations for a fragility, vertebral, stress, high energy and pathological #

A 
fragility=fall from standing height or less
vertebral=bending, lifting and falling
stress=running
high energy=major trauma
pathological=spontaneous minimal trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

diseases that cause pathological #

A

malignancy
paget
osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

investigation for a fracture main points

A
  • order x-rays in 2 projections at right angles

- request MRI if # cant be seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

management of a #

A 
analgesia
immobilisation
reduction
-cast
-splint
-internal fixation 
ie ex fix vs in fix
-dvt phx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

that often need surgical management

A
  • watershed areas
  • long bone #
  • peri articular#
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the most common cause of compartment syndrome

A

trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

who does non-union usually affect

A
  • high energy or open# with extensive damage to nv supply

- or smoking, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is avascular necrosis

A

where blood supply to one of the major fragments crosses the plane of fracture so gets disrupted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

definition of a fracture, dislocation and sublaxation and comminuted

A 
#=disruption in bone continuity 
dislocation=complete loss of continuity of 2 bones forming a joint
sublaxation: partial loss of continuity of 2 bones forming a joint
comminuted= break into more than 2 fragments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ways of describing #

A 
displacement
-translation
-angulated
-rotated
-shortened
(impaction or bayonetting)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

shapes of fractures

A

simple:

  • transverse
  • linear
  • oblique
  • spiral
    complex: more than 2

green stick
impaction
bayonetting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is a green stick #

A

one side is fractured and the other one is bent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are buckle fractures and who gets them

A

all compresses either side of fracture to buckle
in children
also called torus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

difference between impaction and bayonetting

A

both shorten but the proximal fragment goes past the fracture site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what causes a #

A

1.injury mechanism that exceeds the max force a bone can withstand
normal bone abnormal force
2.abnormal bone norm force if have tumours, degenerative or congenital ostoegenesis imperfecta
3. co-morbidities that increase the risk of trauma eg balance, visual impair, alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

physical signs of a #

A 
abnormal movement
crepitus
deformity
bruising
tenderness
pain on stressing limb
impaired function
swelling
17
Q

primary # healing requirenements

A
  • direct healing
  • needs end of bones to be touching
  • WITHOUT a callus
  • therefore needs an operation probably to align with plates first
18
Q

mechanism of primary # healing

A
  • gaps are invaded with blood vessels and cells that differentiate into osteoblast that lay down woven and lamella bone
  • osteoclast act as cutting cones and pass directly across the fracture site leaving channel for the blood vessels and osteoblast to follow
  • remodelling then occurs
19
Q

stages of secondary bone healing

A
  1. inflamamtion get a haematoma formed and inflamamtory cells, granulation tissue for 2 weeks
  2. soft callus in 2-6 weeks
  3. soft callus calcified by chondroblast to form a hard callus 12-26 weeks
  4. 1-2 years of bone remodelling to form lamellar bone and osteoclast remove woven bone
20
Q

what is a callus

A

deposition of collagen and fibrocartilage tissue

21
Q

fracture healing timeframe in children, adult humerus, distal radius, femur, ankle and tibia

A 
children=2-4 weeks
humerus=6-12 weeks
radius=5-6 weeks
femur=24 weeks
ankle=6 weeks
tibia=12 weeks
22
Q

factors affecting # healing

A
  • patient related eg smoke and dm
  • energy related so high and blood supply, soft tissue
  • fixation related: is it adequate, infection
23
Q

how delayed does healing have to be to be considered delayed healing

A

3-6 months

24
Q

at what point is non-union defined

A

at minimum of 9 months and # shown no sign of healing for 3 months

25
Q

conservative vs non conservative managent depending on the # considerations

A
  • is the position acceptable ie consider soft tissue and NV risk, salter harris
  • is it stable or unstable
  • will it slip
  • risk of not operating ie prolonged bed rest in eldery, bed sores, independence
  • do they work as takes longer secondary healing
26
Q

options for non-op

A

splint
braces
elevate
casting

27
Q

when should someone seek attention if they had non-op

A
  • increasing pain
  • numbness
  • pins and needles
28
Q

pros and cons of non-op

A

-cheap
-easy
-reduce op risk
cons
-stiffness
-doesnt fully control if unstable
-pressure issues
-comfort
-bed rest
-morbidity risk

29
Q

surgical pros and cons

A 
pros
-less immobilisation
-earlier rehab and pain control
-anatomical reduction reduce risk of further disability
cons
-expensive
-slow healing
-risk of complication
30
Q

cons of surgical ext fix

A
  • pin site infection
  • osteomyelitis risk
  • NV injury
  • over distraction causing non-union
31
Q

cons of surgical internal fix risk

A

-infection
NV injury
-non-union
-implant failure and subsequent # through a bony defect removal

32
Q

absolute indication for op management

A
  1. displaced intra-articular#
  2. open #
  3. pathological #
  4. polytrauma
  5. # of long bones
  6. NV damage
33
Q

relative indication for op management of #

A
  1. failure of conservative management
  2. # with high risk complication
  3. morbidity of conservative manage
  4. elderly patients intolerant to prolonged bed rest
34
Q

indications for external fixation

A
  1. open # with sif soft tissue damage
  2. highly comminuted
  3. life saving splintage procedure in pelvic#
  4. initial stabilising surgery
  5. salvage option of union problems
  6. definitive treatment of periarticular# eg pilon
35
Q

3 main methods of external fixation

A
  • pin and rods
  • ring fixators
  • circulator fixators for definitive fracture fixation

othopaedics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions