Fractures Flashcards
1
Q
What is a dislocation?
A
Complete joint disruption
2
Q
What is a subluxation?
A
Partial dislocation
3
Q
How can dislocations be diagnosed?
A
Clinical exam and radiology
4
Q
Which injuries are associated with dislocations?
A
- Fractures
- Neurovascular damage
5
Q
What are the long term effects of a dislocation?
A
- Recurrent instability
- Stiffness
6
Q
Why are open fractures important?
A
- Higher energy injury
- Increased infection rate
- Soft tissue complications
- Long term morbidity
7
Q
Describe the Gustilo classification of open fractures
A
- Type 1: wound < 1 cm, clean and simple
- Type 2: wound > 1 cm, moderate tissue damage but simple and adequate skin coverage
- Type 3: extensive soft tissue damage and complex
- 3A: adequate periosteal coverage
- 3B: requires soft tissue covering procedure
- 3C: vascular injury requiring repair
8
Q
How should open fractures be managed?
A
- Full ATLS assessment and treatment
- Tetanus and antibiotic prophylaxis
- Cefuroxime/ augmentin/ clindamycin - Gent at the time of fixation
- Repeated examination of n/v status
- Wound only handled to remove gross contamination
- Photograph, cover and stabilise limb
- No provisional irrigation/exploration
- Radiographs
9
Q
When is emergency urgent surgery required for an open fracture?
A
- Polytraumatised patient
- Marine or farmyard environment
- Gross contamination
- Neurovascular compromise
- Compartment syndrome
10
Q
What are the four Cs of surgical debridement and fixation?
A
- Colour
- Contraction
- Consistency
- Capacity to bleed
11
Q
When should an amputation be considered?
A
- Insensate limb/foot
- Irretrievable soft tissue or bony tissue
- Other life threatening injuries
12
Q
Describe the features of cortical bone
A
- Diaphysis
- Resists bending and torsion
- Laid down circumferentially
- Less biologically active
13
Q
Describe the features of cancellous bone
A
- Metaphysis
- Resists and absorbs - compression
- Site of longitudinal growth
- Very biologically active
14
Q
What is a fracture?
A
A break in the structural continuity of bone
15
Q
Why can bones fail?
A
- High energy transfer in normal bones
- Repetitive stress in normal bones
- Low energy transfer in abnormal bones (osteoporosis, metastatic tumour etc.)
