Fractures and dislocations Flashcards

1
Q

Polytrauma

A

severe injury to more than one body system

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2
Q

ATLS

  • A
  • B
  • C
  • D
  • E
A

Advanced trauma life support

  • airway + cervical spine control
  • breathing and ventilation
  • control of bleeding + replace lost blood
  • disability brain protection
  • exposure: remove clothes + inspect body for injury
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3
Q

SIRS

A

systemic inflammatory response syndrome

- response to noxious stressor (sepsis = SIRS in response to infection)

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4
Q

ARDS

A

acute respiratory distress syndrome

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5
Q

MODS

A

multiple organ dysfunction syndrome

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6
Q

Terrible triad

A

acidosis
coagulopathy
hypothermia

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7
Q

Damage control orthopaedics

A

control bleeding
soft tissue management (fasciotomy, decompress tension pneumothorax, arterial repair)
provisional fracture stability (external fixators)

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8
Q

Compartment syndrome

A

increased pressure in a closed space (compartment)
leads to ischaemia of components
urgent fasciotomy required

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9
Q

Fracture

A

no continuation between 2 parts of one bone

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10
Q

Twisting force causes a

A

spiral/oblique fracture

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11
Q

Bending force causes a

A

transverse fracture (and often a bending wedge)

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12
Q

High energy force causes a

A

comminuted fracture (+ lots of fragments)

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13
Q

Skin intact

A

closed fracture

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14
Q

Skin broken

A

open (compound) fracture

- increased risk of infection

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15
Q

Reading an x-ray (OSCE steps)

A
read name
confirm name + DOB (with patient + wrist band)
read hospital number
check x-ray date
note part of region (left/right)
standing/weight-bearing?
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16
Q

Valgus

A

apex medial

17
Q

Parallel

A

no angulation

18
Q

Varus

A

apex lateral

19
Q

Intertrochanteric femoral neck fracture

A

between lesser and greater trochanters

fix with dynamic hip screw

20
Q

Sub-capital fracture

A

(neck of femur)

intracapsular femoral head fracture

21
Q

Dislocation

A

no articulation between 2 bones when there usually is one

22
Q

AMPLE

A
Allergies
Medications
Past medical history
Last meal
Events
23
Q

Principles of fracture management

A

reduce
retain - maintain reduction until fracture heals
rehabilitate - restore to original status before injury

24
Q

Dislocation initial management

A

analgesia
reduce dislocation
reassess neurovascular status before + after reduction

25
Principles of management of severely injured
save life save limb save joint
26
Areas you do not x-ray
``` ribs (x-ray doesn't change management) nasal bones (most of nose = cartilage) coccyx (only intervention = analgesia) ```
27
Radiographic fracture signs (bone)
lucent lines - darkenings on x-ray sclerotic lines - whiter line on x-ray (due to increased density where ends of fracture overlap) cortical breach - breach of outline of white bone disruption of trabeculae - decreased space in joint change in body contour
28
Radiographic fracture signs (complementary)
haemarthrosis (blood in joint) - may displace other structures (eg. elevated fat pad) lipohaemarthrosis (fat and blood in joint) soft tissue swelling - more grey than expected
29
Boney rings
rigid ring must break in at least 2 places - pelvis - obturator foramen x2 - paired longbones (forearm + leg) - mandible - zygomatic arch - vertebra
30
Fracture description criteria
``` position (angulation, displacement, distraction, impaction, foreshortening) path of fracture line simple or comminuted joint involvement closed or open ```
31
Children fractures
``` plastic (bending) torus greenstick growth plate fractures non-accidental injury ```
32
Growth plate injury classification
SALTR - Slipped - Above - Lower - Through - Ruined
33
Special fractures
- fatigue (stress) fractures - insufficiency fractures - pathological fractures