Fractures And Fracture Healing Flashcards

1
Q

First stage of healing

A

Haematoma
Bleeding from lacerated medullary vessels-> coagulates
Osteophytes near the # surface a deprived of nutrients -> necrosis -> acute inflam response -> granulation tissue

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

Second stage of healing

A

Organisation
Capillary and fibroblast proliferation-> fibrovascular granulation tissue
Osteoproginstor cells differentiate into osteoblasts and migrate into granulation tissue
2 weeks

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

Third stage of healing

A

Callus formation
Osteoblasts synthesises osteoid -> calcified to form callus off woven bone
3-6w

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

Fourth stage of healing

A

Modelling
Osteoblasts and osteoclasts activity-> woven bone is replaced by lamellar bone
1-2y

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

Fifth stage of healing

A

Remodelling or completion
Under load the bone is strengthen under lines of stress
1-2y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

risk fractures

A
Age 
Females
BMI
PH
FH osteoporosis 
Smoking
RA
Alcohol
Corticosteroids
Osteomalacia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fracture classification

A

1) open/closed
2) type
3) location
4) displacement
5) angulation
6) anything else

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

Fracture types

A
Transfers
Oblique
Spiral
Commuinuted >2 parts 
Bowing
Buckle-> # on the concave surface
Green stick-> # on the convex surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fracture location

A

Diaphysis-> shaft
Metaphysis -> by growth plate
Epiphysis-> end of bone
Articular-> involves joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Open fracture management

A
Take photos and cover with sterile dressing 
Antibiotics and tetanus
Stabilise 
Analgesia
Check neurovascular status 
X Ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Early fracture complications

A
Skin damage 
Nerve compression/damage 
-numeral shaft-> radial nerve
-supra condylar humeral-> ant. Interosseous/median nerve
-distal radius-> median 
-posterior acetabulum-> sciatic 
Blood vessel injury 
-loss
-ischaemia 
Infection 
Compartment syndrome 
Thromboembolism 
Fat embolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Compartment syndrome clinical features

A

Muscle swelling with a facial compartment-> occluded capillaries-> ischaemia
Unusually bad untreatable pain
Increased pain on passive stretching
No pulses and parasthesia-> late signs

Tibial shaft or forearm

Remove any compression -> 15 mins -> decompress
BP/compartment pressure >30

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

Late complications

A

Delayed/non Union 5%
Mal Union-> inadequate reduction/stabilisation
Post traumatic osteoarthritis
A vascular necrosis -> femoral neck, scaphoid, tallus
Complex regional pain syndrome

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

Risk factors for non Union

A
Smoking
Alcohol
Age
Steroids
DM
Chronic renal failure 
High enters # 
Open # 
Infection 
Bone loss
Fixation failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complex regional pain syndrome clinical features

A
Burning/ crushing pain 
Usually upper limb, foot or ankle
Red, swollen and shiney
Excessive joint stiffness 
Idiopathic 

CBT
Physio
Analgesia

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