fractures: general management Flashcards

1
Q

how long does it take for soft callus to form after a break

A

2-3 weeks

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

how long does it take for hard callus to form after a break

A

6-12

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

how do transverse fractures usually occur + what are they

A

bending force (can angulate) // perpendicular - 1 break

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

how do oblique fractures usually occur + what are they

A

shearing force with fall or deceleration // diagonal along long axis of bone

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

how are oblique fractures usually managed

A

screw

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

how to spiral fractures usually occur + what are they

A

rotational force // severe form of oblique fracture

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

how are spiral fractures managed

A

screws

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

how are segmental fractures managed + what are they

A

long rods and plates // more than 1 fracture in a bone

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

what classification is used for open fractures

A

Gustila and anderson: 1 = <1cm wound // 2 = >1cm wound + some soft tissue damage // 3 = >1cm wound + significant soft damage // a = enough coverage // b = not enough coverage // c = vascular injury

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

mx open fractures

A

immobilise, IV abx, debride, external fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how are undisplaced fractures usually managed

A

splint, immobilise, rehab

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

how are angulated/ displaced fractures usually managed

A

reduction under anaesthesia + cast // X ray for progress

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

how are unstable extra-articular fractures usually managed

A

ORIF (plates and screws)

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

how are displaced intra-articular fractures usually managed

A

ORIF (wires, screws, plates) - poor outcomes

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

what early local complications of fractures can occur

A

compartment, neurovascular injury, ischaemia

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

what systemic complications of fractures can occur

A

hypovolaemia, ARDS, renal failure, SIRS, PE, fat embolism

17
Q

which fractures usually cause compartment syndrome

A

supracondylar (humerus at elbow) or tibial shaft

18
Q

symtpoms compartment syndrome

A

pain+++, loss of function, swollen, pallor, extensive analgesia (pulse may still be present)

19
Q

invx compartment syndrome

A

pressure >40 mmHg // Xrays will not show anything

20
Q

mx compartment syndrome

A

remove tight clothing // fasciotomy // IV fluids

21
Q

SE fasciotomy

A

myoglobulinuria

22
Q

what neurovascular component is commonly damaged in knee dislocation

A

popliteal artery

23
Q

what neurovascular component is commonly damaged in paediatric supracondylar fracture at elbow

A

brachial artery

24
Q

what neurovascular component is commonly damaged in shoudler dislocation

25
RF fat embolism
long bone fracture
26
symptoms fat embolism
tachypnoea, dyspnoea within 72 hours injury, hypoxia, brown peticheal rash, oral or eye haemorrhage, confusion + agitation
27
invx fat embolism
CTPA - ground glass appearance
28
mx fat embolism
DVT prophylaxis and supportive care
29
symptoms of a non-union fracture
pain, oedema, movement, xray: bridging callus
30
which fractures have poor blood supply
scaphoid, distal clavicle, femur
31
what fractures may cause DVT
pelvic or lower limb
32
which fractures may cause AVN
femoral neck, scaphoid, tallus
33
which fractures may cause OA
intra-articular