General orthopaedics Flashcards
List two types of fractures that typically occur in children
greenstick
buckle
salter-Harris
Which fracture only ever arises in children
salter-harris = growth plate fracture
What is another name for dinner form deformity
colle’s fractrue
what is colle’s fracture?
transverse fracture of distal radius
What is the cause of colle’s fracture
FOOSH- fall onto outstretched hand
What is the blood supply of the scaphoid?
retrograde blood supply
List two complications of scaphoid fracture
AVN and non-union
List four bones at risk of AVN
scaphoid
femoral head
humeral head
talus
navicular
fifth metatarsal foot
What is the classification for ankle fractures
Weber classification
What are pathological fractures?
underlying disease
State two causes of pathological fracture
tumour
osteoporosis
paget’s disease
List three cancers that metastasize to bone
PoRTaBLe
Po – Prostate
R – Renal
Ta – Thyroid
B – Breast
Le – Lung
T score > -1?
normal
T score
-1 to -2.5
T score <-2.5?
osteoporosis
What is FRAX>
Patient fragility score- predicts risk of fracture over the next 10 years
What is the medical treatment to reduce risk of fall
calcium
vit D
biphosphonates
What is the MOA of biphosphonates
reduce oscteoclastic activity, prevent reabsorption of bone
What is the advice on admin of oral biphosphonates?
take on empty stomach, sittingupright for 30 mins before moving or eating
What are the side effects of biphosphonates
reflux
oesophageal erosions
osteonecrosis of jaw
osteonecrosis of external auditory canal
What is closed reduction?
manipulation of limb to correct mechanical alignment
List two principles of fracture management
mechanical alignment
stability- fixing bone
List three early complications of fractures
Damage to local structures (e.g., tendons, muscles, arteries, nerves, skin and lung)
Haemorrhage leading to shock and potentially death
Compartment syndrome
Fat embolism (see below)
Venous thromboembolism (DVTs and PEs) due to immobility
List three long term complications of fractures
Delayed union (slow healing)
Malunion (misaligned healing)
Non-union (failure to heal)
Avascular necrosis (death of the bone)
Infection (osteomyelitis)
Joint instability
Joint stiffness
Contractures (tightening of the soft tissues)
Arthritis
Chronic pain
Complex regional pain syndrome
Why does fat embolisation arise following fracture of long bone?
fat globules released into circulation, possibly from bone marrow. Fat become lodged in blood vessels
What is Gurd’ criteria?
the result of fat embolism resulting in systemic inflammatory response
What are the components of Gurd’s criteria?
Major:
respiratory distress
petechial rash
cerebral involvement
Minor:
Jaundice
Thrombocytopenia
Fever
Tachycardia
Which classification is used for open fractures?
Gustilo grade
Describe the gustilo grade classification
Grade 1- wound ≤1 cm, minimal contamination or muscle damage
Grade 2- wound 1-10 cm, moderate soft tissue injury
Grade 3a- bad
3b- extra bad
3c- horror show- vascular involvement/repair
Which investigation is best for assessing intra-articular fractures?
CT scan
