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Int Spec (Ortho) > General Trauma > Flashcards

General Trauma Flashcards

1
Q

Fractures of which bones are particularly prone to developing AVN?

A

Femoral neck, scaphoid and talus

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2
Q

An x-ray showing patchy osteopenia, greater than what would be expected for the condition, is suggestive of what complication of a fracture?

A

Complex regional pain syndrome

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3
Q

In general terms, how are fractures which are undisplaced, minimally displaced or minimally angulated treated?

A

A period of splintage/immobilisation and then rehabilitation

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4
Q

If compartment syndrome is left untreated, ischaemic muscles will necrose, resulting in poor function and fibrotic contracture known as what?

A

Volkmann’s ischaemic contracture

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5
Q

Fractures with residual displacement or angulation are most associated with what complication?

A

Post-traumatic osteoarthritis

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6
Q

What imaging method can be used to detect stress fractures?

A

Technetium bone scan

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7
Q

Fractures involving a joint with a predictable poor outcome may be treated with what?

A

Joint replacement or arthrodesis

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8
Q

What must be done both before and after reduction of a dislocation?

A

Assessment of neurovascular status

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9
Q

During secondary bone healing, how long does it take for a) the soft callus, and b) the hard callus to form?

A

a) 2-3 weeks b) 6-12 weeks

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10
Q

In cases of closed reduction and indirect internal fixation, what is used for internal fixation?

A

IM nails

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11
Q

Which method(s) of managing unstable extra-articular diaphyseal fractures allow secondary bone healing to occur?

A

Closed reduction internal fixation and external fixation

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12
Q

In what situations should a fracture reduction be performed before waiting for x-rays?

A

Grossly displaced, obvious fracture-dislocation or risk of skin damage

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13
Q

What type of fracture is this describing: fractures due to torsional forces, i.e. a twisting injury; inter-fragmentary screws may potentially be used?

A

Spiral fractures

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14
Q

Supracondylar fractures of the elbow are associated with injury to which nerve?

A

Median nerve (anterior interosseous branch)

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15
Q

What is the term given to chronic pain, allodynia, swelling, stiffness and colour changes that occur after a fracture?

A

Complex regional pain syndrome

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16
Q

What imaging method can be used to detect occult fractures where there is clinical suspicion but a normal x-ray?

A

MRI

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17
Q

Humeral shaft fractures are associated with injury to which nerve?

A

Radial nerve

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18
Q

Which type of fracture non-union occurs due to rigid fixation with a fracture gap and lack of blood supply to the affected site?

A

Atrophic non-union

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19
Q

Fracture non-union is said to have occurred when there is no evidence of progression towards healing, clinically or radiologically, within what timeframe?

A

6 months

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20
Q

Fractures where are most likely to result in complex regional pain syndrome?

A

Distal upper limb

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21
Q

In the initial phase, what prophylaxis against infection should be given to individuals with open fractures?

A

IV antibiotics, tetanus injection and sterile/antiseptic soaked dressings

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22
Q

What antibiotic prophylaxis is most commonly used in individuals with open fractures?

A

IV amoxicillin, gentamicin and metronidazole

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23
Q

How are most fracture related nerve injuries managed?

A

Observation for recovery

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24
Q

How is fat embolism treated?

A

ITU support for respiratory failure

25
Q

Describe the very initial management of a long bone fracture?

A

Analgesia (usually morphine), splintage/immobilisation and investigation (usually x-rays)

26
Q

After which types of fracture would a fat embolism be most likely to occur?

A

Pelvic or femur fracture

27
Q

If, after a fracture, a patient develops altered mental status, pyrexia, shortness of breath and a petechial rash, in association with hypoxia and tachycardia, what diagnosis is most likely?

A

Fat embolism

28
Q

Which method(s) of managing unstable extra-articular diaphyseal fractures allow primary bone healing to occur?

A

Open reduction internal fixation (ORIF) with plates and screws

29
Q

How should displaced, intra-articular fractures be treated?

A

ORIF with wires, plates and screws

30
Q

What type of fracture is this describing: fractures which usually occur from a shearing force (e.g. fall from height, deceleration) and tend to shorten and also may angulate; these are able to be fixed with an inter-fragmentary screw?

A

Oblique fractures

31
Q

How is complex regional pain syndrome managed?

A

Referral to pain management services

32
Q

Why is it important to monitor renal function and maintain hydration in patients with compartment syndrome?

A

Compartment syndrome can cause rhabdomyolysis which can lead to renal failure

33
Q

Supracondylar fractures of the elbow are associated with injury to which vascular structure?

A

Brachial artery

34
Q

Anterior shoulder dislocations are associated with injury to which nerve?

A

Axillary nerve

35
Q

The following statement is describing which type of nerve injury that may be associated with a fracture: this occurs from either a sustained compression or stretch, or from a higher degree of force; the axons regenerate at a rate of 1mm per day, meaning recovery is variable and full power or sensation may not be achieved?

A

Axonotmesis

36
Q

How soon after a fracture is a fat embolism likely to occur?

A

2-3 days

37
Q

Knee dislocations are associated with injury to which vascular structure?

A

Popliteal artery

38
Q

What type of fracture is this describing: fractures with three or more fragments, generally indicative of a high energy injury (or poor quality bone); these are very unstable and tend to require surgical stabilisation?

A

Comminuted fractures

39
Q

Posterior dislocations of the hip are associated with injury to which nerve?

A

Sciatic nerve

40
Q

Which type of fracture non-union occurs due to instability and excessive motion at the fracture site?

A

Hypertrophic non-union

41
Q

The following statement is describing which type of nerve injury that may be associated with a fracture: this is complete transection of a nerve, which commonly occurs in penetrating injuries; no recovery will occur unless the affected nerve is surgically repaired?

A

Neurotmesis

42
Q

The following statement is describing which type of nerve injury that may be associated with a fracture: this occurs when the nerve has a temporary conduction defect from compression or stretch- this will resolve over time with full recovery, but can take up to 28 days?

A

Neurapraxia

43
Q

What prophylaxis is given against VTE in patients undergoing surgery for a fracture?

A

Enoxaparin 12-24 hours post-op, and continued for at least 7-10 days

44
Q

What type of fracture is this describing: fractures which occur with pure bending force, these may not shorten but may angulate or result in rotational malalignment?

A

Transverse fractures

45
Q

Colles’ fractures are associated with injury to which nerve?

A

Median nerve

46
Q

What complication can result in delayed union, and both types of non-union of a fracture?

A

Infection

47
Q

What imaging method can be used to assess fractures of complex bones, and can help determine the degree of articular damage and help surgical planning for complex intra-articular fractures?

A

CT

48
Q

Displacement or angulation of a fracture describe the direction of translation of what fragment of the bone?

A

The distal fragment

49
Q

What feature of compartment syndrome is a feature of end-stage ischaemia and an indication that the diagnosis has been made too late?

A

Loss of pulses

50
Q

Which type of fracture is most likely to result in compartment syndrome?

A

Tibial shaft fracture

51
Q

Primary bone healing occurs where the fracture gap is less than what?

A

1mm

52
Q

Trauma to the shoulder can be associated with injury to which vascular structure?

A

Axillary artery

53
Q

If someone presents with an open fracture and has not been vaccinated against tetanus, what should be given?

A

Tetanus immunoglobulin

54
Q

After a fasciotomy for compartment syndrome, how long should the wound be left open for?

A

A few days

55
Q

What investigations are the gold standard for fracture assessment?

A

AP and lateral x-rays

56
Q

How is compartment syndrome treated?

A

Removal of any tight bandages/casts and emergency fasciotomy

57
Q

In those with compartment syndrome, pain will be increased on what movement?

A

Passive stretching (extension) of an involved muscle

58
Q

What type of fracture is this describing: the bone is fractured in two different places; these injuries are very unstable and require stabilisation with long rods or plates?

A

Segmental fractures

59
Q

Severe pain outwith the anticipated severity of the clinical context is a classic sign of what complication of a fracture?

A

Compartment syndrome

Int Spec (Ortho) (10 decks)

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