Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MUSCULOSKELETAL AND RHEUMATOLOGY 2 > MANAGEMENT OF SPECIFIC FRACTURES > Flashcards

MANAGEMENT OF SPECIFIC FRACTURES Flashcards

1
Q

What are the clinical signs of a fracture?

A 
Pain
Swelling
Crepitus
Deformity
Adjacent structural injury (nerves/vessels/ligaments/tendons)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the imaging techniques that can be done to investigate fractures

A

Radiograph/Xray
CT scan
MRI
Bone scan

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

What are the 5 details when describing a fracture radiograph?

A 
Location
Pieces: simple/multifragmentary
Pattern: transverse/oblique/spiral
Displacement: (translated/angulated)/undisplaced
Plane: XYZ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is translational displacement and it what planes can it occur?

A

Lateral straight line displacement

Proximal/distal (Y plane)
Anterior/posterior (Z plane)
Medial/lateral (X plane)

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

What is angulational displacement and it what planes does it occur?

A

Internal/external rotation (Y plane)
Dorsal/volar (Z plane)
Varus/valgus (X plane)

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

What are the 4 steps in fracture healing and what cells do they involve ?

A

Bleeding
Inflammation (neutrophils, macrophages)
New tissue formation/repair (-blasts)
Remodelling (macrophages, osteoclasts, -blasts)

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

Describe what occurs in the inflammation step of fracture healing

A

Haematoma formation
Cytokine release
Granulation tissue and blood vessel formation

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

Describe what occurs in the repair step of fracture healing

A

Soft callus formation (type II collagen - cartilage)

Converted to hard callus (type I collagen - bone)

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

Describe what occurs in the remodelling step of fracture healing

A

Callus responds to activity, external forces, functional demands and growth (Wolff’s law)
Excess bone is removed

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

What is primary bone healing?

A

When the fragments are close together allowing for intramembranous healing and absolute stability with mesenchymal stem cells forming woven bone directly

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

What is secondary bone healing?

A

When the fragments aren’t completely together causing endochondral healing and relative stability. Done by endochondral ossification which results in more callus

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

How long does it take for a fracture to heal?

A

3-12 weeks depending on site

Phalanges: 3 weeks
Metacarpals: 4-6 weeks
Distal radius: 4-6 weeks
Forearm: 8-10 weeks
Tibia: 10 weeks
Femur: 12 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the general principles to help heal fractures?

A

Reduce (open and closed)
Hold (closed and fixation)
Rehabilitate (use, move, strengthen, physiotherapy)

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

What are the different options for reduction of a fracture?

A

Closed:

  • manipulation
  • traction (skin or skeletal - pins in bones)

Open:

  • mini-incision
  • full exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the different options for holding of a fracture?

A

Closed:

  • Plaster
  • Traction (skin or skeletal)

Fixation (many options)

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

What are the options of fixation of a fracture?

A

Internal:

  • Intramedullary (pins or nails)
  • Extramedullary (plates/screws or pins)

External:

  • Monoplanar
  • Multiplanar
17
Q

What are some general complications of fractures?

A

Fat embolus
DVT
Infection
Prolonged immobility

18
Q

What are some specific complications of fractures?

A 
Neurovascular injury
Muscle/tendon injury
Non union/mal union
Local infection
Degenerative change (intra-articular)
Reflex sympathetic dystrophy
19
Q

What are some factors affecting tissue healing?

A

Mechanical environment:

  • Movement
  • Forces

Biological environment:

  • Blood supply
  • Immune function
  • Infection
  • Nutrition
20
Q

What are the causes for a fractured neck of femur?

A

Osteoporosis
Trauma
Combination

21
Q

Are the femoral head and femoral neck considered intra or extra capsular?

A

Intracapsular

22
Q

Are the less trochanter and greater trochanter of the femur considered intra or extra capsular?

A

Extracapsular

23
Q

Why is an intracapsular fracture of the femur considered more dangerous?

A

Blood supply is more likely to be compromised leading to a higher risk of avascular necrosis

24
Q

How would you treat an extracapsular fracture to the femur?

A

Fix with plate and screws due to low risk of avascular necrosis

25
Q

How would you treat an undisplaced intracapsular fracture to the femur?

A

Fix with screws due to less risk to blood supply

26
Q

How would you treat an displaced intracapsular fracture to the femur?

A

Replace in a > 55 yrs patient and fix if young patient

25-30% of avascular necrosis

27
Q

What would a fit and mobile patient > 55 yrs who fractured their neck of femur have as treatment?

A

Total hip replacement

28
Q

What would a less fit and mobile patient > 55 yrs who fractured their neck of femur have as treatment?

A

Hemiarthroplasty

29
Q

How does a shoulder dislocation present?

A

Variable history but often direct trauma
Pain
Restricted movement
Loss of normal shoulder contour

30
Q

What can be done to investigate a patient with a shoulder dislocation?

A

X-ray prior any manipulation to identify fracture

Scapular y view

31
Q

How is a shoulder dislocation managed?

A 
Reduce dislocated shoulder
Traction-counter traction +/- gentle internal rotation to disimpact humeral head (safest method)
Patient relaxation (entonox, benzodiazepines)

Avoid vigorous/twisting manipulation to avoid fractures

32
Q

What are some complications of shoulder dislocation?

A

Hills-Sachs defect

Bankart lesion

33
Q

What is a Hills-Sachs defect?

A

When humerus dislocates it collides with the glenoid and causes a dent in the posterior humeral head

34
Q

What does management of a distal radius fracture involve?

A

Cast/Splint - temporary until definitive fixation or definitive if minimally displaced and extra-articular

Mua and K-wire - extra-articular but have instability particularly in children

ORIF (open reduction and internal fixation) - displaced, unstable fractures

35
Q

What is most likely fractured if a patient falls over and complains of wrist pain?

A

Scaphoid bone

36
Q

What is a lipohaemarthrosis?

A

Presence of intra-capsular floating fat in a joint cavity seen via imaging. It is indicative of a a intra-articular fracture

37
Q

How is a tibial plateau fracture managed?

A

Non-operative - only truly undisplaced fractures with good joint line congruency assessed on imaging

Operative - restoration of articular surface using plates and screws. Bone graft/cement may be necessary to prevent further depression after fixation

38
Q

What is the management for an ankle fracture?

A

Non-operative:
- Below knee cast (6-8 weeks) then walking boot then
physiotherapy
- Weber A if stable and Weber B if no evidence of
instability

Operative:
- Patients need strict elevation as injury swells
considerably
- Open reduction internal fixation +/- syndesmosis repair
using either screw or tightrope
- Syndesmosis screw can be left or removed at later date
- Weber B/C

MUSCULOSKELETAL AND RHEUMATOLOGY 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions