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MSK > Management of specific fractures > Flashcards

Management of specific fractures Flashcards

1
Q

Fracture assessment

A

Pain
Swelling
Crepitus
Deformity
“Collateral damage”
- Nerve
- Vessel

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2
Q

What are the steps of describing a fracture radiograph?

A

Name, date, projection
LPPD:
- Location (which bone, side),
- Pieces (simple, multifragment),
- Pattern (transverse/oblique/spiral) - tells how it happened, the amount of energy that went into it
- Displacement

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3
Q

What are two types of displacement?

A

Translation - displaced bone moves in a plane
Angulation - displaced bone moves at an angle

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4
Q

Describe translation in the X Y and Z planes

A

X - anterior/posterior // Y - proximal/distal // Z - medial/lateral

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5
Q

Describe angulation in the X Y and Z planes

A

X - varus/vulgus // Y - internal/external rotation // Z - dorsal/volar

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6
Q

Direct fracture healing

A

Anatomical reduction
absolute stability/compression
no callus

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7
Q

Indirect fracture healing

A

Sufficent reduction
Micromovement
Callus

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8
Q

What is a callus?

A

Connective tissue that forms around a fracture, will eventually solidify into bone

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9
Q

What is Wolff’s Law?

A

Bone grows and remodels in response to forces placed around it

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10
Q

What are the three stages of indirect fracture healing?

A

Inflammation (haematoma formation),
Repair (callus formation),
Remodelling (from external forces)

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11
Q

How long do fractures take to heal

A

Typically 6 weeks

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12
Q

What are the three stages of managing fractures?

A

Reduce,
Hold,
Rehabilitate

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13
Q

What are the two types of reduction and what is the difference?

A

Open (reposition bone surgically), using incisions/full exposure
Closed (reposition bone without exposing), via manipulation (brace) or traction (pins)

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14
Q

What is the other term for open/closed reduction?

A

Internal (open) / External (closed) fixation

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15
Q

What are some general fracture complications?

A

Fat embolus, DVT, infection,
Prolonged immobility can lead to utis and sores

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16
Q

What are some specific fracture complications?

A

Neurovascular injury
Muscle/tendon injury
Non union/mal union
Local infection
Degenerative change (intraarticular)
Reflex sympathetic dystrophy

17
Q

What are factors of the mechanical environment that affect fracture healing?

A

Movement and Forces

18
Q

What are factors of the biological environment that affect fracture healing?

A

Blood supply, immune function, infection, nutrition

19
Q

What is the most common cause of FNoF in younger and older patients?

A

Younger - Trauma // Older - Osteoporosis

20
Q

What is a fractured neck of femur commonly known as?

A

Hip fracture

21
Q

History of FNoF px

A

age
comorbidity
preinjury mobility
social hx

22
Q

What are the four types of FNoF?

A

1 - Subcapital (intracapsular)
2 - Transcervical (extracapsular)
3 - Basicervical (extracapsular)
4 - Subtrochanteric/intertrochanteric

23
Q

Which type of FNoF is most likely to affect blood supply?

A

Subcapital/Intracapsular

24
Q

How would you treat FNoF extracapsular?

A

Internal Fixation - plate or screws

25
Q

How would you treat undisplaced intracapsular FNoF?

A

Fixation with screws

26
Q

How would you treat displaced intracapsular FNoF

A

under 55s? - Fixation with screws
over 55s? - Total hip replacement if fit OR Hemiarthroplasty (replace head of femur) if less fit

27
Q

What is the presentation for shoulder dislocation?

A

Pain, Restricted movement, Loss of contour, Physical displacement

28
Q

What clinical examination would you do for shoulder dislocation?

A

Neurovascular status - axillary nerve

29
Q

How would you treat a shoulder dislocation?

A

Benzodiazepine to relax // Traction-Counter Traction to push back in

30
Q

What complication can form from a shoulder dislocation?

A

Hill-Sachs Defect (dent in shoulder)

31
Q

What are the signs of distal radius fracture?

A

Swelling and limited movement of wrist, neurovascularly intact

32
Q

What are the three managements of a distal radius fracture?

A

Cast, minimal displacement
Wire Fixation, extra-articular but unstable
Open Reduction Internal Fixation (ORIF), displaced, unstable fractures

33
Q

What is a trimalleolar fracture also known as commonly?

A

Ankle fracture

34
Q

What is the non-operative management of malleolus fracture?

A

Non-weightbearing below knee cast, walking boot and physiotherapy
For stable fractures

35
Q

What is an operative management of malleolus fracture?

A

Open reduction internal fixation, Syndesmosis repair with screws
For unstable fractures that may be above syndesmosis

36
Q

What is a syndesmosis

A

(fibrous joint between bones)

MSK (7 decks)

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