Managment Of Specific Fractures

Question 1

How do you describe a radiograph?

Answer 1

Name date projection
Location- which bone, side, part of bone (proximal 1/3, middle, distal)
Pieces: simple/multifragmentary
Pattern:oblique/transverse/spiral
Displaced/Undisplaced/shortened/rotated
Angulated: varus/valgus

Question 2

What is the difference between direct and indirect fracture healing?

Answer 2

Direct: no callus, absolute compression and stability during healing
Indirect: callus, micro movement

Question 3

What are the stages of indirect fracture healing?

Answer 3

Inflammation: haematoma formation and blood vessel formation
Repair: soft callus (T2 collagen) turns to hard callus (T1 collagen)
Remodelling: callus responds to external force and excess bone is removed

Question 4

Label the type of reduction each of these pictures show

Answer 4

Question 5

Label the neck of femor anatomy

Answer 5

Question 6

What are the differences between intra and extracapsular NOF fractures? What is the treatment plan for each?
How does this differ for under 55’ and over 55?

Answer 6

Intra: above intertrochanteric line blood supply more likely to be compromised, commonly needs replacement
IF DISPLACED AND UNDER 55: FIXATION WITH SCREWS
IF DISPLACED AND OVER 55: TOTAL HIP REPLACEMENT
Extra: below intertrochanteric, internal fixation with screws

Question 7

What is the management for shoulder dislocation?

Answer 7

Benzodiazepine for relaxation
X-ray
Gentle rotation/traction-counter traction

Question 8

Shoulder dislocation complications?

Answer 8

Hill Sach defect: dent in humerus
Bankart lesion: bit of bone coming off glenoid bone

Question 9

What Is a callus?

Answer 9

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

Question 10

What is Wolf’s Law?

Answer 10

Bone grows and remodels in response to forces placed around it

Question 11

What factors of the mechanical and biological environment affect fracture healing?

Answer 11

Mechanical- movement and forces
Environmental-blood supply, immune function, infection, nutrition

Question 12

Which wrist bone Is the scaphoid?
How are fractures to this bone managed?

Answer 12

Distal carpal closest to thumb
Plaster

Question 13

What commonly causes a tibial plateau fracture?
What sign might be present?

Answer 13

Valgus/Varus force on the femoral condyles splitting the plateau surface of tibia
Lipohaemarthrosis- blood and fat within the joint following trauma

Question 14

What is a trimalleolar fracture?
How is it managed?

Answer 14

Ankle fracture affecting all three lateral, medial, posterior malpolis of the tibia and fibula
Cast, moon boot, no weight bearing on ankle