MM3 Flashcards
List the common causes of PATHOLOGICAL bone fractures.
- Tumour (primary or secondary)
- Infection (chronic osteomyelitis)
- Metabolic bone disease (Ricketts, Paget’s, Osteoporosis, Malnutrition, Hyperparathyroidism)
- Neuropathic
- Congenital (Osteogenesis imperfecta)
- Iatrogenic
(4.3)
The nexus criteria outlines whether a imaging is needed when there is cervical spine trauma.
TorF,
1. if there is posterior midline tenderness imaging is not required
2. if there are distracting injuries (eg visceral or burns) imaging is required
- F
- T
(3.1)
In high risk cervical spine trauma patients who fit the nexus criteria, which imaging modality do you go straight to?
CT- don’t waste time with Xrays.
High risk trauma eg >60km/hr injury, fall >3m or if there is death at the scene.
(3.1)
What imaging modality might you consider to investigate neurological deficits after cervical spine trauma?
MRI- to image extent of cord injury. MRI is best modality for evaluation of soft tissue structures and ligamentous injury.
Note: MRI for soft tissue structures are best done <72hours.
(3.1)
What imaging has highest specificity and sensitivity for imaging of spinal infection?
MRI
3.1
TorF
Xrays are most useful imaging for facial fractures
F- mainly a screening test. Best is CT- excellent sensitivity and specificity and is multiplanar so it can make up 3D image
(3.2)
List the stages of normal fracture healing
- Immediate effects- damage to soft tissues with haemorrhage and fibrin deposition. Necrosis of ends of bone
- Early reaction- inflammatory, first 4-5days. Phagocytosis of debris and necrotic tissues. Early organisation of capillaries and fibroblasts
- Formation of Callus (early bone regeneration) after 1 week.
- Mature callus (from 3 weeks onwards)- gap healed by ossification
- Remodelling of callus- weeks to months, osteoblasts and osteoclasts active
(3.3)
Name two biological situations for why non-union of fracture occurs:
- Atrophic- no biological stimulus to unite
- Hypertrophic- too much movement
(3.3)
