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Laura MSK LL > MSK LL Fractures Lecture > Flashcards

MSK LL Fractures Lecture Flashcards

1
Q

What are the functions of bone?

A

Biomechanics, growth, repair, protection, mineral homeostasis, Haemopoiesis

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2
Q

What are the main causes of fractures?

A

Car accidents, DIY and sport

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3
Q

What are the signs and symptoms of fractures?

A

Pain, loss of funciton, swelling, deformity, bony tendernedd, crepitus and abnormal movement

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4
Q

What is crepitus?

A

Grating, crackling or popping sounds and sensations experienced under the skin and joints

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5
Q

How are fractures described?

A

By their anatomically, by the mechanism and pathologically.

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6
Q

How are fractures described anatomically?

A

Due to their location, configuration, parts, whether the articular layer has been damaged and the displacement of the distal fragment.

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7
Q

What specifically do you want to know about the displacement of a distal fragment?

A

It’s angulation, displacement, axial and rotation

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8
Q

What do you want to known about the mechanism of a fracture?

A

The fracture pattern, the energy, the soft tissue envelope and the skeletal maturity.

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9
Q

Why do you want to know about the skeletal maturity?

A

Because a younger age means better remodelling

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10
Q

Describe bone healing by callus formation

A

A haematoma forms, Procallus of granulation tissue arises, A fibrocartilaginous callus forms, Bony trabeculae appear which then develops into hard cancellous bone, this then is remodelled to compact bone.

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11
Q

What is granulation tissue?

A

A tissue rich in capillaries and fibroblasts

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12
Q

What 3 types of factors can influence bone healing?

A

Local, regional and systemic

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13
Q

What 3 local factors influence bone healing?

A

Injury (it’s configuration and whether it is a soft tissue injury),The type of bone, Treatment - reduction, stability and infection

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14
Q

Which type of bone heals better than what?

A

Cancellous (soft) bone heals better than cortical bone

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15
Q

What regional factors influence bone healing?

A

The blood supply (if poor - slow bone healing) and when it has muscle over

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16
Q

What systemic factors influence bone healing?

A

Age, co-morbidity, bone pathology and head injury

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17
Q

How does a head injury effect bone healing?

A

It makes a bone heal faster because bone is laid down really quickly.

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18
Q

What is malunion of a fracture?

A

It is a clinical term used to indicate that a fracture has healed, but that it has healed in a less than an optimal position.

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19
Q

What is arthrosis?

A

Arthrosis is another name for osteoarthritis

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20
Q

What is arthrosis caused by?

A

Normal wear and tear on you joins and cartilage

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21
Q

What can malunion of a fracture lead to?

A

Deformity and late arthrosis

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22
Q

What is non union?

A

Nonunion is permanent failure of healing following a broken bone

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23
Q

What can be causes of non union of a fracture?

A

Hypertophic (potential for healing but bone moves too much) or Atrophic is caused by a poor blood supply

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24
Q

What type of fracture complication is infection?

A

Local early fracture complication

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25
Q

What is hypovolaemia/shock?

A

It is a state of decreased blood volume

26
Q

What is compartment syndrome?

A

Raised pressure within an enclosed fascial space leading to localised tissue ischaemia. Caused when inflow into a fascial compartment is greater than outflow

27
Q

What is avascular necrosis?

A

The death of bone tissue due to a lack of blood supply

28
Q

Why can fractures cause fat embolisms?

A

Because yellow bone marrow is fat storage so fat is released when the bone is broken

29
Q

What is acute respiratory distress syndrome?

A

It is a life threatening medical condition where the lungs can’t provide enough oxygen for the rest of the body

30
Q

What is disseminated intravascular coagulation?

A

It is when there is an imbalance between the clotting and the lysis systems

31
Q

What is delayed union?

A

When a fracture takes longer to heal than normal

32
Q

What is myositis ossificans?

A

When there is bleeding into muscle and the muscle starts to become hard due to calcium being laid down

33
Q

What is osteoporosis?

A

Condition that weakens bones, making them fragile and more likely to break. Low bone mineral content, enhances bone fragility and increased fracture risk OR Sensitivity to oestrogens.

34
Q

What is chronic regional pain syndrome?

A

When someone suffers from a greater pain than usual due to an injury. Also increased heat.

35
Q

How can you tell someone has compartment syndrome?

A

They have excessive pain, it is progressive and it is not relieves by analgesia. The neurovascular changes (loss of pain) are late. Surgical decompression needs to be performed.

36
Q

How do to measure an open fracture?

A

You measure it after the surrounding damaged tissue has been taken away

37
Q

Name the types of children’s fractures/features

A 
Incomplete fractures (buckle fractures so the periosteum is in tact) 
Rapid healing 
Growth plate (epiphyseal) fractures
38
Q

What is a side effect of a growth plate (epiphyseal) fracture?

A

It can stunt growth

39
Q

What is a stress fracture?

A

A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture.

40
Q

What bones suffer most commonly from stress fractures?

A

Spine/tibia/femur/pelvis/foot

41
Q

What factors predispose people to stress fractures?

A

Osteoporosis, sports and eating disorders

42
Q

How can you prevent osteoporosis?

A

Vitamin D and calcium

43
Q

What must you consider when assessing a fracture?

A

Airways, breathing and circulation, NVT assessment, soft tissues

44
Q

What is reduction of a fracture?

A

It is a surgical procedure to restore a fracture or dislocation to the correct alignment.

45
Q

What can be used to immobilise a fracture?

A

Strapping, plaster or metal wires can be used to immobilise many fractures.

46
Q

Give an example of non operative treatment of a fracture

A

Protection by wool and crepe, sing, collar and cuff, crutches, a cast or a functional brace or traction

47
Q

What is traction?

A

Traction is the use of weights, ropes and pulleys to apply force to tissues surrounding a broken bone.

48
Q

What instructions must be followed if your limb is in plaster?

A

Elevate limb, exercise all joints not in plaster, do’t push anything down the plaster and return is fingers are pale, blue or swollen, there is increasing pain or the plaster becomes loose or cracked

49
Q

When may operative treatment be carried out?

A

To protect soft tissues/avoid infection. Open or closed reduction, to put in implants,

50
Q

What is important about implants?

A

They must be biologically inert so the body doesn’t react to them e.g titanium

51
Q

What is inter-fragmentary compression?

A

-

52
Q

What do clavicle fractures often leave people with? How are they treated?

A

A deformity. With a sling

53
Q

What is fixation of a fracture?

A

Anchoring a bone in place

54
Q

What is the difference between internal and external fixation?

A

Internal is with rods or screws

55
Q

How are distal radius fracture normally treated?

A

Using POP

56
Q

What does POP stand for?

A

Plaster of paris

57
Q

What fracture has a high AVN risk?

A

Intracapsular hip fractures

58
Q

What is the difference between intra and extracapsular hip fractures?

A

Intracapsular is the femoral neck where as extracapsular is of the intertrochanteric line

59
Q

Why can an intracapsular hip fracture lead to avascular necrosis?

A

Because the medial circumflex artery may be damaged

60
Q

What does syndesmosis mean?

A

It is a slightly moveable joint in which bones such as the tibia and fibula are joined together by connective tissue

61
Q

What is the difference between closed and open reduction?

A

Closed reduction is reducing a fracture without making an incision in the skin and open reduction is reducing a fracture by making an incision in the skin.

Laura MSK LL (6 decks)

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