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BRS - Year 2 > 🩻MSK🩻 - Management of Fractures > Flashcards

🩻MSK🩻 - Management of Fractures Flashcards

1
Q

What are the steps for assessing damage in orthopaedics?

A

Look
Feel
Move X-ray

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2
Q

What are the steps for repairing a fracture?

A

Reduce (realign fracture)
Hold - plaster, external fixator, internal fixator
Rehabilitate - usually 6 weeks later

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3
Q

How is trauma approached in orthopaedics?

A

The fracture is usually the least important bit
Keep the patient alive first – ATLS
-Airway
-Breathing
-Circulation
-Disability (i.e. neurology)

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4
Q

What should be looked for while assessing a fracture?

A

Pain
Swelling
Crepitus
Deformity
“Collateral damage” - nerves, vessels

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5
Q

What are the investigations in orthopaedics?

A

X-ray (go-to in most cases)
CT sometimes indicated - make diagnosis or assess pattern
MRI if unsure

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6
Q

How are fractures described on a radiograph?

A

Location: which bone and which part of bone?
Pieces: simple/multifragmentary?
Pattern: transverse/oblique/spiral
Displaced/undisplaced?
Translated/angulated?
X/Y/Z plane

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7
Q

How can fractures be displaced?

A

Translation
Angulation
Rotation
Impaction

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8
Q

Describe translation

A

Bone is translated and displaced either medial/lateral or dorsal/volar

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9
Q

Describe angulation

A

Valgus/varus

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10
Q

Describe rotation

A

Internal/external

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11
Q

Describe impaction

A
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12
Q

What are the two types of fracture healing?

A

Direct fracture healing
Indirect fracture healing

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13
Q

Outline direct fracture healing

A

Anatomical reduction
Absolute stability/compression
No callus

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14
Q

Outline indirect fracture healing

A

Sufficient reduction
Micromovement
Callus

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15
Q

What is Wolff’s law?

A

Bone grows and remodels in response to the forces that are placed on it

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16
Q

What are the steps of indirect fracture healing?

A

Inflammation - haematoma, release of cytokines, granulation tissue and blood vessel formation
Repair - Soft callus - type 2 collagen+cartilage, Hard callus - type 1 collagen+bone
Remodelling - Callus responds to activity, external forces, functional demands and growth
Excess bone is removed

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17
Q

How long do fracture take to heal?

A

Usually 6 weeks
3-12 weeks depending on the site
Phalanges - 3 weeks
Metacarpals, distal radius - 4-6 weeks
Forearm, tibia - up to 10 weeks
Femur - 12 weeks

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18
Q

How are fractures managed?

A

Reduce - closed, open
Hold - plaster/splint, internal or external fixation
Rehabilitate - early/late, weight bearing, physiotherapy

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19
Q

What are the options for reduction?

20
Q

What type of fixture is this?

21
Q

What type of fixture is this?

A

Internal intramedullary

22
Q

What type of fixture is this?

A

Internal extramedullary

23
Q

What type of fixation is this?

A

External monoplanar

24
Q

What type of fixation is this?

A

External multiplanar

25
Q

What are the types of fracture complications?

A

General (away from site)
Specific (at site)

26
Q

What are some general fracture complications?

A

Fat embolus
DVT
Infection
Prolonged immobility - UTI, chest infections, sores

27
Q

What are some specific fracture complications?

A

Neurovascular injury
Muscle/tendon injury
Non0union/mal-union
Local infection
Degenerative change (intraarticular)
Reflex sympathetic dystrophy

28
Q

What factors affect fracture healing?

A

Mechanical environment - movement, forces
Biological environment - blood supply, immune function, infection, nutrition

29
Q

What are the causes of fractured neck of femur?

A

Osteoporosis (older)
Trauma (younger)
Combination

30
Q

What should be identified in a history of someone resenting with a neck of femur fracture?

A

Age
Comorbidity - respiratory, cardiovascular, diabetes, cancer
Preinjury mobility - independent, shopping, walking, sports
Social hx: relatives, stairs, etoh

31
Q

Describe the neck of femur anatomy

32
Q

Outline the different types of neck of femur fractures

33
Q

What is the majore risk of an intracapsular NoF fracture?

A

Blood supply is more likely to be compromised
-AVN
-Non-union

34
Q

How are extracapsular fractures managed?

35
Q

When are intracapsular NoF fractures fixed or replaced

36
Q

What are the techniques to reduce a dislocated shoulder?

38
Q

What are the management options for a distal radius fracture?

41
Q

Give an overview of tibial plateau fractures

42
Q

What are the management options for tibial plateau fracture?

44
Q

What are the non-operative management options for an ankle fracture?

45
Q

What are the operative management options for an ankle fracture?

BRS - Year 2 (75 decks)

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