Orthapaedic Trauma Flashcards
What are open fractures?
Broken bone is exposed through the skin
Requires urgent Tetanus and Abx
Semi-urgent surgical debridement
What are high energy fractures associated with?
Extensive soft tissue damage, leading to disruption of healing pathways
What is the first test for fractures?
X-ray
What is the most sensitive test for fractures?
MRI
What is the treatment for fractures?
Recognition - xray
Reduce - Set the bone to anatomical position
Retain - cast or surgery
Rehab - balance between stability and stiffness
What is malunion and nonunion?
Nonunion - bone does not heal
Malunion - bone heals in unacceptable alignment
What is compartment syndrome?
Swelling from soft tissue damage compresses nerves and vessels, causing permanent damage
Emergency, nerve and vessel damage must be repaired or bypassed
What is primary healing?
Intramembranous
Direct healing between the two ends of the bone, with no callous formation
What is secondary healing?
Enchondral
Indirect formation of bone from uncommitted mesenchymal cells
Controlled motion - rods, casts
What are the three stages of secondary healing?
Inflammatory - 48 hours
Reparative - 8 weeks
Remodeling - 1 year
How is nonunion diagnosed?
Lack of radiographic evidence of progression of callus formation over 3-5 month period
What are osteogenic bone grafts?
Bone forming
Only autologous grafts contain viable osteoblasts
What are osteoinductive bone grafts?
Bone stimulation
Encourages differentiation of mesenchymal cells into osteoblasts
BMP-2 and 7
What are osteoconductive bone grafts?
Bone scaffold
Cancellous allograft
What is the best bone graft to use?
Autographs from cancellous pelvis
genic, inductive and conductive
