Ortho - Fractures Flashcards
What are the clinical signs of fracture?
Pain Swelling Crepitus Deformity Adjacent structural injury (nerves, vessels, ligament, tendons)
What investigations are useful for fractures?
Radiograph
CT scan
MRI scan
Bone scan (used mainly to look for infection/tumours)
What features are important to describe on a radiograph?
Location
Pieces
Pattern
Displaced/undisplaced
What types of displacement of fractures are possible?
Translation - moving in a straight line
Angulation - moving around a point
How is translation described?
x axis - medial/lateral
y axis - proximal/distal
z axis - anterior/posterior
How is angulation described?
x axis - varus/valgus
y axis - internal/external rotation
z axis - dorsal/volar
What are the principles of fracture management?
Reduce
Hold
Rehabilitate
What are the options for closed reduction of fracture?
Manipulation
Traction: skin or skeletal (pins in bones)
What are the options for open reduction of fracture?
Mini-incision
Full exposure
What are the options for closed holding of fracture?
Plaster
Traction: skin or skeletal
What are the internal fixation options?
Intramedullary: pins or nails
Extramedullary: plate/screws or pins
What are the external fixation options?
Monoplantar
Multiplanar
Why might external fixation be useful?
If there has been a lot of soft tissue damage so there is risk of infection, can be removed easily
What is involved in rehabilitation?
Move Physiotherapy Use: pain relief, retrain Strengthen Weight bare
What are the general complications of fractures?
Can occur early or late:
- Fat embolus
- DVT
- Infection
- Prolonged immobility - UTI, chest infection, sores