Principles of Fracture Management Flashcards
Treatment
-Manipulation
-splinting
-joint movement and function
Closed Fractures
-reduce
-maintain
-internal fixation
-external fixation
-rehabilitation
Reduction
-manipulation
-mechanical traction
-open operation
Maintain
immobilisation=sustained traction
-traction by gravity
-balanced traction
-fixed traction
Indications of internal fixation
-wide separation of fragments
-# that units poorly
-# that cannot be reduced by closed manipulation
-unstable #s
-pathological #s
-large fragments
-complications
-early moblisation is desired
Types of internal fixation
-screws
-wires
-plates
-intramedullary nails
Complications of internal fixation
-infection
-non-union
-implant failure
-refractures
-additional ST trauma
-require skilled surgeon
-risk of failure implant
-plates require add stripping of periosteum
-anaesthetic time longer
Indications of external fixation
-severe tissue damage
-comminuted and unstable #s
-pelvic #s
-nerve or vessel damage
-infected #s
-ununited #s
Complications of external fixation
-damage to ST structures
-over distraction
-pin-track infection
Advantages of external fixation
-easy access for cleaning
-good alignment for comminuted #s
-quick application
-minimal interference of adjacent jts
-adjustable frame
-early mobilisation
Disadvantages of external fixation
-expensive
-infection at pin sites
-not suitable for bulky areas
-may hold fragments apart
Rehabilitation
-prevent oedema
-active exc.
-assissted mvmnt
-fxnal activity
Management of open #s
-RX at scene of accident
-cover wound with clean material
-leave site undisturbed until you’ve reached the hospital
-gen. Ax and condition addressed
-tetanus prophylaxis admin.
-wound carefully inspected
Principles of treatment
-sterility and antibiotic cover
-debridement and wound excision
-wound closure
-stabilisation of #
-aftercare
-teamwork
Physio management
-pain
-swelling
-circulation
-ROM
-strength
-weight bearing
-fxn
