Principles of fracture management Flashcards by Holly O'Flanagan | Brainscape

Q

Complications of surgery

A

Loss of life

Loss of limb

Loss of function

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Q

General/ systemic complications of surgery

A

CVS

RS

GIT

GUS

NS

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Q

Specific/ local complications of surgery

A

Infection

Dislocation

Neurovascular damage

Fracture

Metalwork failure

Operation specific

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Q

Acute handover ATMIST

A

Age

Time

Mechanism

Injuries

Signs

Treatment

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Q

Airway

A

With cervical spine control

Give oxygen

Talking

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Q

How might an airway be compromised?

A

Drugs/ alcohol

Vomit

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Q

Immediate life threatening A and B problems

A

ATOM FC

Air obstruction

Tension pneumothorax

Open pneumothorax

Massive haemothorax

Flail chest

Cardiac tamponade

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Q

Physiology of shock

A

Tachycardia

Decreased pulse pressure

Altered conscious level

Decreased urine output

Reduced BP

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Q

Save limb

A

Vessels

Nerves

Bones

Soft tissues/ muscles

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Q

Vascular problems

A

Direct arterial injury

Occlusion of venous outflow

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Q

Compartment syndrome

A

Pressure in enclosed space is increasing

Venules damaged

Pressure builds up

Diagnosis- pain out of proportion to what you’d expect

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Q

Treatment for compartment syndrome

A

Fasciotomy

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Q

Where can you bleed from enough to die quickly?

A

Pelvis- normally venous

Abdomen

Neck

Chest

Long bones

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Q

What to do with an arterial bleed?

A

Compress

Operating theatre

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Q

Occlusion of venous outflow

A

Compartment syndrome

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Q

What happens if you miss compartment syndrome?

A

Muscle dies

Permanent contraction

Volkman’s ischamic contracture

Q

Specific fracture history- red flags

A

Vessels

Nerves

Soft tissues

viability
compartment

Children

Q

Fracture examination

A

Start at the top, ATLS

Listen to the patient

Look
Feel
Move
Special tests

Q

Fracture management

A

Relieve pain

analgesia
splint the bone

Avoid further damage

reduce dislocations
straighten bent limbs
re-establish circulation
relieve pressure on nerves close by

Q

Fracture management: investigations

A

X rays

two views
two joints

Two times?

Q

X ray description

A

Which bone

Where in the bone

intra-articular
epiphysis
physis
metaphysis
diaphysis

What sort of bone

normal
pathological

Q

Fracture pattern description

A

Simple
- transverse, oblique, spiral

Comminuted
- how many parts

Displaced
- angulated, translated, burst

Special types
- greenstick, avulsions

Q

Fracture management: the basics

A

Reduce

Stabilise

Rehabilitate

Q

Reduce

A

Closed vs open

Length

Alignment

Rotation

Q

Stabilise

A

External- sling, POP, external fixator

Internal- wires, intramedullary nail, extramedullary plates

Q

Terrible triad of trauma

A

Acidosis

Hypothermia

Coagulopathy