Principles of Fracture Management and Open Fractures

Question 1

What does ORIF stand for in fracture management?

Answer 1

Open Reduction and Internal Fixation

Question 2

List three indications for ORIF.

Answer 2

• Intra-articular fractures
• Diaphyseal fractures of long bones
• Fracture-dislocation of joints

Question 3

What are K-wires used for?

Answer 3

Stabilizing fractures

Question 4

What is the purpose of interfragmentary screws?

Answer 4

To provide compression between fracture fragments

Question 5

Fill in the blank: A united fracture means bone healing with restoration of the bone tissue to the extent that it can withstand _______.

Answer 5

[normal physiological loads]

Question 6

What is clinical union in fracture management?

Answer 6

No pain and no movement on physical manipulation of the fracture site

Question 7

Define radiological union.

Answer 7

Callus bridging at least three of the four cortices

Question 8

What is an open fracture?

Answer 8

Any fracture where the fracture haematoma is communicating with the external environment

Question 9

What is the Gustillo-Anderson classification used for?

Answer 9

Classifying open fractures

Question 10

What is the first line of analgesia for open fractures?

Answer 10

Morphine IV

Question 11

What antibiotic is given for Gustillo-Anderson I and II fractures?

Answer 11

Cefazolin 2 gram stat IV

Question 12

What should be done during the treatment of open fractures?

Answer 12

• Inspect wound and classify
• Irrigate wound with saline
• Apply sterile gauze dressing

Question 13

What factors decrease the infection rate in open fractures?

Answer 13

• Quality of debridement
• Timing of debridement
• Timing of soft tissue closure
• Timing of initiation of antibiotics

Question 14

True or False: Perfect reduction is necessary when aligning the limb in open fracture treatment.

Answer 14

False

Question 15

What is the recommended time frame for debridement after an open fracture injury?

Answer 15

Within 24 hours

Question 16

What is the maximum time allowed for soft tissue closure after an injury?

Answer 16

Within 5 days

Question 17

What should be done to prevent infection in open fractures?

Answer 17

• Quality debridement
• Timely debridement
• Timely soft tissue closure
• Timely initiation of antibiotics

Question 18

Fill in the blank: The duration of immobilization for each fracture is determined by its _______.

Answer 18

[clinical and radiological union]