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ortho > principles of fractures > Flashcards

principles of fractures Flashcards

1
Q

what is a fracture ?

A

break in the structural continuity of bone

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2
Q

what are the causes of fractures ?

A

injury
repetitive stress
pathological fracture

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3
Q

what type of fracture does twisting cause ?

A

spiral fracture

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4
Q

what type of fracture does compression cause ?

A

oblique fracture

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5
Q

what type of fracture does bending cause ?

A

triangular butterfly fragment

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6
Q

what type of fracture does tension cause ?

A

transverse bone fracture

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7
Q

when does a stress fracture happen ?

A

1- occur in normal bone which is subjected to repeated heavy loading
2- can happen on steroid therapy

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8
Q

what are the causes of pathological fractures?

A

osteoporosis
osteogenesis imperfecta

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9
Q

what is the difference in healing time between a transverse and spiral fracture ?

A

transverse - slow to join because the area of contact is small - stable under compression
spiral - joins more rapidly - not stable under compression

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10
Q

what are the main principles of fracture management ?

A

resuscitation
reduction
immobilization
rehabilitation

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11
Q

how should history be taken in emergency situations ?

A

AMPLE
Allergies
Medications
Past Medical History
Last Meal
Events surrounding injury

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12
Q

what are the different outcomes in initial reduction ?

A

successful reduction + stable= conservative
successful reduction + unstable = surgical
unsuccessful reduction = surgical

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13
Q

what are the two methods of definitive reduction ?

A

closed
open

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14
Q

what are the indications for open reduction ?

A

closed reduction fails
or if there is a large articular fragment that needs accurate positioning

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15
Q

what are the methods of immobilization ?

A

traction ( skin and skeletal )
cast splintage ( backslab and complete cast )
bracing ( static brace and dynamic brace )
percutaneous fixation
internal fixation
external fixation

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16
Q

how is percutaneous fixation achieved ?

A

fracture reduced by manipulation first
then stabilized by k wires

17
Q

when do we perform temporary external fixation ?

A

1- fractures associated with nerve or vessel damage
2- severe tissue damage
3- fractures of the pelvis
4- infected fractures
5- severe multiple injuries

18
Q

how is rehabitilatioin achieved ?

A

physiotherapy
occupational therapy

19
Q

what are open fractures ?

A

also called compound fractures , with direct communication to the external environment

20
Q

what is the initial management of open fractures ?

A

wound irrigation
gross contamination removed
take a photo
saline soaked dressing
backslab
broad spectrum ab
tetanus prophylaxis

21
Q

what is the gustilo classification ?

A

Type 1 - wound less than 1 cm
Type 2 - wound 1-10 cm, moderate soft tissue injury
Type 3A - more than 10 cms , high energy, extensive soft tissue damage
Type 3B - wound requires soft tissue coverage
Type 3C - vascular injury requiring vascular repair

22
Q

farm injuries are automatically considered what type of gustilo ?

A

at least 3A

23
Q

what is the definitive management for open fractures ?

A

must assume that they are contaminated
1- antibiotic prophylaxis
2- urgent wound debridement
3- temporary stabilization
4- definitive fixation and wound cover

24
Q

what are the principles of management of intra-articular fractures ?

A

anatomical reduction
rigid fixation
early mobilization

25
Q

what are the common complications of intra-articular fractures ?

A

secondary osteoarthritis
stiffness of the affected joint

26
Q

what are the skin complications associated with fractures ?

A

fracture blisters
cannot perform open fixation until blisters heal

27
Q

which nerve is affected in shoulder dislocation or proximal humerus affection ?

A

axillary nerve

28
Q

which nerve is affeected in humeral shaft damage ?

A

radial nerve

29
Q

what is a holstein lewis fracture ?

A

spiral fracture off the distal humerus

30
Q

which nerve is affected in fractures of the distal radius ?

A

median nerve

31
Q

what nerves are affected in knee dislocation ?

A

all peripheral nerves

32
Q

which nerve is affected in fractures of the higher end of the fibula ?

A

common peroneal nerve

33
Q

what is the most sensitive finding associated with compartment syndrome ?

A

pain with passive motion

34
Q

if there is no pulse found in association with compartment syndrome what is the most likely management ?

A

amputation is usually required

35
Q

how is the diagnosis of compartment syndrome made ?

A

mainly a clinical diagnosis
compartment pressure more than 40 mmhg

36
Q

treatment for compartment syndrome ?

A

fasciotomy

ortho (15 decks)

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