Regional fractures Flashcards
How does a femoral shaft fracture occur?
high energy or pathalogical
what is associated with a femoral shaft fracture?
approx 1L blood loss. assoc with other injuries
what are the risks of femoral shaft fractures
ARDs fat embolism
What is the treatment for a femoral shaft fracture
resuscitation, analgesia. thomas splint. is unstable then IM nailing
how are unstable distal femur fractures treated
thomas splint may be used
how are intra articular femur fractures treated
anatomical reduction. rigid fixation. plates and screws
how are extra articular femur fractures treated
not too distal IM nails
distal plates and screws
what causes proximal tibial fractures
high energy in the young. low energy in the old
what can a high energy prox tibial fracture mean
may have soft tissue sweeping - so may need temp spanning ex fix
what investigations can be done for a proximal tibial fracture and what risks are there for this fracture
CT scan
post traumatic arthritis
what is the treatment for proximal tibial fractures
reduce. rigid fixation. elevation depressed articular fragments. bone graft
what is a key feature in tibial shaft fractures
internal rotation poorly tolerated
different between union and non union in tibial shaft fractures
16 wks is union
over a year is non-union
what do tibial shaft fractures have a high risk of
compartment syndrome
what is the treatment of tibial shaft fractures
conservative - plaster
operative - IM nailing, plating. ex fix
what is a pilon fracture
a intra articular distal tibial fracture
how are pilon fractures caused and how do they present
high energy. substantial soft tissue damage
what investigations can be done for distal tibial fractures
CT
what is the treatment for distal tibial fractures
surgical emergency - urgent bridging ex fix. allow soft tissues to settle. +/- limited internal fix
internal fixation once soft tissues settle
how is a isolated distal fibular fracture/minimally displaced medial malleolus treated
they are stable so conservatively
which fracture can occur with a deltoid ligament rupture and what does this lead to
distal fibular fracture leads to talar shift
bimalleolar fractures are what
unstable and they lead to a talar shift
what is the treatment for 1mm talar shift
causes increased joint force -> open reduction internal fixation
