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(1) MS: Orthopedic and Rheumatic Conditions 🩺 > S2_L4: Fractures > Flashcards

S2_L4: Fractures Flashcards

1
Q

TRUE OR FALSE: A fracture is known as a a break in a bone or cartilage. This may be due to abnormal formation of bone in a congenital disease of bone, such as osteogenesis imperfecta.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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2
Q

The following statements are true about fractures, EXCEPT:

A. In open fx, debridement and irrigation should be done within 6 hours
B. In open fx, there is a break in the skin
C. In closed fx, only the angulation that occurred is seen
D. In closed fx, the skin, soft tissues and mucous membranes are intact
E. None of the above

A

A. In open fx, debridement and irrigation should be done within 6 hours

NOTE: The allotted time is 8 hours to prevent anything infection to the bone. Bleeding should also be stopped as patient and also die from hypovolemia.

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3
Q

Match the following patterns of failure

  1. failure due to compressive forces
  2. due to high loads
  3. 3 or more fragments

A. Segmental fracture
B. Comminuted fractures
C. Spiral fractures
D. Oblique fractures
E. Transverse fractures

A
  1. D
  2. B
  3. B
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4
Q

Match the following patterns of failure

  1. due to torsional forces
  2. due to tensile forces
  3. due to a 4 point bending

A. Segmental fracture
B. Comminuted fractures
C. Spiral fractures
D. Oblique fractures
E. Transverse fractures

A
  1. C
  2. E
  3. A
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5
Q

TRUE OR FALSE: A Torus fracture is an example of a complete fracture.

A

False

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6
Q

Bone is the (1)_______ of the body. A fracture is a break in the (2)_______ of a bone resulting in the loss of its mechanical and structural integrity.

A
  1. framework
  2. continuity
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7
Q

This kind of fractures occur in bones weakened by pre-existing bone disease such as tumor, cyst, osteomyelitis or osteoporosis.

A

Pathologic fracture

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8
Q

This kind of fractures result from bone fatigue from repeated unaccustomed loading and inadequate muscular support

A

Stress fracture

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9
Q

TRUE OR FALSE: A description of a fracture may depend on its modifiers

A

True

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10
Q

TRUE OR FALSE: A description of a fracture may depend on the measurement of skin breakage

A

False

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11
Q

TRUE OR FALSE: A description of a fracture may depend on the location in the bone

A

True

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12
Q

TRUE OR FALSE: A description of a fracture may depend on its pattern

A

True

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13
Q

In complete fractures, both _____ has been disrupted

A

cortices

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14
Q

Which type of fracture is predominant in children?

A. Complete fractures
B. Incomplete fractures

A

B. Incomplete fractures

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15
Q

Displacement is named according to direction of the _______ fragment

A

distal

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16
Q

Determine the stages of fracture healing.

  1. stability begins
  2. woven bone is converted to lamellar bone
  3. where PT becomes active in treatment
  4. clot is replaced with reparative fibrovascular granulation tissue
  5. bridging callus about the fracture site is formed

A. Inflammation
B. Repair
C. Remodeling

A
  1. B
  2. C
  3. C
  4. A
  5. B
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17
Q

Determine the stages of fracture healing.

  1. Fibroblast and chondroblast appear in the area
  2. Osteoblasts from the inner cambium layers of the uninjured periosteum and endosteum lay down primitive osteoid
  3. Acute inflammatory cells invade the clot, followed by chronic inflammatory cells and macrophages
  4. Nodules of cartilage form an envelope of cartilaginous tissue that encircles the fracture site
  5. Osteoid begins to mineralize in the medullary canal

A. Inflammation
B. Repair
C. Remodeling

A
  1. A
  2. B
  3. A
  4. B
  5. B
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18
Q

The following is true about
vertebral compression fracture, EXCEPT:

A. Most common osteoporotic fracture of the spine in elderly
B. Pain may wrap around rib cage
C. Scoliosis results from multiple compression fractures
D. Imaging: X-ray
E. None

A

C. Scoliosis results from multiple compression fractures

NOTE: Kyphosis results.

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19
Q

A complication after fracture is termed as non-union if there is no fracture union in at least how many days/ months/ years?

A

6 months

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20
Q

Wrong position of the two segments

Which complications of fracture is being described?

A. Delayed union
B. Non-union
C. Malunion

A

C. Malunion

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21
Q

Process of bone repair are retarded but still going on, union develops in time

Which complications of fracture is being described?

A. Delayed union
B. Non-union
C. Malunion

A

A. Delayed union

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22
Q

The process of bone repair have ceased with no formation of firm union

Which complications of fracture is being described?

A. Delayed union
B. Non-union
C. Malunion

A

B. Non-union

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23
Q

Determine which fracture is being described.

  1. More common in children 4-10 years old
  2. Volar angulation of distal fragment
  3. Extra-articular distal radius fracture
  4. Fracture of proximal ⅓ ulna with associated radial head dislocation
  5. AKA Goyrand fracture

A. Monteggia fracture
B. Smith fracture

A
  1. A
  2. B
  3. B
  4. A
  5. B
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24
Q

Determine which fracture is being described.

  1. Fracture of the fibula 2-3 inches above distal tip
  2. Due to repetitive impact to the metatarsals with weight bearing exercises
  3. With associated rupture of medial ligament and lateral subluxation of the talus
  4. Fracture of the medial and/or lateral malleoli with associated ligamentous injuries
  5. Uses Danis Weber Classification

A. Pott’s fracture
B. March fracture

A
  1. A
  2. B
  3. A
  4. A
  5. A
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25
Q

TRUE OR FALSE: Simple stress could cause breaking of bone.

A

True

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26
Q

Enumerate the 6 optimal conditions for fracture healing.

A
  1. Minimal necrosis
  2. Anatomic reduction
  3. Immobilization of fracture ends
  4. Presence of physiologic stress
  5. Absence of infection
  6. Adequate vascular supply
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27
Q

This law explains that there is a need of some stress in order for bones to become strong.

A

Wolf’s law

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28
Q

________ is the most important factor for fracture healing

A

Blood supply

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29
Q

Topic: Fracture Healing

Within hours to days, bone blood flow increases, peaks at approximately (1)______, and returns to normal in (2)_______.

A
  1. 2 weeks
  2. 3 to 5 months
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30
Q

______ is needed for clotting and structural and biomechanical support for inflammatory cells

A

Hematoma

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31
Q

What is the approximate time frame for the inflammation stage of fracture healing?

A

0-2 weeks

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32
Q

What is the approximate time frame for the hard callus stage of fracture healing?

A

3-6 weeks

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33
Q

What is the approximate time frame for the remodelling stage of fracture healing?

A

8 weeks to 2 years

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34
Q

What is the approximate time frame for the soft (cartilaginous) callus stage of fracture healing?

A

2-4 weeks

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35
Q

_______ strengthens the bone during remodeling phase of fracture healing

A

Physiologic stress

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36
Q

TRUE OR FALSE: In history taking after fractures, the last meal of the patient must be reported

A

True.

NOTE: since treatment of most fractures require general anesthesia, this is asked to avoid complications of aspiration in surgical procedures.

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37
Q

TRUE OR FALSE: In history taking after fractures, the immunization status of patient is taken into account.

A

True

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38
Q

What are the 3 types of deformity associated with fractures?

A
  1. Shortening
  2. Rotation
  3. Angulation
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39
Q

TRUE OR FALSE: Upon physical examination, marked local tenderness is noted in fx. Crepitus is not seen.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

40
Q

In utilizing the X-ray, the practitioner must include joints (1)______ and (2)______, with at least (3)______ views of the extremity at (4)_____ to one another

A
  1. above
  2. below
  3. 2
  4. 90 degrees
41
Q

This type of imaging is used in complex fractures

A

CT scan

42
Q

This is the classification used for fractures in children.

A

Salter-Harris classification

NOTE: Take note of this classification as it is often asked in the board exams.

43
Q

TRUE OR FALSE: The younger the patient, the greater the remodeling potential

A

True

44
Q

What is the mechanism of injury of Pott’s Fracture?

A

foot was anchored and twisting of the ankle while running or walking

45
Q

How is the X-ray of the ankle taken in Pott’s Fracture?

A

With leg in 15-20 degrees internal rotation

46
Q

What is the mechanism of injury of a Smith’s fracture?

A

fall on a flexed wrist

47
Q

The following is true about March fracture, EXCEPT:

A. Second metatarsal neck is most common location affected
B. Males > Females
C. Osteoblastic activity lags behind osteoclastic activity during initial increases of exercise stress
D. Pain is dull and aching
E. None

A

B. Males > Females

48
Q

TRUE OR FALSE: Osteomyelitis of bone happens in response to infection. Avascular necrosis happens due to a lack of blood supply

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

49
Q

TRUE OR FALSE: Fat embolism syndrome that is most commonly associated with short bone and pelvic fracture. Acute compartment syndrome is common in fractures of the forearm.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

D. Only the 2nd statement is true

50
Q

Malunion happens due to? (1-2)

A
  1. Inadequate reduction
  2. Inadequate length of immobilization
51
Q

Greenstick fracture is an example of a/an?

A

incomplete fracture

52
Q

This occur in normal bone when there is continued overuse.

A

Stress fractures

53
Q

TRUE OR FALSE: The longer bleeding happens, higher rate of necrosis in the area.

A

True

54
Q

This imaging is for identification of ligamentous injuries associated with fractures

A

MRI

55
Q

This kind of management deals with realignment for approximation of normal placement of bone or as near to the anatomic position as possible

A

Fracture reduction

56
Q

__________ is the most common method of restoring the alignment

A

Reduction by manipulation

57
Q

This method of fracture reduction indicated for polytrauma patients and pathologic fractures

A

Open reduction

58
Q

TRUE OR FALSE: Maintenance of reduction until healing is sufficient to prevent displacement. Internal fixations are the most common method of maintaining reduction.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

59
Q

These kinds of external fixators are effective where bones are close to the surface and less effective in bones that lie deep in muscle.

A

Casts

60
Q

This is best used for comminuted, open fractures are associated with soft tissue injury.

A. Pins
B. Skin traction
C. Skeletal traction

A

A. Pins

61
Q

This is applied by means of adhesive or reinforced foam rubber strips and elastic bandaging

A. Pins
B. Skin traction
C. Skeletal traction

A

B. Skin traction

62
Q

This is drilled through the bone, above and below the fracture and connecting metal bars/rods with adjustable clamps on either side of the limbs

A. Pins
B. Skin traction
C. Skeletal traction

A

A. Pins

63
Q

This is can be applied to distal areas where skin traction cannot be applied or difficult to apply

A. Pins
B. Skin traction
C. Skeletal traction

A

C. Skeletal traction

64
Q

This is used in femoral fractures which may require as much as 20-30 lbs of pull for reduction

A. Pins
B. Skin traction
C. Skeletal traction

A

C. Skeletal traction

65
Q

This is requires a wire or pin is drilled through the bone

A. Pins
B. Skin traction
C. Skeletal traction

A

C. Skeletal traction

66
Q

This type of skin traction exerts traction in the long axis of the lower extremity with hip and knee in neutral position

A

Buck’s traction

67
Q

This type of skin traction is for femoral fractures, used for children over 3 years and for adolescents

A

Russel’s traction

68
Q

Skin traction isused for cases not more than _____ lbs of weight as this causes maceration of the skin

A

5-6

69
Q

TRUE OR FALSE: Traction is used for fractures not adequately immobilized by cast. In this technique, muscles act as internal splint to protect the fracture.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

70
Q

This kind of fracture reduction is used when other methods of maintaining reduction are unreliable.

A

Internal fixation

71
Q

What is the disadvantage of the internal fixation method?

A

converts a closed fracture to an open fx, thus more prone to infection

72
Q

Determine which internal fixators are being described.

  1. promotes contact-compression of the fracture ends
  2. fastened to the surface of the bone fragments by at least 2 screws above and below the fracture
  3. enables patient to walk with crutches soon after injury
  4. for oblique fractures especially tibial fractures
  5. used commonly in femoral shaft fractures

A. Transfixation screws
B. Bone plates
C. Intramedullary nails

A
  1. C
  2. B
  3. C
  4. A
  5. C
73
Q

This refers to the constellation of symptoms and physical changes that happens during prolonged immobilization of a fractured extremity

A

“Fracture disease”

74
Q

TRUE OR FALSE: Degree of atrophy and stiffness depends on the length of immobilization. Immobilization is continued long enough for firm healing but discontinued as soon as joint motion can be safely resumed.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

75
Q

Most important factor in restoration of function is ________.

A

active exercise of patient’s muscle

76
Q

The following is true about Pediatric fractures, EXCEPT:

A. High modulus of elasticity
B. Able to spontaneously correct mild to moderate degrees of angulation and overriding
C. Thicker periosteum offers additional support
D. Heal rapidly due to the rich vascular circulation
E. None

A

A. High modulus of elasticity

77
Q

TRUE OR FALSE: In children, ligaments are functionally stronger than bone

A

True

78
Q

A pt’s X-ray reveals of a fracture on the metaphysis and epiphysis.

Based Salter-Harris classification, what type of fracture is this?

A

Type IV

79
Q

A pt’s X-ray reveals of a fracture on the physis area.

Based Salter-Harris classification, what type of fracture is this?

A

Type I

80
Q

A pt’s X-ray reveals of a fracture due to compression forces.

Based Salter-Harris classification, what type of fracture is this?

A

Type V

81
Q

A pt’s X-ray reveals of a fracture in the metaphysis and physis area.

Based Salter-Harris classification, what type of fracture is this?

A

Type II

82
Q

A pt’s X-ray reveals of a fracture on the physis and epiphysis.

Based Salter-Harris classification, what type of fracture is this?

A

Type III

83
Q

This complication is when a fracture fails to consolidate (or form callus) in the time usually required for union to take place

A

Delayed union

84
Q

TRUE OR FALSE: Delayed union happens when the tibia does not become clinically firm in 16 weeks.

A

False

85
Q

TRUE OR FALSE: Delayed union happens when the humerus does not become clinically firm in 10 weeks.

A

True

86
Q

This term refers to fracture ends covered with fibrocartilage, surrounded by pseudocapsule, and contains synovial fluid

A

pseudarthrosis

87
Q

The following are clinical features of non-union, EXCEPT:

A. Pain on weight bearing
B. Swelling after activity
C. Muscle atrophy
D. Motion of fragments elicit pain
E. Bone loss

A

E. Bone loss

88
Q

The following are functions of bone grafts, EXCEPT:

A. To serve as scaffolding to which new bone attaches
B. To provide stability
C. To stimulate osteogenesis
D. To fill a gap or defect
E. None

A

E. None

89
Q

Match the kinds of grafts.

  1. taken from patient
  2. taken from another person
  3. greatest osteogenic potential

A. Autogenous bone graft
B. Iliac cancellous bone graft
C. Homogenous bone graft

A
  1. A
  2. C
  3. B
90
Q

TRUE OR FALSE: When non-union is associated with infection, control of infection must precede treatment of non-union

A

True

91
Q

The following are common sites of non-union, EXCEPT:

A. Scaphoid
B. Talus
C. Femoral shaft
D. Humerus
E. None

A

B. Talus

92
Q

The following are common sites of non-union, EXCEPT:

A. Radius
B. Ulna
C. Femoral Neck
D. Tibia
E. None

A

E. None

93
Q

Match the positions of malunion to its corresponding description.

  1. more problematic in LE than UE
  2. results to LOM in the forearm region
  3. causes changes in the alignment that result in abnormal stresses on the adjacent joints
  4. may results in a varus or valgus deformity
  5. occurs when distal fragment heals in a position of internal or external rotation with respect to the proximal fragment

A. Shortening
B. Angulation
C. Rotational

A
  1. A
  2. C
  3. B
  4. B
  5. C
94
Q

TRUE OR FALSE: In March Fracture, there is more distraction rather than formation

A

True

95
Q

TRUE OR FALSE: In March Fracture, fractures may not be seen until after 2-4 weeks after onset of pain

A

True

(1) MS: Orthopedic and Rheumatic Conditions 🩺 (13 decks)

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