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Musculoskeletal System > Session 10 - Common Fractures > Flashcards

Session 10 - Common Fractures Flashcards

1
Q

What is a pathological fracture?

A

-A fracture which occurs to abnormal bone under physiological load

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2
Q

What are local causes of pathological fractures?

A
  • Infection

- Tumour

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3
Q

Name some systemic causes of pathological fractures?

A
  • Osteomalacia
  • Malabsorption
  • Tumour
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4
Q

What factors influence how bones heal?

A
  • Local factors -> soft tissue injury, type of bone involved, treatment
  • Regional factors -> blood supply, muscle cover
  • Systemic factors -> age, co-morbidity, bone pathology
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5
Q

Which bones have a classical poor blood supply?

A
  • Radial head
  • Scaphoid
  • Talus
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6
Q

What are the approximate of healing times of upper limb and lower limb in children and adults?

A
  • Upper limb -> Child 3 weeks, Adult 6 weeks

- Lower limb -> Child 6 weeks, Adult 6-12 weeks

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7
Q

What is malunion? What are the consequences of malunion?

A
  • When bones don’t heal in the right place
  • Deformity
  • Late arthritis
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8
Q

What are the two types of non-union?

A
  • Hypertrophic

- Atrophic

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9
Q

What are the signs and symptoms of fractures?

A
  • Pain
  • Loss of function
  • Swelling
  • Deformity
  • Crepitus
  • Abnormal movement
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10
Q

What anatomical features of fractures are important when describing the fracture?

A
  • Location
  • Parts
  • Displacement (angle, axial, rotation)
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11
Q

Briefly describe fracture healing by callus

A
  • Haematoma formation
  • Soft callus formation as cartilage is laid down and calcified -> granulation tissue forms
  • Bony callus formation->Soft callus becomes cancellous bone
  • Remodelling
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12
Q

How is healing by callus effected when using screws and plates to treat a fracture?

A

-Callus formation is limited

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13
Q

What is hypertrophic non-union?

A

-Excess callus deposition but the bone does not heal due to large mobility of the bones

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14
Q

When does atophic non-union often occur?

A

-When there is poor blood supply

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15
Q

Name some early local complications which can occur with fractures?

A

-Nerve injury, vascular injury, compartment syndrome, infection, avascular necrosis

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16
Q

Name some early systemic complications of fractures

A
  • Hypovalaemia/shock in open fracture
  • Fat embolism
  • Thrombus formation
  • Acute respiratory distress syndrome
  • Disseminated intravascular coagulation
17
Q

Name some late local fracture complications

A
  • Delayed union (fracture takes longer to heal)
  • Non-union
  • Malunion
  • Myositis ossificans
  • Refracture
18
Q

What is myositis ossificans?

A

-Belleding into muscle causes calcification and muscle resembles bone

19
Q

What is compartment syndrome?

A

-Raised pressure within an enclosed fascial space leading to localised tissue ischaemia

20
Q

What are the classic symptoms of compartment syndrome if caught early?

A
  • Progressive pain which does not match original injury and is not relieved by analgesia
  • Pain on passive strectching
  • Feeling of tightness
21
Q

What is the treatment for compartment syndrome?

A

-Surgical decompression

22
Q

Why is it often too late when neurovascular changes are occurring in compartment syndrome?

A

-Ischaemia has often already ensued and muscle cannot regenerate

23
Q

What are the two types of incomplete childrens fracture?

A
  • Greenstick fracture

- Buckle fracture

24
Q

What type of fractures only occur in children (or young adults)?

A

-Epiphyseal plate fracture

25
Q

How are epiphyseal plate fractures graded?

A
  • Salter and Harris

- Metaphyseal, articular or growthplate

26
Q

What is a stress fracture?

A

-Repetitive, non-violent stresses cause bones to fracture

27
Q

What predisposes to stress fractures?

A
  • Osteoporosis
  • Sports
  • Eating disorders
28
Q

Describe the bone in osteoprososis

A

-Low bone density, enhanced bone fragikity and consequent increased fracture risk

29
Q

How is osteoporosis diagnosed?

A

-DEXA scan

30
Q

How are fractures assessed?

A
  • Airway, breathing, circulation
  • NVT assessment
  • Prioritise soft tissues
  • Splint
  • Look, feel move
  • Assess joint above and below injury
31
Q

Name some non-operative treatments of fractures

A
  • Sling/ collar
  • Crutches
  • Cast
  • Functional brace
  • Traction
32
Q

When would you tell a patient to return when wearing a cast?

A
  • If fingers are pale, blue or swollen
  • Plaster becomes loose or cracked
  • Increasing pain

Musculoskeletal System (34 decks)

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