Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 2 MSK > Specific fracture management > Flashcards

Specific fracture management Flashcards

1
Q

Function of bones

A

See BRS I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different types of bones?

A 
Flat bones
Long bones
Irregular bones
Short bones
See BRS I
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the three parts of the bone?

A

Epiphysis
Metaphysis
Diaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the role of the periosteum?

A

Provides blood supply and nutrition to the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of bone?

A

Woven

Lamellar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What comprises the extracellular matrix of bone?

A

Collagen (90% Type I) (Type V)

Mineral salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What comprised the cellular components of bone?

A

Osteoblasts
Osteocytes
Osteoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are osteocytes?

A

As osteoid mineralises

Osteoblasts are entombed between lamellae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is special about osteocytes?

A

The are multinucleated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens once bones are formed?

A

Constant state of remodlling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do osteoblasts have receptors for?

A

PTH
Prostaglandins
Vitamin D
Cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a fracture?

A

Discontinuity of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you describe fractures?

A

Orientation
Location
Displacement
Skin penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the AO/OTA classification?

A

Number for a specific bone e.g. humerus 1

Number for location e.g. proximal end 11

Subgroup relating to type of fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the features of primary bone healing?

A

Direct bone healing
Generally intermembraneous healing
Small gap and no movement
Key is that this is a very slow process and that achieving no movement is very difficult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the features of secondary bone healing?

A

Stage III

Neovascularisation

Calcified matrix is deposit as osteoblasts is brought in by the new blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is an expected timeline of healing for a fracture?

A

6 months
6 weeks for callus formation
1 year for full remodelling

Lower limb twice as long as upper limb
Children half as long adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give an example of Wolff’s law

A

If the femur heals bent
Bone will remodel so new cells are formed on the concave side
Reabsorption on the other side
Straightens the bone out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the two categories of fracture healing complications?

A

Non-union

Union

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Malunion?

A

Bone healing occurs outside of the normal parameters of alignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is non-union?

A

Failure of bone healing within an expected time frame

Atrophic- healing completely stopped with no XR changes often physiological

Hypertrophic - too much movement causing too much callus healing. Bone does not unite and form a callus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are examples of hypertrophic non-union?

A

Elephant’s foot

Horse’s foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is pseudoarthritis?

A

fibrous callous formation that forms like a joint

becomes mobile at that site but is not stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the steps of fracture management?

A

Resuscitate

Reduce - bring the bone back together in an acceptable alignment, can allow for pain relief and prevent any further blood loss.

Rest- hold the fracture in a position to prevent distortion or movement

Rehabilitate- get function back and avoid stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What must you think about with regards to a period of immobility?
Functional limitations and support needed wider MDT (catherisation, nutrition etc.) VTE prophylaxis Physio Occupational therapist
26
What is the conservative approach to fracture management?
Try in this order until happy with managment Rest Ice Elevation Plaster/Fibreglass cast or Splint Traction - skin/bone Pulls on the leg until the bone ends are reconstituted - provides almost immediate relief Hummerus - tend to use collar and shaft which utlises gravity
27
Why is a backslap cast used in A&E as opposed to a circumferential cast?
Acute injuries - tendency to swell If a circumferetial cast is used the blood flow will be limited Can create compartment syndrome?
28
What is an example of internal fixation?
K wire - reduces with patient under anaesthetic, useful for children as they have thick periosteum's that prevent the fracture from holding in position
29
What os ORIF?
Open reduction | Internal Fixation
30
What are IM nails?
Intramedullary nails Useful for long bone fractures - insufficient soft tissue coverage for extramedullary methods Can be very dangerous since you can disrupt the physiology of a patient
31
What are examples of external fixators?
Mono/biplanar Sits within one or two planes Goes in from outside the skin - apply rods on the outside and build a construct that allows for stability of the fracture pattern Used often in open fractures where there is poor soft tissue coverage
32
What are examples of external fixators?
Mono/biplanar Sits within one or two planes Goes in from outside the skin - apply rods on the outside and build a construct that allows for stability of the fracture pattern Used often in open fractures where there is poor soft tissue coverage After the soft tissue injury has been dealt with other internal fixation methods can be used Quick an easy
33
When would you used a ring fixator?
When other methods have been used and there is still non-union Patient is non-compliant with intramedullary methods Use computer tomography to say where to place the pins Multiplanar construct thats more stable
34
How do approach orthopaedic X-rays?
``` Projection Patient details Technical adequacy Obvious abnormality Systematic review of X-ray Summarise ```
35
What is projection?
At least two views
36
What is important when checking patient details?
NHS number | 2 people may have the same name
37
How might shoulder dislocation present?
Variable Hx but often direct trauma Pain Restricted movement Loss of normal shoulder contour
38
What must be assessed prior to internvention?
Assess neurovascular status Axillary nerve Sensation of regimental patch
39
What are the types of shoulder dislocation?
Anterior Posterior Inferior
40
What are the features of anterior shoulder dislocation?
Commonest type 90% Bimodal distribution Humeral head not overlying glenoid
41
What are the features of posterior shoulder dislocation?
Rare (around 6%) Associated with seizures/shock Lightbulb sign on Xray
42
What is the safest method of shoulder dislocation management?
Traction-counter traction | Gentle internal rotation
43
What is Hills-Sachs defect?
During injury or reduction Catch humeral head on glenoid or other bony strucure
44
What is a Bankart lesion?
During injury or reduction Lesion to the glenoid
45
What is the consequences of Hills-Sachs or Bankart defects?
Can cause instability or impingement
46
What is a typical presentation of proximal humerus fracture?
Fall onto outstretched hand | Typically in the elderly or those with osteoporosis
47
How can proximal humerus fractures be classified?
Neer classification
48
When would you opt for conservative management for proximal humerus fracture?
Collar and Cuff 2-part fracture, minimally displaced High surgical risk
49
What is a Colles fracture?
Distal radius fracture Dorsal angulation Extra articular
50
What is Smith fracture?
Distal radius fracture Volar angualtion Extra articular
51
What is a Barton fracture?
Distal radius fracture Dorsal angualtion Intra articular
52
What is a Reverse barton fracture?
Distal radius fracture Volar angualtion Intra articular
53
How to scaphoid fractures present typically?
Commonest carpal bone injury, usually in young patients | Typically a fall backwards onto their hand
54
How is a scaphoid fracture examined?
Anyone with FOOSH or with distal radius fracture should have a scaphoid exam Palpation of anatomical snuffbox
55
What is Perilunate instability?
Spectrum of disorders around the lunate
56
What is a perilunate dislocation?
Remainder of your carpal bones do not line up and not articulate with the radius But the lunate does
57
What is lunate dislocation?
All carpal bones BUT Lunate articulate
58
How do pelvic fractures typically present?
Usually as as result of high energy trauma | Patients can become very unstable - lots of visceral organs and vasculature are adherent to the pelvis
59
How to manage pelvic fractures?
ABCDE principles Hypovolaemia is common Pelvic binders are used as a tamponade device but need to placed accurately Ongoing instability should suggest surgical intervention
60
What line indicates disruption to the femoral head?
Shenton's line
61
What are the features of neck of femur fractures?
Makes up 25% of all fractures seen in hospital Pathological fracture, often as a result of osteoporosis and minimal trauma in the elderly
62
What is common signs of neck of femur fracture in the history?
Minor fall May report groin, thigh or buttock pain Want to ask about preceding symptoms
63
What is the clinical examination for neck of femur fracture?
Look Feel Move Thorough secondary survey to look for other injuries
64
What is the protocol for neck of femur fracture management?
Rule out other pathology that could cause fall Involve orthogeriatricians/medical team early Pain relief Catheterise Blood tests ECGs/CXR Pre-op optimisation
65
How do you classify neck of femur fractures?
Intracapsular: Subcapital Transcervical Basicervical Extracapsular: Intertrochanteric Subtrochanteric Reverse Oblique
66
What are the mangement option for intracapsular NOF fractures?
Total hip arthroplasty Hemiarthroplasty Cannulate screws
67
What is the criteria for total hip arthroplasty?
``` Mobile with <1 walking stick outdoors No cognitive impairment Medically suitable for procedure and anaesthetic ```
68
What are the management options for extracapsular NOF fracture?
Dynamic hip screws | Intramedullary nails
69
What is the criteria for hemiarthroplasty?
``` Mobile with >1 walking stick outdoors Reduced AMTS Comorbidities or reduced baseline not benefiting from THR ```
70
What is key in post-op management?
Prevent leading causes of death – hospital acquired infections, DVTs/PEs by early mobilisation

Year 2 MSK (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions