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Y2 MSK > Trauma > Flashcards

Trauma Flashcards

1
Q

What is the medical term for a broken bone?

A

Fracture

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2
Q

Give examples of situations that would cause high-energy fractures

A

RTA
Gunshot
Fall from heightbomb blast

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3
Q

What is meant by a pathological fracture?

A

Underlying bone disease/weakness causes the fracture

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4
Q

What is meant by primary/first-intention bone healing?

A

Minimal fracture gap (hairline) is bridged by new bone formation by osteoblasts

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5
Q

What is meant by secondary bone healing?

A

Gap needs to be filled to act as a scaffold for new bone formation

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6
Q

Ourline the fracture process of secondary bone healing

A 
Fracture
Haematoma + inflammation
Macrophages + osteoclasts remove debris
Granulation tissue forms + angiogenesis
Chondroblasts form soft cartilage callus
Osteoblasts lay down type 1 collagen
Calcium mineralisation produces hard callus
Remodelling with organisation
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7
Q

When does soft callus usually form by?

A

2-3weeks

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8
Q

When does hard callus usually form by?

A

6-12weeks

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9
Q

What lifestyle habit may severely impair fracture healing?

A

Smoking

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10
Q

List the 5 basic fracture patterns

A 
Transverse
Oblique
Spiral
Comminuted
Segmental
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11
Q

Describe a transverse fracture

A

Bending force causing horizontal break

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12
Q

Describe an oblique fracture

A

Shearing force causing diagonal break

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13
Q

Describe a spiral fracture

A

Tortional force causing diagonal + circular break

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14
Q

Describe a comminuted fracture

A

Has 3 or more fragments, usually due to high-energy injury

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15
Q

Describe a segmental fracture

A

Bone fractures in two separate places

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16
Q

What is meant by an intraarticular fracture?

A

Fracture at the end of a long bone extending into a joint

17
Q

When describing a fracture, displacement is described by the tranlation of the proximal fragment. True/False?

A

False

Displacement describes direction of translation of the distal fragment

18
Q

How is anterior/posterior and medial/lateral displacement in the forearm/hand described?

A

Volar/dorsal

Ulnar/radial

19
Q

What does angulation of a fracture describe?

A

Which way the distal fragment points

20
Q

List clinical signs of a fracture

A

Localised tenderness
Swelling
Deformity
Crepitus

21
Q

List the factors that should be considered when assessing an injured limb

A

Open/closed
Neurovascular status
Compartment syndrome
Skin/soft tissue status

22
Q

List ways of checking neurovascular status

A 
Capillary refill
Pulses
Temperature
Colour
Sensation
Motor power
23
Q

Which XRAY views are usually used to assess the personality of a fracture?

A

AP

Lateral

24
Q

When is CT useful for assessing fractures?

A

Complex bones (vertebrae, pelvis, feet)

25
Q

Outline initial management of a long bone fracture

A

Clinical assessment
Analgesia (IV morphine)
Splint/immobilise
Imaging

26
Q

Describe a fracture that would be considered “stable” and be treated with a period of splintage + rehab

A

Undisplaced
Minimally displaced
Minimally angulated

27
Q

How can unstable/acceptable fractures be treated?

A

Reduction
Cast application
Surgical stabilisation

28
Q

List materials that can be used in surgical stabilisation/open reduction and internal fixation

A

Plates and screws
Intramedullary nails
Cerclage wires

29
Q

List early local complications of fractures

A

Compartment syndrome
Vascular injury/ischaemia
Nerve damage
Skin necrosis

30
Q

What is compartment syndrome?

A

Increased pressure (inflammatory exudate, bleeding) compresses the venous system, causing congestion within muscle compartments and ischaemia since arterial blood cannot get through

31
Q

List the cardinal clinical signs of compartment syndrome

A

Increased pain on passive stretching of muscle
Severe pain outwith severity of context
Swollen/tender limb

32
Q

What is the urgent surgery for compartment syndrome?

A

Fasciotomy

33
Q

What is the name of the fibrotic contracture that can develop from necrotised muscle in compartment syndrome?

A

Volkmann’s ischaemic contracture

34
Q

What is the mainstay of treatment for most soft tissue trauma?

A 
RICE
Rest
Ice
Compression
Elevation
35
Q

List late local complications of fractures

A 
Stiffness/LOF
PT arthiritis
CRPS
Osteomyelitis
AVN
DVT
36
Q

List early systemic complications of fractures

A 
Hypovolaemia
Fat embolism
ARDS
SIRS
MODS
37
Q

List a late systemic complication of fractures

A

Pulmonary embolism

38
Q

What is an escharotomy?

A

Surgical release of eschar, thick leathery skin which forms after burns, to relieve underlying pressure and allow movement

Y2 MSK (30 decks)

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