Unit 5: Common Fractures

Question 1

What is the periosteum?

Answer 1

The periosteum is the membrane that covers the outside of bones

Question 2

Define a fracture

Answer 2

A fracture is when a bone is broken

Question 3

Give two reasons for taking a history after trauma

Answer 3

History taking after trauma is important for both clinical (diagnosis and management) and medico-legal reasons

Question 4

What five questions should be asked about an accident?

Answer 4

1. What happened?
2. How did it happen?
3. Where and when?
4. What was the injured person’s health like before the incident?
5. What are the social circumstances of the person?

Question 5

List six signs which could indicate the existence of a fractured bone

Answer 5

Pain, deformity, tenderness, swelling, discolouration/bruising and loss of function

Question 6

Name four tissues, other than bone, often involved in injuries to the limbs

Answer 6

Skin, fat, blood vessels and nerves

Question 7

Name three techniques for investigating a fracture

Answer 7

X-ray, computer-aided tomography and radioisotope scanning

Question 8

Define an open fracture

Answer 8

A fracture where the overlying skin is broken

Question 9

Define a closed fracture

Answer 9

A fracture where the overlying skin is intact

Question 10

Define a spiral fracture and describe how it occurs

Answer 10

Spiral fractures occur through twisting which is a common, low energy mode of injury

Question 11

Define an oblique fracture and explain how it occurs

Answer 11

An oblique fracture flows diagonally across the bone. It caused by buckling or direct injury to the bone. This involves a lot of energy, resulting in soft tissue stripping and damage to the blood supply

Question 12

Define a transverse fracture and explain how it occurs

Answer 12

In a transverse fracture the break is in a straight line across the bone. It is caused by buckling or direct injury to the bone. This involves a lot of energy, resulting in soft tissue stripping and damage to the blood supply

Question 13

Define a simple fracture

Answer 13

A simple fracture is one where there is a single clean break and the overlying skin and tissue are not torn

Question 14

Define a butterfly fracture

Answer 14

A comminuted fracture resulting from 2 oblique fractures forming a ‘butterfly fragment’

Question 15

Define a comminuted fracture

Answer 15

A bone injury that results in more than 2 separate bone components is known as a comminuted fracture

Question 16

List eight features necessary to describe a fracture

Answer 16

1. Which bone is broken?
2. Which side?
3. Open or closed?
4. Where on the bone is the fracture?
5. What shape is the fracture?
6. How many fragments?
7. The position of the distal fragment
8. Is it pathological?

Question 17

Which fragment of a fractured bone is assumed to be stationary?

Answer 17

The proximal fragment of a fractured bone is assumed to be stationary

Question 18

In which directions may the distal fragment of a broken bone be displaced?

Answer 18

The distal fragment of a broken bone may be displaced anteriorly, posteriorly, medially or laterally

Question 19

What is a pathological fracture?

Answer 19

A pathological fracture is one in which the fracture seems out of proportion to the violence of the injury. This suggests that the bone is weak as a result of osteoporosis or other diseases such as cancer

Question 20

In which directions may the distal fragments of a broken bone be angulated?

Answer 20

Anterior, posterior, varus or valgus

Question 21

In which directions may the distal fragments of a broken bone be rotated?

Answer 21

Internal or external

Question 22

Describe the initial management and investigation of an injured patient

Question 23

Name two ways in which pain can be relieved following a fracture

Answer 23

Following a fracture pain can be relieved by the use of drugs and splintage

Question 24

Why should special care be taken with open fractures?

Answer 24

Special care should be taken with open fractures as contamination is inevitable and may lead to infection

Question 25

How much blood may be lost from a pelvic fracture?

Answer 25

Six units of blood

Question 26

How much blood may be lost from a femoral fracture?

Answer 26

Two to three units of blood

Question 27

What is a closed reduction?

Answer 27

Closed reduction may be achieved by traction on the distal fragment and then a relocation of that distal part back onto the proximal fragment by manipulation