W1

Question 1

Fracture definition

Answer 1

A complete or partial break in the continuity of bone

Question 1

Fracture Classification

Answer 1

1. The cause of the fracture
   - traumatic (e.g. MVA)
   -stress
   -pathological (cancer)
2. Closed V open
   open fracture is one in which skin damage allows bacteria to enter the fracture heamatoma. Also called simple (closed) and compound (open)
3. Pattern of fracture
   related to the MOI, and can provide indication of stability:
   -transverse
   -spiral
   -oblique
   -comminated
   -stress
   -compression
   -greenstick

Question 2

Fracture Principles: Reduce

Answer 2

To align fragments into anatomical position (if necessary). Many fractures do not need to be reduced to heal well (e.g. rib #)

Methods:
closed manipulation
Mechanical traction
ORIF etc.

Question 3

Fracture Principles: Hold

Answer 3

To prevent movement (if necessary)

Methods of holding:
-cast (POP)
-slings
-cont. traction

Question 4

Fracture Principles: Move

Answer 4

While immobilised: active movement of all non-splinted joints

After immobilised:

Move: Physio Guidelines

Not United:
-Non WB
-Static, non-splinted joints active
-no passive mobs

united:
-Partial WB
-Free active, light resistance
-light: grade 3,4

Well united:
-Progressing to full WB
-Moderate resistance, WB exercise
-Grades 3/4

Consolidated
-Full WB
-Strong resistance
-Strong grades 3,4

Question 5

RAPT

Answer 5

The risk assessment prediction tool, can indicate pre surgery, the most likely discharge destination after surgery, can allow better preparation etc.

Score out of 12
* <6- extended inpatient rehab
* 6-9 additional intervention to discharge directly home (e.g. rehabilitation in the Home)
* >9- directly home

Question 6

Perkins formula: how long until union?

Answer 6

Perkin’s formula:
A rough guide :
Spiral fracture upper limb 3/52 for union, x2 for consolidation, x2 for lower limb, x2 for transverse fracture

Question 7

Wells Probability Score

Answer 7

DVT Screening
<2 DVT likely
>2 DVT unlikely

Question 8

‘5 P’s

Answer 8

5 P’s for compartment syndrome:
Pain, pallor, paraesthesia, pulselessness, paralysis