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Musculoskeletal System > Week 10 - Fractures And Anterior/medial Leg > Flashcards

Week 10 - Fractures And Anterior/medial Leg Flashcards

1
Q

What are types of fractures can children have?

A
  • Incomplete fracture
  • – Buckle fractures = compression
  • – Greenstick fractures = tension
  • Rapid healing
  • Growth plate (epiphyseal) fractures
  • – These can stunt growth
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2
Q

What are stress fractures?

A

Fractures caused by repetitive, non-violent stresses

  • More common in females than males
  • Predispositions = osteoporosis, sports, eating disorders
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3
Q

What are some early fracture complications?

A 
Local:
- Nerve injury
- Vascular injury
- Compartment syndrome
- Avascular necrosis
- Infection
- Surgical
Systemic:
- Hypervolaemia/shock
- Fat embolism
- Thromboembolism
- Acute respiratory distress syndrome
- Disseminated intravascular coagulation
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4
Q

What are some late fracture complications?

A 
Local:
- Delayed union
- Non union
- Malunion
- Myositis ossificans
- Re-fracture
Regional:
- Osteoporosis
- Joint stiffness
- Chronic regional pain syndrome
- Abnormal biomechanics
- Osteoarthritis
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5
Q

What are the signs and symptoms of fracture?

A
  • Pain
  • Loss of function
  • Swelling
  • Deformity
  • Bony tenderness
  • Crepitus
  • Abnormal movement
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6
Q

What are the factors that influence bone healing?

A 
Local:
- Injury (configuration/soft tissue injury)
- Bone (cancellous/cortical)
- Treatment (reduction/stability/infection)
Regional:
- Blood supply
- Muscle cover
Systemic:
- Age
- Co-morbidity
- Bone pathology
- Head injury
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7
Q

How can bone healing go wrong?

A
  • Malunion (when the bones don’t heal in the right place)
  • Non-union (hypertrophic, atrophic)
  • Infection
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8
Q

Which muscles are fiund in the anterior compartment of the leg?

A
  • Tibialis anterior
  • Extensor hallucis longus
  • Extensor digitorum longus
  • Fibularis tertius
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9
Q

What are the actions of the tibialis anterior?

A
  • Dorsiflexion (main dorsiflexor of the foot)

- Inversion of the foot

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10
Q

What innervates the tibialis anterior?

A

Deep fibular nerve

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11
Q

What are the actions of the extensor digitorum longus?

A
  • Extension of the 4 lateral toes

- Dorsiflexion of the foot

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12
Q

What innervated the extensor digitorum longus?

A

Deep fibular nerve

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13
Q

What are the actions of extensor hallucis longus?

A
  • Extension of the great toe

- Dorsiflexion of the foot

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14
Q

What innervates the extensor hallucis longus?

A

Deep fibular nerve

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15
Q

What are the actions of the fibularis tertius?

A
  • Eversion of the foot

- Dorsiflexion of the foot

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16
Q

What innervates the fibularis tertius?

A

Deep fibular nerve

17
Q

Which muscles are found in the lateral compartment of the leg?

A
  • Fibularis longus

- Fibularis brevis

18
Q

What are the actions of the fibularis longus?

A
  • Eversion of the foot
  • Plantarflexion
  • Supports the lateral and transverse arches of the foot
19
Q

What innervates the fibularis longus?

A

Superficial fibular nerve

20
Q

What are the actions of the fibularis brevis?

A

Eversion of the foot

21
Q

What innervates the fibularis brevis?

A

Superficial fibular nerve

22
Q

What are the motor functions of the common fibular nerve?

A
  • Innervates the short head of the biceps femoris directly
  • Also supplies the muscles in the lateral (via superficial fibular nerve) and anterior compartments (via deep fibular nerve) of the leg
23
Q

What are the sensory functions of the common fibular nerve?

A
  • Innervates the skin over the upper lateral (via lateral sural cutaneous nerve) and lower posterolateral leg (via sural communicating nerve)
  • Supplies cutaneous innervation to the skin of the anterolateral leg (via superficial fibular nerve) and the dorsum of the foot (deep fibular nerve)
24
Q

How can the common fibular nerve be damaged?

A
  • Most commonly, by a fracture of the fibula
  • – It wraps around the fibular neck, so a fracture of the fibular neck can cause nerve palsy
  • Use of a tight plaster cast
25
Q

What is the effect of damage to the common fibular nerve?

A

Lose the ability to dorsiflex the foot at the ankle joint
- Foot appears permanently plantarflexed (known as foot drop)
- Present with a characteristic gait
Loss of sensation over the dorsum of the foot and lateral side of the leg

26
Q

What is the effect of superficial fibular nerve entrapment?

A

Can cause pain and paraesthesia over the lower leg and dorsum of the foot

27
Q

How can superficial nerve entrapment occur?

A
  • Usually results from ankle sprains or twisting of the ankle
  • – This causes the nerve to stretch in the lower leg
  • Can also be compressed by the deep fascia of the leg
28
Q

How can the superficial fibular nerve be directly damaged?

A
  • Fracture of the fibula

- Perforating wound to the lateral side of the leg

29
Q

What is the effect of direct damage to the superficial fibular nerve?

A
  • May result in loss of eversion

- Loss of sensation over the majority of the dorsum of the foot and the anterolateral aspect of the leg

30
Q

How can the deep fibular nerve be compressed?

A
  • Excessive use of anterior leg muscles

- Tight-fitting shoes (compresses the nerve beneath the extensor retinaculum)

31
Q

What is the effect of compression of the deep fibular nerve?

A

Foot drop

32
Q

What is the arterial supply to the leg?

A
  • At the lower border of the popliteus, the popliteal artery terminates by dividing into anterior and posterior tibial arteries
  • Posterior tibial artery continues inferiorly
  • – The fibular artery branches off from it
  • The anterior tibial artery passes anteriorly between the tibia and fibula
  • – It then moves inferiorly down the leg
  • – It runs down into the foot, where it becomes the dorsalis pedis artery
  • – It moves down the leg close to the deep fibular nerve
33
Q

What are open fractures?

A
  • Fractures that have an open wound
  • They are more likely to become infected
  • Used to be called compound fractures

Musculoskeletal System (12 decks)

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