Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Ortho > chapter 11 - complications of fractures and dislocations > Flashcards

chapter 11 - complications of fractures and dislocations Flashcards

(62 cards)

Start Studying
1
Q

2 examples of early complications

A

arterial injury

neural injury

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

when can arterial injury occur and why

A

early: immediate damage to arteries
late: later after injury due to displacement

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

how to prevent late arterial injury?

A

fracture splintage and reduction if needed

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

what can happen to the artery? 4 things

A

lacerated
avulsed
compressed
contused

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

why is there an absent pulse following arterial injury

A

thrombos formation and occludes blood supply

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

the 6ps of arterial injury to make a diagnosis

A 
pain
pallor
parasthesia
paralysis
pulseless
polar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the management after diagnosis?

A
  1. remove tight dressings and pops
  2. realignment and relocation of dislocation
  3. if no reversal of symptoms after 1+2 –> vascular angiography and surgical repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the magic hours and how many hours post arterial injury?

A

6 hours - beyond which irreversible muscle ischaemia occurs

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

what types of nerve injuries may occur as a complication

A

neurapraxia

neurotemesis

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

causes of nerve complications

A

initial insult

inadequate splinting

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

causes of intermediate injuries

A

fat embolism syndrome
compartment syndrome
DVT
pulmonary embolism

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

define intermediate injury

A

occurs soon after injury but not at the time of injury

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

mehcanism of fat embolism syndrom

A

fat enters blood stream from marrow after a long bone fracture - the fat emboli occludes arteries and capillaries in all organs mechanically and as part of a systemic inflammatory response

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

clinical manifestations of fat embolism syndrome

A

agitation
tachypnoea
hypoxia
later - petechial hmg - ocular and skin

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

how to prevent fat embolism syndrome

A

adequate splinting and fluid resuscitation

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

how to manage fat embolism syndome

A

oxygen and respiratory support

aim: prev further fat immobilisation and manage fracture to prev resp and systemic insult

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

what is compartment syndrome

A

increased pressure in a closed osteofacial compartment may result from incresed contents - oedema, haematoma, fracture or increased extrinsic pressure - tight dressing, pop, tourniquet

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

mech is compartment syndrome

A

when intracompartmental pressure reaches capillary perfusion pressure then contents of compartment is rendered ischaemic
capillary pressure is usually 25mmhg
distal flow is not interrupted until compartment pressure reaches 100mhg

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

clinical features on hx of compartment syndrome

A

pain out of proportion to injury

paraesthesia

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

examination findings of compartment syndrom

A 
woody hard compartment
altered sensation
muscle weakness and later paralysis
pain on passive stretch
distal pulses preserved till late
limb not as cold as an arterial injiry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

treatment of compartmen syndrome

A

immediate removal or splitting of pop
wait 10-15 min
open fasciotomy

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

when is intracompartmental pressure monitoring indicated

A

high risk patients who cannot communicate - intoxicated, infantile, unconscious

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

examination findings in a pt with a dvt

A

low grade pyrexia
swollen limb
pin with muscle stretching

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

how is the diagnosis of dvt made

A

venography
duplex doppler studies
- intramural clot seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how to treat dvt - prophylxis and management
prophylaxis: elevation, dvt stockings, mechanical foot pumps rx: anticoagulate with heparin, warfarin for 3 months
26
PE exam
``` pyrexia pleuritic chest pain tachypnoea hypoxia haemoptysis ```
27
investigations to help aid in diagnosis and investigations to confirm diagnosis
aid: cxr, ecg, blood gas confirm: ventilation perfusion scans, pulmonary angiography
28
treatment of PE
respiratory support oxygen ventilation | thrombosis elimination - heparin/streptokinase/embolectomy
29
late complications
infection disorders of union joint complications
30
how to limit infection
early wash out and debridement
31
examples of infections
gas gangrene necrotising fascitis tetanus
32
organism in gas gangrene
clostridium wlechii - anaerobic
33
diagnosis of gas gangrene
odour and evidence of gas within tissues
34
clinical signs of gas gangrene
brownish discharge
35
rx gas gangrene
prompt surgical debridement/amputation and antibiotics- penicillin hyperbaric oxygen - not always avail
36
necrotising fascitis cause ( NF)
symbiotic infection of any number of aerobic + anaerobic bacteria
37
where are the bacteria causing NF found and what do they do?
closed degloving injuries - area of relative anoxia | organisms result in seperation between the superficial and deep fascia and may cause massive devitalisation of skin
38
management of NF - prevention
early recognition of degloved tissue debridement of dead tissue insertion of drains
39
treatment of NF
fluid and electrolyte resus appropriate antibiotics skin grafting /flaps to defects
40
pathophysiology of tetatnus
clostridium tetani produce exotoxin which binds to anterior horn cells of the spinal cord after which it cannot be neutralised by tetanus immunoglobulins. organism flourishes in devitalised tissue
41
symptoms of tetauns
``` may present after injury has healed tonic clonic contractions risus sardonicus pooling of secretions/cannot swallow spasm of diaphragm and intercostals ```
42
treatment of tetanus
prevention: debridement and delayed wound closure rx: tetanus toxoid tetanus immunoglobulin sedation muscle relaxants incubation and ventilation
43
D/O of union - 3
malunion delayed union non union
44
what is malunion and what is the cause? and complications
shortening, angulation or rotation after a fracture cause: inadquate reduction of fracutre or failure to keep fracture reduced till union complications: cosmetic, refracture, malaligns joints on either side of it
45
what is delayed union dependent on?
delayed union varies and depends on: host, local soft tissue, type of fracture
46
3 conditions which prolong healing and examples
3 conditions - general: malnutrition, diabetes, smoking, peripheral vascular disease local: compound fracture, comminution and gross soft tissue injury iatrogenic: excessive soft tissue striping, inadequate stabilisation or large fracture gap
47
diagnosis of non union
pain at the # site on loading motion at the # site xray showing clear fracture gap
48
causes of non union
identical to malunion
49
two major forms of non union
atrophic: poor callus formation hypertrophic: callus thrown out to try and heal fracture but due to too large a fracture gap or iadequate immobilisation the union fails
50
treatment of non union
eliminate causes for delaye dunion bone grafting creates a scaffold for callus formation and provides osteoblast stimulating proteins sound fracture stabilisation
51
growth disturbance in children - which fractures do no not cause complications and why
salter harris type 1 and 2 - in the zone of hypertrophy
52
which fractures can cause growth disturbance, where do they occur and what is the mechanism? and complications?
1. salter harris 3,4,5,6 2. germinal region of growth plate 3. premature growth arrest 4. entire plate arrests: limb length discrepancy/ if partial arest: angular deformity
53
joint complications
stiffness myositis ossificans avascular necrosis osteoarthritis
54
causes of stifness and how to prevent it
periarticular adhesions | splints for shortest time possible, early physio
55
what is myositis ossificans? the most common areas?
heterotopic calcification within muscles adjacent to injured joint elbow, biceps, brachialis
56
predisposing factors to myositis ossificans
severe head injruies
57
prophylaxis and rx of myositis ossificans
prophylaxis: nsaids, post op single dose radiotherapy rx: surgical excision
58
what is avscular necrosis
ischaemic and death of bone subsequently with bony collapse and degeration of joint
59
areas of avascular necrosis
most common:: hip after dislocation or intracapsular fractures other: scaphoid, lunate, talus
60
how tp prevent avascular necrosis
early reduction and fracture fixation
61
what happens to joints after trauma and the complication of this
cartilage destruction with trauma impossible to see on plain xray - lead to early degenerative OA
62
mechanism of joint injury after trauma and how to prevent it
- malalignment of intra articular and long bone fractures results in abn joint loading - accurate early intraarticualr fracture reduction and stable fixation

Ortho (41 decks)

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