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Flashcards in Common fractures Deck (15):
1

Colles vs Smiths fracture

Both distal radial fractures caused by FOOSH
Colles - distal fragment dorsal angulation resulting in dinner fork deformity
Smiths - distal fragment volar angulation

2

Management of Colles fracture

If good alignment, backslab for 1 week and then full cast for ~5 further weeks
If poor alignment, closed reduction (under anaesthetic) and K wires followed by cast
Plate and screws alternative to K wires

3

Management of proximal humerus fractures

Collar and cuff sling so gravity pulls distal fragment down
Mobilise shoulder at 2 weeks to prevent frozen shoulder
Check rotator cuff tears in elderly, can have shoulder replacement if deltoid intact and poor function following conservative management

4

What is frozen shoulder

Adhesive capsulitis (scarring in capsule)
Shoulder painful and stiff
Reduced ROM (can be reduced to no movement)

5

Mechanism of olecranon fracture

Avulsion fracture of olecranon due to rapid elbow extension
Direct blow to elbow

6

Management of olecranon fracture

Elbow cast for no longer than 3 weeks as elbow will become very stiff

7

Surgical management for intraarticular fractures

Tension band wiring
A tension band (plate or wire loops) placed across convex side of fracture and converts tension to compression so brings articular surfaces together

8

Interpreting pelvic X-rays

Sacroiliac widening - lateral compression
Pubic symphysis widening - AP compression

Look at whole ring, never breaks in 1 place

9

Management of pubic rami fractures

Medical management
Analgesia
Initial bed rest then mobilisation with walking aids (not fully weight bearing for several months)

10

What fractures risk damage to sciatic nerve

Hip
Pelvic

11

Test for sciatic nerve damage

Positive sciatic nerve damage if unable to dorsiflex foot

12

Fracture complications

Neurovascular damage
Fat embolism
Infection
Malunion, nonunion
Avascular necrosis
Contracture
DVT, PE
Compartment syndrome
Complex regional pain syndrome

13

Describe complex regional pain syndrome

type 1 - nerve damage
type 2 - no nerve damage

Imbalance between sympathetic and parasympathetic NS

14

Describe compartment syndrome

Pain out of proportion on passive movement
Analgesia makes no difference
Pain has crescendo pattern

15

Management of compartment syndrome

Emergency fasciotomy with large excision
Excise necrotic muscle
Slowly close wound over weeks
Keep in broad arm sling with wet bandages