Flashcards in Complications of fractures Deck (24):
What are the early local complications of fractures?
Vascular injury and distal necrosis
What is a neurapraxia?
Temporary conduction block/demyelination
Within how long should neurapraxia resolve?
What is axonotmesis?
Axon dies distally from point of injury/wallerian degeneration
Does axonotmesis recover?
What is neurotmesis?
Complete transection of a nerve
How common is neurotmesis with fracture or dislocation?
Does neurotmesis recover?
Not without surgery
When should a nerve injury be explored?
Why is neuralgic pain an indication for surgical exploration of a fracture?
Indicates ongoing compression
What can be done if no nerve function returning?
Nerve conduction studies
What are the early systemic complications of a fracture?
Acute respiratory distress syndrome
Multi-organ dysfunction syndrome
Systemic inflammatory response syndrome
What are the late local complications of a fracture?
Loss of function
Chronic regional pain syndrome
Non-union (atrophic, hypertrophic)
Volkmann's ischaemic contracture
What are the symptoms of malunion?
Loss of function
Which fractures require x-rays to confirm healing?
Diaphyseal fractures of major long bones
What are the signs of fracture healing?
No movement at site
No swelling or oedema
What causes atrophic non-union?
Poor blood supply to the fracture site
Fracture gap too big
Steroids, NSAIDs, biphosphonates
What causes hypertrophic non-union?
Too much movement at the fracture site
Does infection cause atrophic or hypertrophic non-union?
What causes volkmann's ischaemic contracture?
Obstruction of brachial artery in forearm
What is complex regional pain syndrome?
Exaggerated pain response due to injury
What are the symptoms of complex regional pain syndrome?
How is complex regional pain syndrome treated?
Referral to pain specialist