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Flashcards in Complications of fractures Deck (24):
1

What are the early local complications of fractures?

Vascular injury and distal necrosis
Skin necrosis
Nerve injury
Compartment syndrome

2

What is a neurapraxia?

Temporary conduction block/demyelination

3

Within how long should neurapraxia resolve?

28 days

4

What is axonotmesis?

Axon dies distally from point of injury/wallerian degeneration

5

Does axonotmesis recover?

Yes, slowly

6

What is neurotmesis?

Complete transection of a nerve

7

How common is neurotmesis with fracture or dislocation?

Rare

8

Does neurotmesis recover?

Not without surgery

9

When should a nerve injury be explored?

Open fracture
Neuralgic pain
Penetrating injury

10

Why is neuralgic pain an indication for surgical exploration of a fracture?

Indicates ongoing compression

11

What can be done if no nerve function returning?

Nerve conduction studies
Grafting
Tendon transfers

12

What are the early systemic complications of a fracture?

Fat embolism
Hypovolaemia
Acute respiratory distress syndrome
Multi-organ dysfunction syndrome
Systemic inflammatory response syndrome

13

What are the late local complications of a fracture?

Loss of function
DVT
Avascular necrosis
Osteomyelitis
Chronic regional pain syndrome
Post-traumatic arthritis
Non-union (atrophic, hypertrophic)
Malunion
Volkmann's ischaemic contracture

14

What are the symptoms of malunion?

Pain
Stiffness
Deformity
Loss of function

15

Which fractures require x-rays to confirm healing?

Diaphyseal fractures of major long bones

16

What are the signs of fracture healing?

Pain improved
No movement at site
No swelling or oedema
No tenderness

17

What causes atrophic non-union?

Poor blood supply to the fracture site
Fracture gap too big
Systemic disease
Smoking
Steroids, NSAIDs, biphosphonates

18

What causes hypertrophic non-union?

Too much movement at the fracture site

19

Does infection cause atrophic or hypertrophic non-union?

Both

20

What causes volkmann's ischaemic contracture?

Obstruction of brachial artery in forearm

21

What is complex regional pain syndrome?

Exaggerated pain response due to injury

22

What are the symptoms of complex regional pain syndrome?

Causalgia
Allodynia
Swelling
Skin changes

23

How is complex regional pain syndrome treated?

Referral to pain specialist

24

What is a late systemic complication of a fracture?

Pulmonary embolus

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