fractures

Question 1

greenstick fracture

Answer 1

doesnt break all the way through

Question 2

salter harris

Answer 2

break across epiphyseal growth plate

Question 3

buckle fracture

Answer 3

One side of a bone bends, raising a little buckle, without breaking the other side of the bone.

Question 4

comminuted

Answer 4

breaks into little pieces

Question 5

monteggia and galezzi

Answer 5

radial or ulnar break and dislocation
MUGR

Question 6

gustilo grading

Answer 6

open fracture grading scale type 1 -typ111C

Question 7

type 1 open fracture

Answer 7

low energy, wound <1cm

Question 8

type 2 open fracture

Answer 8

moderate soft tissue change, wound 1-10cm

Question 9

type 3a open fracture

Answer 9

lots of soft tissue damage, not grossly contaminated

Question 10

type 3b open fracture

Answer 10

periosteal stripping

Question 11

type 3c open fracture

Answer 11

assoc neurovascular complication

Question 12

automatic type 3 open fractures

Answer 12

gun shots, farm accident, wound over 10cm, high energy

Question 13

spiral

Answer 13

due to rotational force

Question 14

oblique

Answer 14

across

Question 15

complete stability fractures

Answer 15

transverse

Question 16

no stability fractures

Answer 16

oblique, spiral, comminuted

Question 17

potential stability fractures

Answer 17

oblique fractures less than 45 degrees

Question 18

compound

Answer 18

hits external soft tissue

Question 19

management of open fractures

Answer 19

tetanus and antibiotic prophylaxis
photograph cover and stabilise
surgical emergency- all within 24 hrs
early and thorough wound excision and toilet
leave skin open
repeat wound review and toilet
stabilise fracture
fasciotomies if risk of compartment syndrome

circulation, neuro and open vs closed check

Question 20

indications for external fixation

Answer 20

fractures with poor soft tissue conditions inc open fractures

where distraction through fixator may help with fragment reduction

emergency pelvic stabilisation for haemorrhage control

limb reconstruction

Question 21

complications of external fixation

Answer 21

neurovascular injury
pin tract infection
loss of fracture alignment
joint contractures- stiffening
tardy union

Question 22

indications of intramedullary nailing

Answer 22

long bone diaphyseal fracture

Question 23

types of plate

Answer 23

compression- squeeze bone together
neutralisation- resist rotating forces
buttress- stops collapse
strut/bridging- more like external nail, no opening fracture

Question 24

hip fractures managment

Answer 24

Intracapsular fractures in a patient who is otherwise fit and well, should be managed with internal fixation with hip screws

displaced fractures can be managed by hemi or full arthroplasty

Question 25

humeral shaft fracture managemnt

Answer 25

Uncomplicated, closed fractures of the humeral shaft often require nothing more than analgesia and conservative management with a basic sling.

Question 26

causes of pathological fracture

Answer 26

Tumours: Primary, Secondary (metastatic, most common) Osteoporosis (most common) Paget's disease Hyperparathyroidism

Question 27

complex fracture features

Answer 27

communited, severely displaced or angulated, intra-articular fracture

Question 28

capsular fractures of femur treatment

Answer 28

Inter and sub-trochanteric are extra-capsular fractures, Open repair with internal fixation and a dynamic hip screw if displaced and old then hemiarthroplasty

Question 29

Mid-shaft fracture of humerus

Answer 29

radial nerve palsy

Question 30

colles fracture

Answer 30

distal radial fracture with dorsal displacement and angulation of the distal fragment.

Question 31

smith fracture

Answer 31

distal radius with volar displacement and angulation of the distal fragment. wrist drop/ unable to extend wrist

Question 32

hip fracture that is extracapsular signs

Answer 32

pain and inability to bear weight, along with a shortened and externally rotated leg bruising around the hip joint more commonly occurs with extracapsular fractures as the bleeding is not contained within the capsule. intertrochanteric fracture is a subtype