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Flashcards in FRACTURES Deck (61)
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What is the difference between a break and a fracture?

There is no difference

1

What are the different causes of fracture in normal bone?

Direct force
Indirect force (twist of a bone)
Repetitive stress fracture

2

What is a callous?

A mass of new bone at the site of fracture

3

What is the process of bone healing?

Haematoma, cell injury, release of gf and cytokines leading to inflammation
Mesenchymal precursors differentiate to osteoblasts
Osteoblasts then lay down osteoid which is primitive bone tissue (soft callus)
The soft callus then ossifies into hard callus.

4

What are some factors that affect healing of bone?

Energy transfer in injury / soft tissue injury
Infection
Avascularity (hip, scaphoid, talus)
Smoking
NSAIDs
Systemic disease

5

What is a mal-union?

When the bone doesn't heal in the anatomical position.

6

According to Perkin's rule of thumb, how quickly should a child upper limb fracture heal?

3 weeks

7

According to Perkin's rule of thumb, how quickly should a child lower limb fracture heal?

6 weeks

8

According to Perkin's rule of thumb, how quickly should an adult upper limb fracture heal?

6 weeks

9

According to Perkin's rule of thumb, how quickly should a adult lower limb fracture heal?

12 weeks

10

What is a spiral fracture?

A fracture from a twist injury will break in a spiral shape

11

What is an oblique fracture?

A fracture caused by compression leading to a roughly 30 degree break across the bone.

12

What is a comminuted fracture?

When the bone has fractured into several pieces, maybe too many to count.

13

If you see fat coming out of an open fracture wound, where has it Mort likely come from?

The bone marrow

14

What the two surgical emergencies in orthopedics?

Septic arthritis
Compartment syndrome

15

How is compartment syndrome caused?

A fracture may lead to an internal bleed. This leads to increase in pressure in the fascial compartment. This eventually blocks the venous return from the compartment as the veins collapse. This further increases the pressure in the compartment as the arterial supply continues.

16

What are the principles of fracture management?

Reduction
Stabilisation
Rehabilitation

17

What factors promote bone healing?

Good blood supply
Loading and micro motion
Nutritional status, vitamin D
Local growth hormones BMP

18

What are some factors that impair bone healing?

Diabetes
Corticosteroids
NSAIDs
Radiotherapy
Distraction of the fracture
Soft tissue interposition

19

What is a transition fracture?

When the distal part of the bone has moved away from the proximal part so that the two fractured ends no longer communicate.

20

What is an angulation fracture?

When the distal part of the bone has bent in a direction away from the anatomical position. The two ends of the fracture are still communicating sightly.

21

How do you treat an open fracture, before the reduction of the fracture?

Pain killers
Clean wound
Antibiotic prophylaxis
Anti-tetanus injection
Take a photograph (maybe)
Dress wound

22

What is de-gloving?

When the flesh is stripped off the bone. Often happens in a car accident when a tyre goes over the patient.

23

What is the gold standard treatment of open wounds?

Theatre within 6 hours for debridement followed by reduction.

24

What are the complications of intrarticular fractures?

Arthritis

25

Define a fracture.

Soft tissue injury associated with a break in bone.

26

What is the difference between primary and secondary ossification?

Secondary ossification is when callus is put down first. This is what happens naturally. Primary ossification is the direct formation of new bone to fuse the two ends together. This only happens with absolute stability.

27

When can you not use compression to fix a bone?

When the break is not across the shaft, so if the epiphysis is involved.
If the fracture is communited, and the individual pieces are hard to put back together.

28

What are some examples of early complications of a fracture?

Haemorrhage
Nerve damage
Soft tissue damage - tendons, muscles, skin, organs such as lung, liver, urethra and bladder.
Pain
Compartment syndrome

29

What are the six Ps of compartment syndrome?

Parasthesia
Pallor
Paralysis
Poikilothermia
Pulselessness
Pain