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Flashcards in Fractures Deck (246)
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1

What are the features of a fracture?

pain
loss of function
tenderness
deformity
swelling
crepitus
abnormal movement or positioning
soft tissue

2

What is the metaphysis?

the ossified portion of bone in a transitional one between the epiphysis and the diaphysis- should always have a smoothly curved cortex

3

What is an apophysis?

bony outgrowth independent of a centre of ossification

4

What is fracture disease?

muscle atrophy; stiff joints and osteoporosis

5

What are the indications for ORIF?

failed conservative Rx; 2 #s in 1 limb; bilateral indentical #s; intra-articular #s; open #s

6

When might external fixation be used?

burns; loss of skin and bone or open #

7

What are the 7 A's of open #s?

ATLS
assessment- neurovascular and soft tissues
antisepsis- swab wound and irrigate
alignment
anti-tetanus
antibiotics- ceftriaxone +/- metronidazole
analgesia

8

What is the mnemonic for Salter-Harris #s?

SALTR-
S- slipped
A-above
L-lower
T-through
R-rammed

9

What are the immediate complications of fractures?

internal bleeding
external bleeding
organ injury
nerve/skin injury
vessel injury (limb ischaemia)

10

What ar teh later local complications of fractures?

skin necrosis/gangrene
pressure sore
infection
non or delayed union

11

What are the lateral geeneral complications of #s?

venous or fat embolism; PE; pneumonia; renal stones

12

What are the signs of a fat embolism?

confusion; dyspneoa; increased pulse' decrased PaO2; fits; coma; increased Temp; petechial rash

13

What prevents fat embolism?

early fixation of #s

14

What is the viscious cycle of compartment syndrome?

pressure--vascular occlusion-- hypoxia-- necrosis-- increased pressure

15

What are the signs of compartment syndrome?

erythema; mottling; blisters; swelling; pain on passive stretching

16

What are hte late complications of #s?

wound sepsis
failure of fixation
joint stiffness, contracture or malalignment
CRPS
non-union
delayed union

17

What is non-union defined as?

no evidence of progression towards healing

18

What causes non-unions?

abnormal biology eg infection; blood supply or mechanics

19

What is delayed union?

when a # has not healed within the time expected for THAT #

20

What are hte causes of delayed union?

# in a bone that has finished growing
poor blood supply or avascular fragment
comminuted/ infected #s
generalised sieases eg malignancy or infection
distraction of bone ends by muscel- ORIF prevents

21

What are the two types of CRPS?

type 1- no nerve injury
type 2- if nerve lesions are present

22

What are the signs of CRPS?

only local sign (no systenic)- pain (burning); allodynia; vasomotor instability; abnormal sweating
patchy oseopenia

23

Where a # clavicle most common?

middle third

24

What is the management of a fractured clavicle?

broad arm sling with x-rays at 6 weeks

25

What are the potential neurovascular injuries with a clavicle# ?

brachial plexus; sublcavlisn vessels

26

What other complication can you get with clavicle #?

pnuemothorax

27

How do AC dislocations commonly happen?

fall onto the point of hte hsoulder

28

What are the signs of AC dislocation?

tender prominence over ACJ; adduction of arm across body is very painful

29

What is the mx of AC dislocation?

sling support and early mobilisation

30

Who tends to get #s of proximal humerus?

osteoporotic #s in the elderly after FOOSH