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Flashcards in Fractures Deck (29):
1

When you suspect a fracture how should you manage it?

Abcde
X-ray for at least 2 views
Check neurovascular compromise

2

Four Rs of orthopaedics

Resuscitate
Reduction
Restriction
Rehabilitation

3

What are some of the main problems arising after a fracture?

Shock
Crush syndrome
Resp distress from fat embolus
Tetanus
Compartment syndrome
Sudecks atrophy

4

What's the classification system used for open fractures?

Gustily and Anderson
1 - low engery wound <1cm
2- >1cm with soft tissue damage
3 - High energy wound >1cm with extensive soft tissue damage

5

Open fractures are a medical emergency what is the management?

Immobilise
Tetanus prophylaxis
Iv broad spec Abx
Debridement (avoid internal fixation) and lavage within 6hours

6

What's the blood supply to the femoral head and neck?

Mainly from the circumflex arteries from the deep femoral artery.

Some to the head through the ligamentum teres artery from the obturator artery

7

Major risk of an intracapsular NOF?

Avacular Necrosis of the femoral head

8

NOF intracapsular vs extracapsular treatment

Intracapsular -
Undisplaced and young - internal fixation.
Older - with co-moridities hemiarthroplasty. With no problems do total hip replacement

Extracapsular-
Dynamic hip screw. Or intramedullary device

9

Which metacarpal is involved in a boxers fracture?

5th

10

Who gets buckle fractures?

Children 5-10. See a bulging cortex

11

What is a colles fracture?

Fall on outstretched hand
1) transverse fracture of the radius
2) 1 inch proximal to the radio-carpal joint
3) dorsal displacement and angulation

12

What is a smiths fracture?

Reverse colles. Fall backwards or with flex wrists.
Volar angulation of distal radius fragment

13

What is Bennetts fracture?

Intra-articular fracture of the first carpometacarpal joint
Caused by fist fight.

14

What's a Potts fracture?

Bimalleolar ankle fracture
Forced foot eversion

15

What is seen in a scaphoid fracture?

Fall onto hand. Pain and swelling of the anatomical snuffbox, pain on wrist movement,longitudinal compression of thumb.


Risk - AVN as only small area for blood supply.

16

Most common carpal fracture?

Scaphoid

17

Which system is used for paediatric fractures?

Salter-Harris

18

X-ray in possible ankle fracture is determined by the Ottawa ankle rules. What are they?

Pain in malleolar zone
4 steps unable to sight bear
Bony Tenderness distal tibia

19

Ankle fracture Weber system. What is it?

Type a- below syndesmosis
Type b - at level of tibial Plafond
Type c - above syndesmosis

Maisonneuve fracture disrupts the syndesmosis with widening of the ankle joint. Surgery required.

20

What does the leg look like in a hip fracture?

Short and externally rotated

21

What is seen on electrophysiology for carpal tunnel syndrome?

Prolongation of the action potentials

22

What is the treatment of compartment syndrome ?

Fasciotomies
Iv fluids (to prevent renal failure when there in myoglobinuria post fasciatomy)
Pain control

Do not give anticoagulants

23

How are tibial plateau fractures classified?

Schatzker classification system

24

What is the recommended treatment for a trochanteric fracture?

Sliding hip screw

25

What the the Ottawa ankle rules

Decide whether X-ray is nessary

Pain in malleolar zone
Can't walk 4 steps

26

What are the Ottawa foot rules

Mid foot pain

Bony tenderness at navicular or 5th metatarsal base
Can't walk 4 steps

27

How do you diagnose a stress fracture?

Using US or bone scintography
(X-ray is not reliable)

28

How should pathological fractures be managed?

Surgically if possible eg by internal fixation

29

Possible underlying causes of fractures in young people?

Vit d (would get bone pain and weakness)
Osteoporosis (ovarian failure, heparin, bisphosphonates, steroids)
Medications (topiramate for epilepsy or migraines causes chronic acidosis leading to defective bone mineralisation)