Fractures

Question 1

is primary or secondary bone healing more common?

Answer 1

secondary

Question 2

what fills in the fracture gap in primary bone healing?

Answer 2

bone

Question 3

what fills in the fracture gap in secondary bone healing?

Answer 3

granulation tissue THEN cartilage THEN bone

Question 4

what comprises a “soft callus”?

Answer 4

cartilage

Question 5

typical path of fracture healing?

Answer 5

haematoma -> soft callus -> hard callus -> remodelling

Question 6

what fracture complications should you look out for when examining a fracture?

Answer 6

neurovascular problems
soft tissue injury
compartment syndrome

Question 7

cause of a comminution fracture?

Answer 7

high energy

poor quality bone

Question 8

treatment for a fit patient with an unstable fracture?

Answer 8

operative stabilisation

Question 9

treatment for a s imple, minimally displaced fracture that is stable?

Answer 9

conservative management

splint

Question 10

when should you not do open reduction internal fixation surgery?

Answer 10

high energy fracture,

soft tissue swelling

Question 11

treatment for a displaced intraarticular fracture?

Answer 11

anatomic reduction and rigid internal fixation to prevent post traumatic OA

Question 12

when should you consider joint replacement in a peri articular fracture?

Answer 12

risk of non-union,

AVN

Question 13

treatment for open fractures?

Answer 13

antibiotics
early debridement
operative stabilisation

Question 14

treatment for compartment syndrome

Answer 14

fasciotomy

operative stabilisation

Question 15

treatment for vascular injury with fracture?

Answer 15

reduction
stabilisation
reassess circulation
revascularisation

Question 16

most common cause of a femoral shaft fracture

Answer 16

high energy

pathological

Question 17

risks for a femoral shaft fracture?

Answer 17

fat embolism

ARDS

Question 18

treatment for femoral shaft fracture?

Answer 18

resus
analgesia
splintage

if unstable, IM nailing

Question 19

treatment for an extra articular distal femur fracture?

Answer 19

thomas splint
nail if not too distal,
plating

Question 20

treatment for an intra articular distal femur fracture?

Answer 20

anatomical reduction
rigid fixation
plate and screws

Question 21

common cause of proximal tibial fractures?

Answer 21

valgus stress

high energy if young, low energy if old

Question 22

investigations for proximal tibial fracture?

Answer 22

CT

Question 23

treatment for proximal tibial fracture?

Answer 23

anatomical reduction

rigid fixation

Question 24

can you get open fractures with a tibial shaft fracture?

Answer 24

yes, not uncommon

Question 25

conservative treatment for a tibial shaft fracture?

Answer 25

plaster

Question 26

operative treatment for a tibial shaft fracture?

Answer 26

IM nailing | plating

Question 27

what kind of fracture typically is a distal tibial fracture

Answer 27

pilon

Question 28

what other bone injuries are associated with a distal tibial fracture

Answer 28

spine pelvis calcaneus

Question 29

which fractures are considered to be surgical emergencies?

Answer 29

distal tibial

Question 30

treatment for distal tibial fracture?

Answer 30

bridging ex fix to allow soft tissues to settle | internal fixation once they have

Question 31

which ankle fractures are considered stable fractures

Answer 31

isolated distal fibular fracture, | minimally displaced medial malleolus fracture

Question 32

what ankle fractures are deemed to be unstable?

Answer 32

bimalleolar

Question 33

who gets proximal humeral fractures?

Answer 33

elderly osteoporotic patients

Question 34

complications of a proximal humeral fracture?

Answer 34

brachial plexus/ axillary artery injury | AVN

Question 35

treatment for proximal humeral fracture?

Answer 35

old- conservative | young- internal fixation

Question 36

usual treatment for an intra articular fracture?

Answer 36

open reduction internal fixation

Question 37

what kind of fracture is an olecranon fracture usually?

Answer 37

avulsion

Question 38

how should you treat a comminuted fracture of the radial head?

Answer 38

excise +/- replacement

Question 39

what injury in what other structure can be suspected if the radius is fractured?

Answer 39

dislocated distal radioulnar joint

Question 40

what injury in what other structure can be suspected if the ulna is fractured?

Answer 40

dislocation of radial head

Question 41

treatment if both forearm bones fractured?

Answer 41

ORIF

Question 42

what is a colles fracture?

Answer 42

extra articular fracture, dorsal angulation, dorsal displacement

Question 43

what action causes a smiths fracture?

Answer 43

falling onto back of hand

Question 44

where does a smiths fracture happen?

Answer 44

distal radius

Question 45

treatment for a smiths fracture?

Answer 45

ORIF

Question 46

what injuries would come under a polytrauma

Answer 46

long bones +/- pelvis

Question 47

what fractures tend to cause the most bleeding?

Answer 47

pelvic | femoral shaft

Question 48

treatment for polytrauma?

Answer 48

skeletal stabilisation | reduced bleeding and fat embolism

Question 49

what is 1st degree nerve injury called?

Answer 49

neurapraxia

Question 50

what happens in neurapraxia?

Answer 50

temporary conduction block

Question 51

what is 2nd degree nerve block called?

Answer 51

axonotmesis

Question 52

what happens in axonotmesis

Answer 52

nerve cell axon dies distally from point of injury

Question 53

can 1st or 2nd degree nerve injury repair itself?

Answer 53

both can

Question 54

treatment for nerve injury that isnt repairing itself?

Answer 54

nerve conduction study then nerve gafting tendon transfer