Fractures and soft tissue injuries Flashcards

week 2

1
Q

In reaching a diagnosis of soft tissue injury/fractures, what should you consider?

A
  1. History
  2. Past medical history incl medications
  3. Physical examination
  4. Imaging
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2
Q

What is involved in the management of injuries?

A
  1. Immediate management (resus, prophylactic protection)
  2. MSK history and exam
  3. Diagnostic tests
  4. Definitive management (treatment)
  5. Rehabilitation
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3
Q

Soft tissue injury

A

Acute connective tissue injury. May involve: skin, subcutaneous tissue, muscle, ligament, tendon, nerve, blood vessel, capsule, cartilaginous structures.

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4
Q

What should you look out for when assessing soft tissue injuries in children?

A

Signs of child abuse

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5
Q

Signs of child abuse with soft tissue injuries

A
Bruising in unusual places (e.g. inner thigh, under arms)
Burns
Multiple injury sites
Fractures in children under 1
Atypical fracture patterns given context
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6
Q

Age related changes to the skin and soft tissue can include:

A
Thinning
Loss of strength
Loss of elasticity of skin
Loss of subcutaneous tissue
Blood vessels more fragile
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7
Q

First degree soft tissue injury

A

Minor contusion with bleeding
Minimal pain/brusing
Minimal functional impairment

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8
Q

Second degree soft tissue injury

A

Moderate contusion, some tearing of fibres. Overalls structure in tact.
Bruising, muscle spasms, pain
Joint is stable although painful, some loss of muscle power/range

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9
Q

Third degree soft tissue injury

A

Structural disruption
Severe bruising, muscle spasm and pain
Instability and/or loss of muscle function

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10
Q

Immediate management of soft tissue injuries uses the acronym…

A

PRICE

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11
Q

PRICE =

A
Protection
Rest
Ice
Compression
Elevation
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12
Q

What are the key physical signs of a fracture?

A
Local bone tenderness
Crepitus
Deformity
Swelling
Loss of function
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13
Q

Ways to image fractures and soft tissue injuries

A

X-ray, CT, MRI, ultrasound

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14
Q

What imaging technique is best for soft tissue?

A

MRI

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15
Q

Skin intact, fracture uncontaminated

A

Closed/simple fracture

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16
Q

Colles’ fracture

A

Fracture of radius, posterior displacement

17
Q

Smith fracture

A

Reverse Colles’ fracture, anterior displacement

18
Q

Fracture in which soft tissues are contaminated. Has a risk of infection and nerve damage.

A

Open/compound fracture

19
Q

Fracture in which one does not move and maintains proper alignment.

A

Undisplaced fracture

20
Q

Fracture in which bone snaps in 2 or more parts and moves so that the 2 ends are not aligned straight

A

Displaced fracture

21
Q

Bone breaks diagonally

A

Oblique fracture

22
Q

Bone is broken into more than 2 fragments. Occur after high-impact trauma.

A

Comminuted fracture

23
Q

A type of complete fracture which occurs due to rotational or twisting force.

A

Spiral fracture

24
Q

A fracture occurring in an abnormal bone

A

Pathological fracture

25
Q

Type of fracture that happens in osteoporosis. Bone becomes so osteoporotic it collapses under weight (e.g. spine)

A

Wedge fracture

26
Q

Injury where a tendon or ligament attaches to a bone. Tendon/ligament pulls of a piece of bone.

A

Avulsion fracture

27
Q

Fracture of bone causes by repeated mechanical stress

A

Stress fracture

28
Q

2 ways a stress fracture can occur:

A
  1. Repeated abnormal stresses to a normal bone

2. Normal stresses to an abnormal bone

29
Q

4 main aims of fracture management.

A
  1. Fracture heals in good position
  2. Joints have full range of movement
  3. Limb regains normal strength and functions
  4. Person able to take up role in society asap
30
Q

Open wound management (pretty darn soon):

A

Protection - assess neuromuscular status of limb, temporary dressing, antibiotics, tetanus
Debridement
Stabilisation