HIGH YIELD I

Question 1

indications for external fixation?

Answer 1

trauma
limb salvage
osteomyelitis
Charcot neuroarthropathy
offloading external cast

Question 2

contraindications of external fixation?

Answer 2

end stage renal disease
uncontrolled diabetes
psychological
morbid obesity

Question 3

what are the advantages of external fixation?

Answer 3

preserve periosteum and blood supply

early ROM/weightbearing

minimal trauma to limb

stability in compromised bone

Question 4

what are the mechanical disadvantages?

Answer 4

distraction of fracture site

weight

pin bone interface failure

expensive

Question 5

biologic disadvantage?

Answer 5

infection
neuromuscular injury
soft tissue contracture
malunion/nonunion

Question 6

what are the general indications for fx management?

Answer 6

unstable fragments
relative soft tissue CI to ORIF
open fracture tx
osteomyelitis
diabetic neuroarthropathy
complex wound mngmt
arthrodesis
arthrodiastasis (osteoarthritis)
distraction osteogenesis (callus distraction)
gradual deformity correction

Question 7

since rings are used in external fixation, what are the general principles?

Answer 7

ring to bone angle should be as close to 90 degrees

ring to skin distance should allow for some swelling to avoid pressure ulcer

more ring levels, more stability of construct

at least 2 points of bicortical bone fixation per ring

Question 8

main problems with general priniciples of external fixation?

Answer 8

difficult to control swelling due to lack of compression

may affect incision healing

smaller incisions are important consideration

elevation

Question 9

what are the rules of 2s in wires vs pins?

Answer 9

2 levels of fixation per segment

2 wires per level

2 wires=1 half pin

Question 10

what are the key segment zones? (3 of them)

Answer 10

segment 1
-knee joint line to the neck of fibula

segment 2
-neck of fibula to distal metaphyseal flare

segment 3
-distal metaphyseal flare to ankle joint line

Question 11

advantages of curved wires?

Answer 11

able to move bone
able to compress
bone will move toward concave side with tensioning

Question 12

considerations in pin care?

Answer 12

avoid infection

pain control is second

skin shear risk factor for irritation

poor eschar management

pin care regimen w/ abx on hand

Question 13

what are the potential complications (post application)?

Answer 13

incision comp
-poor edema control

pin tract infection
-common but rare disastrous

osteomyelitis
-non-compliance

fracture

DVT
-extreme immobilization