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RD1035 > Introduction To Trauma And Fractures > Flashcards

Introduction To Trauma And Fractures Flashcards

1
Q

What is the definition of a fracture?

A
  • A fracture is a break in the continuity of a bone
    It can be caused by:
  • Direct force
  • Indirect force
  • Repetitive strain (stress)
  • Underlying pathology
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2
Q

What is a fatal injury and what are the main causes?

A
  • Trauma remains the leading cause of death in individuals aged 1 to 44 years, with the majority of injuries preventable
  • Road traffic collisions (RTC) are the leading cause of trauma death in all age groups between 1 to 65 years
  • In individuals over 65 years, falls become the leading cause of death
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3
Q

What is a non-fatal injury and the main causes?

A
  • Falls: 0 to 14 years and 25 years and older
  • Unintentionally struck: leading cause of injury 15 to 24 years
  • Motor vehicle collisions (RTC): second leading cause of injury 15 to 24 years
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4
Q

What are the three basic classes of fractures?

A
  • Simple (closed)
  • Compound (open)
  • Pathological
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5
Q

Describe a simple (closed) fracture.

A

Clear deformity of the bone but has not pierced/ penetrated the skin.

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6
Q

Describe a compound (open) fracture and the two types it includes.

A

In-to-out: sharp ends of bone penetrate the skin from beneath

Out-to-in: high energy injury penetrates the skin causing trauma to soft tissues and bone

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7
Q

List the seven types of fractures.

A
  • Transverse
  • Linear
  • Oblique non-displaced
  • Oblique displaced
  • Spiral
  • Greenstick
  • Communited
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8
Q

Describe a comminuted fracture.

A

Bone that is broken in at least two places.

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9
Q

List the three types of complicated fractures.

A
  • Intra-articular = involving the joint surface
    (Within joint)
  • Avulsion = bone fragment is pulled away at a ligamentous/tendinous attachment
    Could be due to hyperflexion
  • Growth plate = involving the physeal growth plate
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10
Q

List the Salter-Harris 1963 Classification system.

A

SALTR

-Slipped - fracture involves physics (growth plate)
-Above
-Lower
-Through
-Rammed

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11
Q

Describe the Salter-Harris type l fracture.

A

Type I fracture is when there is a fracture across the physis with no metaphysial or epiphysial injury.

S - Slipped

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12
Q

Describe the Salter-Harris type ll fracture.

A

Type II fracture is when there is a fracture across the physis which extends into the metaphysis.

A- Above

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13
Q

Describe the Salter-Harris type lll fracture.

A

Type III fracture is when there is a fracture across the physis which extends into the epiphysis.

L- lower

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14
Q

Describe the Salter-Harris type lV fracture.

A

Type IV fracture is when there is a fracture through metaphysis, physis, and epiphysis.

T- Through

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15
Q

Describe the Salter-Harris type V fracture.

A

Type V fracture is when there is a crush injury to the physis.

R- Rammed

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16
Q

List the signs and symptoms of fractures.

A
  • Severe pain/local tenderness
  • Unnatural movement
  • Swelling/bruising
  • Deformity
  • Irregularity
  • Angulation/rotation
  • Limb shortening
  • Depression
  • Crepitus (crunching)
17
Q

What is shock following a trauma?

A
  • Shock is the body’s physical response to trauma and can be life-threatening.
  • Not enough oxygenated blood is circulated, depriving vital organs of oxygen.
  • Be aware of common signs of shock.
18
Q

List the common signs of shock.

A
  • Dizziness
  • Enlarged Pupils
  • Shallow and rapid breathing
  • Blue/grey fingernails/ lips
  • Cold, pale/clammy skin
  • Drowsiness, irritability, anxiety and fainting
  • Faint pulse
  • Excessive sweating
  • Nausea/vomiting
19
Q

List the three types of treatments of fractures.

A

Reduction
- Closed manipulation
- Open reduction
- Mechanical traction

Immobilisation
- Plaster of Paris/Fibre glass
- Splints
- Screws, plates, pins, rods,
wires

Rehabilitation

20
Q

List the four stages of healing of a fracture.

A
  1. Haematoma formation
  2. Fibrocartilaginous tissue formation
  3. Callus formation
  4. Bone remodelling
21
Q

Explain haematoma formation.

A
  • A blood clot (haematoma) is formed between the bone ends around 6-8 hours after injury.
  • Nearby bone cells die because of restricted blood circulation.
  • Swelling and inflammation occurs.
  • Phagocytes and osteoclasts remove dead or damaged tissue around the haematoma.
22
Q

Explain Fibrocartilaginous tissue formation.

A
  • Fibrocartilaginous tissue is formed on the fracture site surfaces and grows together, absorbing the haematoma and forms the first link between the bone fragments.
  • This occurs within 24 hours.
23
Q

Explain the callus formation.

A
  • After 7 days, osteogenic cells develop into osteoblasts to produce spongy bone trabeculae.
  • This joins living and dead fragments of bone.
  • Fibrocartilaginous tissue is converted to spongy bone.
  • Bony callus is formed.
  • Fluffy bone formation normal 7-10 days (areas bright white on X-ray)
24
Q

Explain the process of Bone remodelling.

A
  • Dead portions of the original fragments of broken bone are reabsorbed by the osteoclasts. (Clearing the bone)
  • Spongy bone is replaced (remodelled) by compact bone.
  • The surfaces form a firm bony reunion.
25
Q

What is AABCS?

A

A- Adequacy

A- Alignment

B- Bony margin

C- Check joint space

S- Check for swelling

26
Q

How is AABCS used in trauma radiographs?

A

A- Adequacy - Check the adequacy of the image

A- Alignment - Follow alignment of the bones in a systematic order (e.g. dislocation and subluxation - still some connection but maligned but not dislocated)

B- Bony margin - Follow the cortical margin of each bone, checking for density and trabecular pattern -> No disruption

C- Check joint space - Check that each joint space is uniform in width. (Is it even)

S- Check for swelling - Check for swelling, particularly in the area of interest.

27
Q

How many images are required?

A

When looking for pathology, two (orthogonal, 90o) views are required.

RD1035 (5 decks)

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