MSK procedures Flashcards
(46 cards)
The most reliable sign of a fracture is?
PAIN
Also
- Swelling
- Deformity
- Eccymosis
- Loss of function
Comminuted fracture
Fracture that results in 2-3 pieces
Avulsion fracture
A fragment of bone tears away from the main mass of bone as a result of physical trauma.
This can occur at the ligament due to the application forces external to the body (such as a fall or pull) or at the tendon due to a muscular contraction that is stronger than the forces holding the bone together.
Impacted fracture
One whose ends are driven into each other
Torus fracture
Also known as buckle fractures, are incomplete fractures of the shaft of a long bone that is characterized by bulging of the cortex.
They result from trabecular compression from an axial loading force along the long axis of the bone
Most common fracture in children?
Greenstick fracture
Open fracture
A fracture that has communicated with the outside environment
Due to high velocity trauma or missile injury
- Spikes of bone pierce the skin and can go back inside
What must you get for your patient with an open fracture?
A surgical consult
- It has to be cleaned as there is a high risk of osteomyelitis
Salter Harris Classification
I- slipped fracture, transverse fracture through growth plate or physis (6% of fractures)
II- above, fracture through metastasis and into growth plate (70%)
III- lower, fracture through epiphysis and into growth plate (8%)
IV- through metastsis, growth plate, and epiphysis (10%)
V- rammed and ruined, see compression of growth plate (1%)
The higher the salter number?
The poorer the prognosis for recovery
- More serious fracture can look benign
Most common growth plate fracture
Salter Type II
Where is the fracture if there is pain in the snuff box?
Scaffoid
not always apparent when first x-rayed
Colles fracture
Fracture of the distal radius with dorsal displacement, with or without ulnar involvement
(Associated with ulnar styloid process > 60%)
Dinner fork deformity
Most common bone fracture?
Clavicle
How do you get a colles fracture?
Falling on an outstretched hand
When won’t external mobilization work?
When the fracture is so unstable. Have to put nails in it.
Tri-malleolar fracture
- Lateral malleolus
- Medial malleolus
- Posterior tibia
Very unstable fracture
How do you get a tri-malleolar fracture and treatment?
Landing flat on the heal from significant height
Surgery- (ORIF): open reduction internal fixation
Local fracture complications
- Vascular injury causing hemorrhage, internal or external
- Visceral injury causing damage to structures such as the brain, lung, or bladder
- Hemarthrosis- blood in the joint
- Compartmet syndrome (Volkmann’s Ischemia)
- Wound infection- common for open fractures
Early Systemic fracture complications
- Fat embolism- long bone/pelvic fractures from bone marrow
- Shock- extensive bleeding
- Thromboembolism (pulmonary or venous)
- Exacerbation of underlying disease such as diabetes or coronary artery disease
- Pneumonia
Late fracture complications
- Delayed union
- Nonunion
- Malunion
- Joint stiffness
- Contractures
- Myositis ossifcans- calcifications and bony masses can form in muscle
- Avascular necrosis- loss of blood supply (hip)
- Algodystrophy (regional pain syndrome)
- Osteomyelitis
- Growth disturbance or deformity
Late systemic fracture complications
- Gangrene, tetanus, septicemia
- Fear of mobilizing
- Osteoarthritis
Compartment syndrome
MEDICAL EMERGENCY
Pressure inside the fascial compartment exceeds the blood (arterial) pressure
- Causes compromise of the circulation to the soft tissues, ischemia, and necrosis
- Irreversible damage can occur in 8 hours
Conditions associated with compartment syndrome
- Soft tissue injuries
- Soft tissue injury with fracture
- Exercised induced
- Crush injury
- Prolonged tourniquet application
- Electrical injury
- Burns
- Animal bites
