Orthopedic trauma - Cheung Flashcards Preview

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Flashcards in Orthopedic trauma - Cheung Deck (34):
1

for open fractures, name 2 urgent medical managements

tetanus and antibiotics
- surgical debridement

2

what image modality is most sensitive for fractures

MRI

3

what bone graft is osteogenic, osteoinductive, and osteoconductive

autogratfs

4

define fractures

disruptions in continuity of bone

5

define open fracture

broken bone is exposed through skin
emergency

6

high energy fractures are associated with what

extensive soft tissue damage, leading to disruption of healing pathways

7

acute fractures are associated with what

trauma, sometime high energy

8

stress fractures have what history

insidious onset of pain, particularly with weight bearing

9

for a fracture what else must you examine

skin
regional joint stability
nerve and vessels for injury

10

If high energy, one must evaluate other limbs and spine for

occult injury

11

for fractures what is the best test for order

X-rays

12

long does it take stress fractures to show up on X-ray

1-4 weeks

13

how well are CT scans for fractures

difficult for 3-D fractures

14

what are the 4 R's for fracture

recognition
Reduce
Retain
Rehab

15

retain?

keep reduction either with cast or surgery

16

reduce?

set bone straight, either with manipulation or surgery

17

nonunion

bone does not heal
-lack of radiographic evidence of progression of callus formation over a 3-5 month period

18

malunion

bones heals in unacceptable way

19

compartment syndrome

swelling from soft tissue damage compresses nerves and vessels, causing permanent damage
- wear loose clothing

20

Nerve and vessel damage how to treat

Emergency!
repaired or bypassed

21

what is primary fracture healing

rigid fixation from plates
-direct healing with no callous
-intramembranous

22

what is secondary fracture healing

-enchondral
- indirect formation of bone from uncommitted mesenchymal cells
-controlled motion

23

what are the 3 stages of secondary fracture healing

inflammatory for 48 hours
- reparative for 8 weeks
remodeling for 1 year

24

what are some risk factors for nonunion

smoking
malnutrition
poor immunization

25

name 3 types of bone grafts

osteogenic
osteoinductive
osteoconductive

26

osteogenic

bone forming
- only autologous bone graft contains viable osteoblasts

27

osteoinductive

bone stimulation
- encourages differentiation of mesenchymal cells into osteoblasts
BMP-2
BMP-7

28

osteoconductive

bone scaffold
cancellous allograft

29

Allografts

osteoconductive
carry infection

30

demineralized bone matrix

inductive
expensive

31

synthetic substitutes

inductive and conductive
good compressive strength
expensive

32

BMP

inductive
expensive

33

external ultrasound can improve what

healing potential

34

Are IM nails load sharing

no, load bearing