Treatment of Fractures

Question 1

Phase of fracture healing that’s the inflammatory phase, has granulation tissue formation, vessels contract, hematoma forms and fibroblasts take over

Answer 1

reactive phase

Question 2

Phase of fracture healing where cartilage callus forms, there’s lamellar bone deposition, and periosteal cells stimulate chrondroblasts

Answer 2

reparative phase

Question 3

Phase of fracture healing characterized by trabecular bone replacing compact bone

Answer 3

remodeling phase

Question 4

What hormones effect healing rates?

Answer 4

thyroid and growth hormone

Question 5

Which LE fractures can have significant blood loss?

Answer 5

pelvic and femoral

Question 6

Patient begins getting SOB a couple days after treatment of fracture. What is their diagnosis according to Dorr?

Answer 6

fat embolism syndrome

Question 7

What fracture heals without treatment?

Answer 7

ribs

Question 8

What type of fracture requires surgical fixation?

Answer 8

displaced, unstable fracture

Question 9

Treatment of choice for undisplaced, stable, and some reduced fractures

Answer 9

casts

Question 10

What is the difference between plaster and fiberglass casts?

Answer 10

fiberglass is more durable, but plaster is easier to mold

Question 11

For unstable injuries and contaminated fractures

Answer 11

external fixators

Question 12

For long bone Fx’s, options for cross locking screws. Gamma nails for unstable hip fractures

Answer 12

intramedullary devices

Question 13

Describe the Salter Harris classificiation system

Answer 13

1-undisplaced 2-physis + metaphysis 3-physis + epiphysis 4- across the physis IV- crush

Question 14

What do you need to worry about with proximal third clavicular fractures?

Answer 14

internal injuries

Question 15

What is the common cause of adult shoulder fractures?

Answer 15

fall from standing height

Question 16

How do you assess healing of distal forearm fracture?

Answer 16

high five after removal of cast

Question 17

Dorsal displacement/angulation of distal radius due to fall on outstretched hand. Tx ranges from splint to pinning to plating

Answer 17

Colle’s Fracture

Question 18

How do you assess malrotation of metacarpal fractures?

Answer 18

look at alignment of fingernails or have patient make a fist

Question 19

When is surgery indicated for vertebral compression fractures?

Answer 19

neuro compromise or unresponsive pain

Question 20

Patient presents with vague pelvic pain, pain with leg motion, inability to bear weight on the leg

Answer 20

pelvic fracture

Question 21

Treatment of choice for hip fractures

Answer 21

surgery unless severly debilitated

Question 22

Patient presents with shortening and external rotation of the leg, groin pain.

Answer 22

femoral neck fracture

Question 23

Has better outcome for femoral neck fractures than pinning

Answer 23

replacement

Question 24

Treatment of intertrochanteric hip fractures

Answer 24

plate and screws

Question 25

Treatment for unstable subtrochanteric hip fractures

Answer 25

intramedullary device

Question 26

Common cause of mid shaft tibial fracture

Answer 26

MVA

Question 27

What should you be on the alert for with a mid shaft tibial fracture?

Answer 27

compartment syndrome

Question 28

When is surgery mandatory for ankle fractures?

Answer 28

if there's ankle joint diastasis

Question 29

What type of xray do you always need to look at for ankle fractures?

Answer 29

mortice

Question 30

Type of fracture that is particularly suspicious of child abuse

Answer 30

metaphyseal corner fractures