Fracture Classification and Management
38 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which type of open fracture has a wound less than 1 cm and minimal soft tissue injury?

  • Type 3A Open Fracture
  • Type 1 Open Fracture (correct)
  • Type 3B Open Fracture
  • Type 2 Open Fracture

What is NOT an indication for internal fixation of fractures?

  • Displaced long bone fractures
  • Fractures with vascular injuries
  • Unstable fractures
  • Wounds greater than 10 cm (correct)

What is a characteristic of Type 3C Open Fractures?

  • Moderate soft tissue damage
  • Arterial injury requiring repair (correct)
  • Inadequate soft tissue coverage
  • Wound less than 1 cm

What was a common practice in the management of open fractures in the last century?

<p>Early amputation to prevent death (C)</p> Signup and view all the answers

Which of the following is NOT part of the S.T.A.N.D management strategy for open fractures?

<p>Assess entire patient (B)</p> Signup and view all the answers

Which type of fracture stabilization is suitable for wounds that are clean with available soft tissue coverage?

<p>Internal fixation (D)</p> Signup and view all the answers

What is the complication associated with the immediate time of injury that involves a risk of blood loss?

<p>Haemorrhage (D)</p> Signup and view all the answers

How many liters of fluid does Anglen recommend for type 2 fractures during irrigation?

<p>6 L (B)</p> Signup and view all the answers

What are the primary focuses of physiotherapy in rehabilitation following a fracture?

<p>Muscle re-education and exercise (D)</p> Signup and view all the answers

Which late complication is associated with localized issues following a fracture?

<p>Tissue necrosis (B)</p> Signup and view all the answers

What is the purpose of immobilization in fracture treatment?

<p>To stabilize the fracture and minimize complications (A)</p> Signup and view all the answers

Which type of fracture is likely to require operative treatment?

<p>Displaced fractures requiring realignment (C)</p> Signup and view all the answers

What type of traction is intended for short-term use?

<p>Skin traction (D)</p> Signup and view all the answers

Which of the following is a method of conservative treatment for fractures?

<p>Traction and counter traction (C)</p> Signup and view all the answers

What is the leading cause of death during the first four decades of life?

<p>Trauma (A)</p> Signup and view all the answers

What does the acronym M.I.S.T stand for in the context of pre-hospital information?

<p>Mechanism, Injury, Signs, Treatment (D)</p> Signup and view all the answers

During trauma care, what does the ‘C’ in the ABCDE approach refer to?

<p>Circulation with hemorrhage control (A)</p> Signup and view all the answers

Which group requires different amounts of fluid and sizes of equipment during trauma care?

<p>Pediatric patients (B)</p> Signup and view all the answers

What is the first priority in trauma care?

<p>Saving the patient's life (C)</p> Signup and view all the answers

What is the focus of the secondary survey in trauma management?

<p>A detailed physical exam and obtaining AMPLE history (B)</p> Signup and view all the answers

What does the 'E' in the ABCDE approach signify in trauma assessment?

<p>Environmental control (C)</p> Signup and view all the answers

What is a common risk factor associated with elderly trauma patients?

<p>Diminished physiologic reserve (C)</p> Signup and view all the answers

What does angulation refer to in the context of fractures?

<p>The amount of bend at a fracture (A)</p> Signup and view all the answers

Which of the following is true about displacement due to shortening?

<p>It is described as the amount a fracture collapses in centimeters (C)</p> Signup and view all the answers

What is the definition of a dislocation?

<p>Separation of two bones at a joint (B)</p> Signup and view all the answers

What characterizes a subluxation?

<p>An incomplete or partial dislocation (C)</p> Signup and view all the answers

When naming a dislocation, what should be included if there is a periarticular fracture?

<p>Add 'fracture' to the name (A)</p> Signup and view all the answers

Which joint is NOT commonly associated with dislocation according to the content?

<p>Wrist (D)</p> Signup and view all the answers

What is a common complication associated with a knee dislocation?

<p>Injury to the popliteal artery (D)</p> Signup and view all the answers

What occurs in a sprain?

<p>Stretching or tearing of a ligament (D)</p> Signup and view all the answers

Which term describes a disruption or break in the continuity of the structure of bone?

<p>Fracture (C)</p> Signup and view all the answers

What is a likely outcome of a comminuted fracture?

<p>The bone is broken into several pieces (D)</p> Signup and view all the answers

Which classification system is specifically used for fractures involving the growth plate?

<p>Salter-Harris classification (B)</p> Signup and view all the answers

In the context of fracture management, what does 'translation' refer to?

<p>The sideways motion of the fracture (C)</p> Signup and view all the answers

What aspects should be evaluated when describing a fracture?

<p>Type, location, and whether it is open or closed (A)</p> Signup and view all the answers

Which of the following is a characteristic of an incomplete fracture?

<p>Bone remains partially intact (B)</p> Signup and view all the answers

Which imaging technique is often used for a comprehensive evaluation of fractures?

<p>CT scan vs. MRI (A)</p> Signup and view all the answers

Which term is NOT used to describe a type of fracture?

<p>Tendon rupture (B)</p> Signup and view all the answers

Flashcards

Fracture

A break in the continuity of a bone.

Dislocation

Separation of bones in a joint.

Sprain

A tear in a ligament.

Strain

A tear in a muscle.

Signup and view all the flashcards

Open fracture

A fracture where the bone breaks through the skin.

Signup and view all the flashcards

Closed fracture

A fracture where the bone does not break through the skin.

Signup and view all the flashcards

Radiological evaluation

Using X-rays to diagnose fractures.

Signup and view all the flashcards

Comminuted fracture

A fracture with more than two fragments.

Signup and view all the flashcards

Simple fracture

A fracture in which the bone breaks in a straight line, with no displacement of the bone fragments.

Signup and view all the flashcards

Displacement

Shifting of the broken ends of a bone out of their normal alignment.

Signup and view all the flashcards

Trauma Epidemiology

Leading cause of death in the first 4 decades, with 150,000 annual deaths in the US. Associated with high rates of permanent disability and significant economic costs (over $400 billion annually).

Signup and view all the flashcards

Prehospital Trauma Care

Involves notifying the receiving hospital, identifying the closest appropriate facility, and reporting pertinent information about the patient (injury mechanism, injuries, symptoms, & treatment given).

Signup and view all the flashcards

Inhospital Trauma Care

Preparing for trauma by warming IV solutions & ensuring all necessary ancillary department staff & equipment are readily available, along with protecting hospital personnel.

Signup and view all the flashcards

M.I.S.T.

A method of documenting and communicating pre-hospital trauma information (Mechanism of injury, Injuries sustained, Signs (vital signs), Treatment given).

Signup and view all the flashcards

ATLS Protocol

A systematic approach to trauma care, including preparation, triage, primary and secondary surveys, resuscitation, and definitive care.

Signup and view all the flashcards

Primary Survey

Initial assessment focused on ABCDEs (Airway, Breathing, Circulation, Disability, Exposure). Priorities are airway protection, ventilation, and hemorrhage control.

Signup and view all the flashcards

Secondary Survey

Comprehensive evaluation of the patient, including the AMPLE history (Allergies, Medications, Past medical history, Last meal, Events), head-to-toe physical exam, frequent reassessment, and diagnostic studies.

Signup and view all the flashcards

Trauma Care-Special Groups

Care for pediatric, pregnant women, and elderly patients requires adjustments based on their unique physiological characteristics and potential comorbidities.

Signup and view all the flashcards

Pediatric Trauma

Pediatric patients require similar priorities in trauma care but with differing fluid amounts and equipment sizes.

Signup and view all the flashcards

Pregnant Woman Trauma

Trauma care for pregnant women involves managing the mother and fetus simultaneously, considering the changes in both anatomy and physiology.

Signup and view all the flashcards

Elderly Trauma

Elderly patients often have decreased physiologic reserves and multiple comorbidities, increasing the risk of death.

Signup and view all the flashcards

Fracture Management

Goals of fracture management are patient safety, limb preservation, and restoration of function.

Signup and view all the flashcards

Angulation

The amount of bend in a fractured bone.

Signup and view all the flashcards

Displacement (shortening)

The amount a fractured bone is collapsed, measured in centimeters.

Signup and view all the flashcards

Fracture

A break in a bone.

Signup and view all the flashcards

Dislocation

Separation of bones at a joint, where they no longer are in their normal position.

Signup and view all the flashcards

Subluxation

An incomplete dislocation.

Signup and view all the flashcards

Sprain

An injury that stretches or tears a ligament.

Signup and view all the flashcards

Ligament

Connective tissue joining bones at a joint.

Signup and view all the flashcards

Signs of fracture/dislocation

Symptoms including pain, tenderness, difficulty moving the joint, swelling, bruising, deformity, unnatural movement, numbness, paresthesias and a wound.

Signup and view all the flashcards

Dislocation Nomenclature

Giving specific details to the type of joint dislocation, the distal fragment's position, mentioning periarticular fracture, or an open wound in a dislocation.

Signup and view all the flashcards

Safe Transport for Injuries

Minimizing complications from spinal injuries, limb fractures, and rib fractures by immediately immobilizing all fractures.

Signup and view all the flashcards

Back Slab

A rigid support used for immobilizing spinal or other back injuries.

Signup and view all the flashcards

Neck Collar

A device used to immobilize the neck, often for suspected spinal injuries.

Signup and view all the flashcards

Traction

Application of a pulling force to realign fractured bones.

Signup and view all the flashcards

Collar and Cuff Sling

A supportive device used to immobilize and support a shoulder or arm injury.

Signup and view all the flashcards

Definitive Fracture Treatment

Either conservative methods (closed reduction or operative (ORIF).

Signup and view all the flashcards

Conservative Treatment

Treating fractures non-surgically, often for undisplaced or minimally displaced fractures.

Signup and view all the flashcards

Closed Reduction

Non-surgical realignment of a displaced fracture.

Signup and view all the flashcards

Operative Treatment

Surgical repair method used for a fracture.

Signup and view all the flashcards

ORIF (Open Reduction Internal Fixation)

Surgical procedure to fix a fracture using plates, screws, pins, or wires.

Signup and view all the flashcards

Immobilization Methods

Methods for keeping injured limbs still such as plaster casts, slabs, functional braces or traction.

Signup and view all the flashcards

Duration of Immobilization (Upper Limb)

Immobilization time for upper limb fractures: 6-8 weeks for adults and 3-4 weeks for children.

Signup and view all the flashcards

Duration of Immobilization (Lower Limb)

Immobilization time for lower limb fractures: 10-12 weeks for adults and 6-8 weeks for children.

Signup and view all the flashcards

Conservative treatment criteria

Undisplaced or minimally displaced fractures, fractures that can be immobilized and reduced non-operatively, patients who are not medically fit, for specific fractures like tarsal or metatarsal, metacarpal bones.

Signup and view all the flashcards

Percutaneous pinning

A minimally invasive method of fixing a fracture using a thin metal pin inserted through the skin.

Signup and view all the flashcards

External fixation

A method of stabilizing a fracture using an external frame that holds the broken bone in place until healed.

Signup and view all the flashcards

Indications for internal fixation

Conditions requiring internal fixation of fractures, including displaced fractures, intra-articular fractures, and unstable fractures.

Signup and view all the flashcards

Displaced fractures

Fractures where the bone fragments have moved out of their normal alignment.

Signup and view all the flashcards

Intra-articular fractures

Fractures that involve the joint surface.

Signup and view all the flashcards

Unstable fractures

Fractures that are likely to shift out of position.

Signup and view all the flashcards

Open fracture

A fracture where the skin is broken, exposing the bone.

Signup and view all the flashcards

Gustilo classification

A system for classifying open fractures based on wound size, contamination, and soft tissue damage.

Signup and view all the flashcards

Type 1 Open Fracture

Open fracture with a small wound (<1cm), minimal soft tissue injury, and minimal contamination.

Signup and view all the flashcards

Type 2 Open Fracture

Open fracture with a wound size of 1-10 cm, moderate soft tissue damage, and mild contamination.

Signup and view all the flashcards

Type 3 Open Fracture

Open fracture with significant soft tissue damage, possibly involving an arterial injury, and severity graded 3A, 3B, 3C.

Signup and view all the flashcards

Management of open fracture (ER)

Emergency Room (ER) treatment priorities for open fractures: ABCs, comprehensive assessment, sterile splinting, and tetanus prevention.

Signup and view all the flashcards

Antibiotics for fractures

Medication used to prevent and treat infections related to fractures.

Signup and view all the flashcards

Narcotic pain control

Medication used to manage pain following a fracture.

Signup and view all the flashcards

Debridement & irrigation

Cleaning the wound of a fracture to remove debris and promote healing.

Signup and view all the flashcards

Irrigation amount (type 1)

3 liters of fluid for a type 1 fracture.

Signup and view all the flashcards

Irrigation amount (type 2)

6 liters of fluid for a type 2 fracture.

Signup and view all the flashcards

Irrigation amount (type 3)

9 liters of fluid for a type 3 fracture.

Signup and view all the flashcards

Splint stabilization

A non-surgical method to stabilize a fracture, often used when surgical procedure is unnecessary.

Signup and view all the flashcards

Internal fixation

Surgical method to stabilize a fracture using plates, screws, or other implants.

Signup and view all the flashcards

External fixation

Fracture stabilization with an external frame that holds the bone in place, often used for complex injuries.

Signup and view all the flashcards

Physiotherapy rehabilitation

Rehabilitation that involves muscle re-education, exercises, instructions for mobility, and gait training.

Signup and view all the flashcards

Immediate fracture complications

Complications that occur at the time of injury; e.g., hemorrhage, internal organ damage, skin loss, shock, nerve damage, compartment syndrome.

Signup and view all the flashcards

Late fracture complications (local)

Complications that occur after injury; e.g., tissue necrosis, local wound infection, loss of alignment, joint stiffness.

Signup and view all the flashcards

Late fracture complications (general)

Complications that occur after injury; e.g., deep vein thrombosis, pulmonary embolism, osteoarthritis, delayed, malunion or non-union.

Signup and view all the flashcards

Study Notes

Classification of Fractures and Fracture Management

  • Fractures are breaks in the continuity of bone structure
  • Dislocations are separations of bones in joints
  • Sprains are tears in ligaments
  • Strains are tears in muscles
  • Tendon rupture is a tear in tendons

Objectives

  • Differentiate between fractures, dislocations, and sprains
  • Recognize signs of fractures and dislocations
  • Categorize fracture types
  • Describe fractures according to radiographs
  • Understand the management of fractures, including open fractures

Fracture Description

  • Radiograph description is crucial
  • Fracture type needs identification
  • Fracture location is important
  • Displacement assessment (displaced or not)
  • Additional issues (joint involvement, other fractures, bone lesions), open or closed)

Why Classify Fractures

  • Facilitates communication among surgeons
  • Guides treatment decisions
  • Aids in prognosis assessment

Skeletal Anatomy

  • Includes knowledge of axial and appendicular skeletons
  • Bones, bone structures (epiphysis, metaphysis, diaphysis)

Bone Structures

  • Includes articular cartilage, spongy bone, compact bone, endosteum, periosteum
  • Medullary (marrow) cavity containing yellow marrow (adult) or red marrow (child)

Bone Terms (Ossification)

  • Epiphysis, epiphyseal plate, metaphysis, diaphysis

Radiological Evaluation (X-rays)

  • Two views are essential
  • Two joints should be seen
  • Two views of each side
  • Special views may be needed
  • Comparing CT scans and MRI scans

Types of Fractures (Complete vs Incomplete)

  • Incomplete fractures (common in children): bowing, torus, greenstick
  • Complete fractures: simple, comminuted, butterfly, segmental.

Fracture Lines (Simple Fractures)

  • Transverse, oblique, spiral, longitudinal

Special Fracture Features

  • Impaction, depression, compression

Uncommon Fractures

  • Stress fractures (fatigue fractures)
  • Pathologic fractures (pre-existing abnormality)

Salter-Harris Classifications

  • Used to classify fractures involving the growth plate (physis)

Salter Harris Fracture Classifications - Characteristics

  • Type 1 (S—slipped)
  • Type 2 (A—above physis)
  • Type 3 (L—lower than physis)
  • Type 4 (T—through physis)
  • Type 5 (E—erasure of physis)

Simple Fractures (Alignment and Displacement)

  • Medial, lateral displacement
  • Internal/external rotation
  • Medial/ lateral angulation
  • Overriding (bayonet apposition)
  • Distraction

Comminution

  • Measured by the number of fragments

Displacement- Translation and Angulation

  • Translation is sideways motion.
  • Angulation is bending at the fracture.

Displacement Shortening

  • Amount of fracture collapse, measured in centimeters.
  • Bayonet apposition is a type of shortening.

Signs and Symptoms of Fractures and Dislocations

  • History of injury
  • Pain, tenderness
  • Difficulty moving the joint
  • Swelling, bruising
  • Deformity
  • Unnatural movement
  • Numbness/paresthesia (tingling)
  • Wound
  • Shock

Joint Dislocations

  • Separation of bones at a joint
  • Displaced bones are no longer in normal position
  • Often associated with periarticular fractures

Subluxation

  • Incomplete or partial dislocation

Nomenclature for Dislocations

  • Name the joint
  • Position of distal fragment
  • Include fracture if present
  • State “open” if wound is involved

Examples of Dislocations/Subluxations

  • PIP (proximal interphalangeal) joint subluxation, elbow dislocation
  • Shoulder dislocation, hip dislocation, knee dislocation

Complications of Fractures and Dislocations

  • Immediate (brain, heart, nerve damage, compartment syndrome)
  • Late (tissue necrosis, wound infection, loss of alignment, malunion/non-union, joint stiffness, osteoarthritis, deep vein thrombosis, pulmonary embolism)

Management of Open Fractures in Emergency Room (ER)

  • ABCs (Airway, Breathing, Circulation)
  • Careful physical examination (PE) – neurovascular status
  • Sterile dressings and splinting
  • Tetanus toxoid
  • Antibiotics
  • Pain management
  • Debridement and local irrigation

Types of Fracture Stabilization

  • Splint (good option if operative fixation not needed)
  • Internal fixation (for clean wounds)
  • External fixation (for extensive soft tissue damage or dirty wounds)

Fracture Management Aims

  • Patient safety
  • Limb safety
  • Function restoration

Prehospital Information

  • Mechanism of injury
  • Injury sustained/suspected
  • Signs and symptoms
  • Treatments initiated

Inpatient Management (Treatment and Care)

  • ATLS (Advanced Trauma Life Support) protocols
  • Preparation and triage
  • Resuscitation
  • Primary and secondary surveys
  • Re-evaluation and definitive care
  • Tertiary survey (late complications)

Duration of Immobilization

  • Varies based on age and the affected body limb
  • Upper limb: Child (3–4 weeks), Adult (6–8 weeks)
  • Lower limb: Child (6–8 weeks), Adult (10–12 weeks)

Conservative Treatment of Fractures

  • Employed if fractures are undisplaced or minimally displaced
  • Closed reduction (under GA or local anesthetic)
  • Immobilization by using POP (plaster of Paris) casts, slabs, functional braces, or traction.

Operative Treatment of Fractures

  • ORIF (open reduction internal fixation)
  • Types of surgical fixation like pins, screws, plates, or intramedullary rods

Rehabilitation (After Fracture)

  • Physiotherapy for muscle re-education, exercises, and instructions on limb mobilization and gait training.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Classification and Management of Fractures PDF

Description

This quiz covers essential concepts of fracture classification, management techniques, and distinguishing between fractures, dislocations, and sprains. It also emphasizes the importance of radiograph descriptions and the implications for treatment and prognosis. Test your knowledge on skeletal anatomy and the different types of fractures.

More Like This

Spine Fracture Management (Denis Class 1-4)
11 questions

Spine Fracture Management (Denis Class 1-4)

JubilantUvarovite avatar
JubilantUvarovite
Tooth Fracture Classification Flashcards
8 questions

Tooth Fracture Classification Flashcards

WieldyJadeite4115 avatar
WieldyJadeite4115
Classification of Fractures Flashcards
14 questions

Classification of Fractures Flashcards

PromisingStonehenge avatar
PromisingStonehenge
Fracture Classification Review DPM 2026
314 questions

Fracture Classification Review DPM 2026

BeneficentTrust avatar
BeneficentTrust
Use Quizgecko on...
Browser
Open
Browser
Browser