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Questions and Answers
What is a characteristic of a complete fracture?
What is a characteristic of a complete fracture?
Which type of fracture is typically seen in children?
Which type of fracture is typically seen in children?
Which type of fracture results from abnormal stress applied to normal bone?
Which type of fracture results from abnormal stress applied to normal bone?
What is the primary goal of local management for fractures?
What is the primary goal of local management for fractures?
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Which fracture type is characterized by the fracture hematoma communicating with outer air?
Which fracture type is characterized by the fracture hematoma communicating with outer air?
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Which method of fracture stabilization involves the use of casts or splints?
Which method of fracture stabilization involves the use of casts or splints?
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When should correction of displacement be performed in the management of fractures?
When should correction of displacement be performed in the management of fractures?
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Which of the following is NOT a pattern of fracture line orientation?
Which of the following is NOT a pattern of fracture line orientation?
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Which condition indicates a failure for fracture fragments to unite and halts the healing process?
Which condition indicates a failure for fracture fragments to unite and halts the healing process?
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What are the general complications that may arise from fractures?
What are the general complications that may arise from fractures?
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Which term describes the process where new bone forms at the fracture site?
Which term describes the process where new bone forms at the fracture site?
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What is a late local complication characterized by the ossification of the subperiosteal hematoma?
What is a late local complication characterized by the ossification of the subperiosteal hematoma?
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Which complication occurs when a fracture heals with angular or rotational deformity that impairs function?
Which complication occurs when a fracture heals with angular or rotational deformity that impairs function?
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Which local complication is associated with injury to surrounding structures, such as nerves or blood vessels?
Which local complication is associated with injury to surrounding structures, such as nerves or blood vessels?
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What condition may result from improper healing of fractures, leading to impaired blood supply and soft tissue interposition?
What condition may result from improper healing of fractures, leading to impaired blood supply and soft tissue interposition?
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What type of preventive care is recommended for open fractures to avoid severe infections?
What type of preventive care is recommended for open fractures to avoid severe infections?
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What is a major advantage of external splinting with Plaster of Paris for fracture stabilization?
What is a major advantage of external splinting with Plaster of Paris for fracture stabilization?
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Which of the following is a disadvantage of using external splinting for fractures?
Which of the following is a disadvantage of using external splinting for fractures?
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What is the main goal in managing an open fracture?
What is the main goal in managing an open fracture?
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Which treatment should NOT be used for an open fracture?
Which treatment should NOT be used for an open fracture?
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Which method of fracture stabilization allows for early mobilization of the patient?
Which method of fracture stabilization allows for early mobilization of the patient?
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What is a potential complication associated with external splinting?
What is a potential complication associated with external splinting?
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During the management of an open fracture, why is the skin not closed immediately?
During the management of an open fracture, why is the skin not closed immediately?
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Which traction method utilizes pins or wires inserted into the bone for stabilization?
Which traction method utilizes pins or wires inserted into the bone for stabilization?
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Study Notes
General Aspects of Fractures and Dislocations
- A fracture is a complete or incomplete break in the continuity of a bone or cartilage, resulting from excessive force.
- A dislocation is a disruption of the normal articulation between two bones, meaning one or more bones are displaced at a joint.
- Subluxation is an abnormal movement of one bone within a joint. It's not a complete dislocation but a partial one.
Fracture Aetiology
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Traumatic (Normal Bone):
- Tubular Bone: Fractures can be direct or indirect.
- Cancellous Bone: Fractures occur through compression and traction.
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Pathological (Abnormal Bone):
- The integrity of the underlying bone is abnormal.
- History often involves minimal trauma.
- Local Causes: Osteomyelitis (OM), tumors, and cysts.
- Generalized Causes: Osteoporosis, among others.
- Stress fracture: Abnormal stress on normal bone.
Fracture Diagnosis
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Clinical Diagnosis:
- A - History: Trauma history.
- B - Symptoms: Pain, loss of function, deformity,
- C - Signs: Swelling, tenderness, abnormal mobility, deformity, loss of function, crepitus (may be present!).
- D - Examination: Neurovascular examination of the affected limb
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Radiological Examination:
- A - The fractured bone.
- B - Joints above and below the fracture.
- C - Images in two planes at right angles to each other.
- D - Special views when necessary.
Fracture Description
- Site: Diaphyseal (shaft), metaphyseal (growth plate region), epiphyseal (end of bone), intra-articular (within a joint).
- Complete: Involves both cortices (outer layers) of the bone.
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Incomplete: Involves only one cortex.
- Greenstick: Incomplete break common in children, along the convex side of the bend.
- Stress Fractures: Common in adults, caused by abnormal stress on normal bone.
- Orientation: Transverse, oblique, spiral, comminuted.
Fracture Displacement
- Distraction: The bone fragments are pulled apart.
- Impaction: The bone fragments are driven into each other.
- Over-riding: The bone fragments are overlapping.
- Rotation: The bone fragments are rotated.
- Translation: The bone fragments are shifted sideways.
- Angulation: The bone fragments are bent.
Fracture Soft Tissue Damage
- Simple (Closed): Skin is intact.
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Compound (Open): Fracture hematoma communicates with the outer air.
- Classification: Types can be further described as compound from within or compound from without.
Fracture Management
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General Management (ABCDEs):
- A - Airway: secure the airway.
- B - Breathing: assess and support breathing.
- C - Circulation: control, assess and maintain circulation.
- D - Disability: monitor neurological status.
- E - Exposure & associated injuries: manage associated injuries.
- F- Other associated injuries, including tetanus, gas gangrene, fat embolism.
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Local Management:
- A- Correction of displacement: aims to correct deformity using closed reduction (manipulation under general anesthesia) or open reduction (surgery) depending on circumstances. Reduction should occur as soon as possible with no rotation or angulation.
- B- Stabilization: Various methods include casting, splinting, traction, and external fixation. Or internal fixation using techniques like plates, screws, nails, wires.
- C -Rehabilitation: begin early after stabilization to regain functional use of the limb.
- Open Fracture Management: Prioritize removing foreign material and managing infection. No internal fixation.
Fracture Complications
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General Complications:
- Shock, fat embolism, prolonged decumbency complications (resp problems, DVT), urinary calculi, bed sores, tetanus, or gas gangrene (open fractures only).
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Early Local Complications:
- Skin injuries, vascular injuries (eg. kink, compression), nerve injuries, tendon or muscle injuries, infection, avascular necrosis, and visceral complications.
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Late Local Complications:
- Malunion, delayed union or non-union of fracture (impaired blood supply, improper positioning, soft tissue interposition, infection), Sudek's atrophy, myositis ossificans, joint stiffness, growth disturbances, osteoporosis.
Fracture Terminology
- Callus: New bone formed at the fracture site.
- Remodeling: Reforming of callus to match the stress lines of the bone.
- Delayed union: Healing takes longer than usual, but ultimately heals.
- Non-union: Fracture fragments fail to unite because healing process stops.
- Mal-union: Fracture heals in an abnormal position, likely causing problems.
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Description
Test your knowledge on fractures with this quiz covering key concepts in fracture management, types, and complications. From complete fractures to abnormal stress fractures, analyze various characteristics and treatment strategies. Perfect for students and professionals in healthcare or orthopedics.
