Podcast
Questions and Answers
What is the goal of stabilizing the pelvis with an external fixator in cases of pelvic fractures?
What is the main cause of compartment syndrome?
What is the commonest site of fracture in the elderly with osteoporosis due to minimal trauma?
Which limb is most commonly affected by compartment syndrome?
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What is the 30-day mortality rate for neck of femur fractures?
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What is the usual cause of patella fractures?
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What is the main symptom of compartment syndrome?
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In cases of tibial shaft fractures, what determines the choice between conservative and surgical treatment?
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Which condition may lead to irreversible muscle and neurovascular damage?
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What is the pathophysiology of compartment syndrome?
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What is the most common cause of femur fractures in nonambulatory infants?
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What is the most common cause of death in children due to deliberate actions against them?
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Which fracture pattern is considered a red flag for non-accidental injury?
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What is the most common cause of fractures in children under 1 year of age?
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Which type of fracture is usually treated conservatively, unless there is intra-articular disruption or avascular watershed area involvement?
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What is the definition of a fracture?
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Which type of fracture suggests a twisting mechanism of injury?
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What is the term for a fracture in which there are more than 2 pieces of bone?
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What is the main difference between an open and closed fracture?
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What should be monitored specifically in certain fractures?
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Which type of fracture involves the growth plate in children?
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What is a characteristic difference between paediatric and adult fractures?
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Which type of fracture exhibits plastic deformation in children?
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What is the most common type of fracture in the upper limb trauma of children?
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When does remodelling occur in paediatric fractures after injury?
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What is the reported rate of spontaneous recovery for secondary palsies associated with fracture manipulation?
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What type of fractures present a higher risk of laceration or entrapment of the radial nerve?
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What can help determine the degree of nerve injury and monitor the rate of nerve regeneration?
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What type of fractures are most commonly associated with neuropraxia?
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What is essential for an acceptable result in the nonsurgical treatment of humeral fractures?
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What is indicated for most forearm fractures?
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Which of the following is a common early symptom of necrotising fasciitis?
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What is the most critical symptom of necrotising fasciitis, usually occurring within 4 to 5 days?
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What is the most important factor for survival in necrotising fasciitis?
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What is LRINEC used for in the context of necrotising fasciitis?
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Which of the following is a potential complication of necrotising fasciitis?
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What is a critical symptom of necrotising fasciitis usually within 4 to 5 days?
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What is the recommended management for necrotising fasciitis that progresses rapidly and can result in death?
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Which factor is most important for the survival of a patient with necrotising fasciitis?
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What characteristic fluid is typically observed during surgical debridement of necrotising fasciitis?
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What complication is associated with necrotising fasciitis and may require amputation to save life?
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Study Notes
Pelvic Fractures
- Stabilizing the pelvis with an external fixator aims to reduce the risk of hemorrhage and improve overall stability of the fracture.
Compartment Syndrome
- Main cause is increased pressure within a closed anatomical space, leading to compromised circulation and function of tissues.
- Commonly affects the anterior compartment of the lower limb.
Osteoporosis and Fractures
- The most common site of fracture in the elderly with osteoporosis is the hip, often due to minimal trauma.
- Neck of femur fractures carry a 30-day mortality rate of about 10% to 30%.
Patella and Tibial Shaft Fractures
- Usual cause of patella fractures includes falls onto the knee or direct trauma.
- In cases of tibial shaft fractures, the decision for conservative versus surgical treatment is based on fracture location, stability, and alignment.
Muscle and Nerve Damage
- Compartment syndrome may lead to irreversible muscle and neurovascular damage if not treated promptly.
Childhood Fractures
- The most common cause of femur fractures in nonambulatory infants is non-accidental injury.
- Fracture patterns, such as spiral fractures, are red flags for potential non-accidental trauma.
- Fractures in children under 1 year are typically caused by falls or abuse.
Fracture Types and Mechanisms
- Fractures involving the growth plate in children are classified as Salter-Harris fractures.
- A definition of a fracture is a break in the continuity of bone.
- Spiral fractures suggest a twisting mechanism of injury, while comminuted fractures involve more than two pieces of bone.
Differences in Fracture Types
- Open fractures involve a break in the skin, while closed fractures do not.
- Pediatric fractures tend to heal faster than adult fractures and often exhibit plastic deformation before fracture.
Upper Limb Fractures in Children
- The most common type of fracture in upper limb trauma among children is a distal radius fracture.
- Remodelling in pediatric fractures occurs over months post-injury, taking advantage of the growth potential in children.
Nerve Injuries
- Secondary palsies associated with fracture manipulation have a spontaneous recovery rate of around 60%.
- Humeral shaft fractures present a higher risk of radial nerve injury which can cause neuropraxia.
Humeral Fractures and Management
- Essential for successful nonsurgical treatment of humeral fractures is proper alignment and stabilization.
- Common management for forearm fractures includes casting or bracing, with surgical intervention reserved for unstable cases.
Necrotising Fasciitis
- Early symptoms include pain out of proportion to physical examination findings, with critical symptoms developing within 4 to 5 days.
- The most critical factor for survival in necrotising fasciitis is prompt surgical intervention.
- LRINEC score is used to assess the severity of necrotising fasciitis.
Complications and Treatment
- Complications from necrotising fasciitis can include systemic infections and may necessitate amputation to prevent death.
- Characteristic fluid observed during surgical debridement is often necrotic tissue and malignantly appearing fluid.
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Description
This quiz provides an overview of orthopaedic trauma, covering topics such as fracture description, types of fractures, avulsion injuries, and sites of bone injury. The quiz is prepared by Mr Georgios Arealis, MD, PhD, FRCS.
