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30 Cards in this Set

  • Front
  • Back
General Classification of fracture complications
Timing (early, intermediate, late)
Bone vs soft tissue
Local vs systemic
Early complications
Compartment syndrome
Vascular damage
Neurological injury
Malunion
Respiratory distress syndrome
Compartment syndrome: outcomes if untreated
Muscle necrosis
Severe contraction
Compartment syndrome: associations
Fractures
Crush injuries
Tight casts
Reperfusion injury
Compartment Syndrome: Clinical presentation
Symptoms - pain esp. with passive stretch(not present if unconscious)
Signs - High measured pressure, paralysis, parasthesias, pulselessness (late)
Compartment Syndrome: Treatment
Clinical diagnosis
Immediate fasciotomy
Vascular Damage: Associations
Displaced and/or open fractures
Neurologic Injury: common nerves
median, ulnar, radial, sciatic, femoral
Malunion: Causes (2)
Reduction not obtained
Reduction lost (sub-optimal follow-up and/or poor patient follow-up)
Acute Respiratory Distress Sydrome: Associations
Long Bone Fractures (fat embolus, associated cerebral dysfunction)
PE
Post-op pneumonia
Atelectasis
MI leading to CHF
Management of fat embolus ARDS
Early mobilization of fractured limb (preventative)
Respiratory support
Intermediate complications
Delayed union
Nonunion
Stiffness
Infection
Compression neuropathy
Tendon rupture
Reflex sympathetic dystrophy
Delayed union: causes
Poor reduction
Inadequate immobilization
Poor blood supply
Nonunion: Associated fractures
Femoral neck
Scaphoid
Nonunion: Treatment
Bone grafting and internal fixation
Delayed union: treatment
Fixation or revision of fixation
Stiffness: causes
Prolonged immobilization
Inadequate rehabilitation
Stiffness: Treatment
Physiotherapy
Splinting
Surgical release (if adhesions, heterotopic ossification)
Infection: causes
Open fractures
Open reduction
Hematogenous
Infection: Treatment
Drainage
Debridement
Antibiotics
Secondary surgery (if necessary)
Compressive neuropathy: nerves commonly affected
Median
Ulnar
Common peroneal
Compressive neuropathy: Treatment
Surgical release
Tendon rupture: associations
Distal radial fracture
Reflex sympathetic dystrophy: definition
Autonomic dysfunction of limb that is often (but not always) preceded by fracture
May cause permanant stiffness
Late Complications
Avascular necrosis
Post-traumatic degenerative arthritis
Avascular necrosis: associated fractures
femoral neck
Avascular necrosis: treatment
Arthroplasty
Post-traumatic degenerative arthritis: assocations
Intra-articular fractures
Post-traumatic degenerative arthritis: symptoms
Stiffness
Pain
Post-traumatic degenerative arthritis: treatment
Arthrodesis (stiffen joint)
Arthroplasty