Orthopedics - Fracture Complications

Front 1

General Classification of fracture complications

Back 1

Timing (early, intermediate, late)
Bone vs soft tissue
Local vs systemic

Front 2

Early complications

Back 2

Compartment syndrome
Vascular damage
Neurological injury
Malunion
Respiratory distress syndrome

Front 3

Compartment syndrome: outcomes if untreated

Back 3

Muscle necrosis
Severe contraction

Front 4

Compartment syndrome: associations

Back 4

Fractures
Crush injuries
Tight casts
Reperfusion injury

Front 5

Compartment Syndrome: Clinical presentation

Back 5

Symptoms - pain esp. with passive stretch(not present if unconscious)
Signs - High measured pressure, paralysis, parasthesias, pulselessness (late)

Front 6

Compartment Syndrome: Treatment

Back 6

Clinical diagnosis
Immediate fasciotomy

Front 7

Vascular Damage: Associations

Back 7

Displaced and/or open fractures

Front 8

Neurologic Injury: common nerves

Back 8

median, ulnar, radial, sciatic, femoral

Front 9

Malunion: Causes (2)

Back 9

Reduction not obtained
Reduction lost (sub-optimal follow-up and/or poor patient follow-up)

Front 10

Acute Respiratory Distress Sydrome: Associations

Back 10

Long Bone Fractures (fat embolus, associated cerebral dysfunction)
PE
Post-op pneumonia
Atelectasis
MI leading to CHF

Front 11

Management of fat embolus ARDS

Back 11

Early mobilization of fractured limb (preventative)
Respiratory support

Front 12

Intermediate complications

Back 12

Delayed union
Nonunion
Stiffness
Infection
Compression neuropathy
Tendon rupture
Reflex sympathetic dystrophy

Front 13

Delayed union: causes

Back 13

Poor reduction
Inadequate immobilization
Poor blood supply

Front 14

Nonunion: Associated fractures

Back 14

Femoral neck
Scaphoid

Front 15

Nonunion: Treatment

Back 15

Bone grafting and internal fixation

Front 16

Delayed union: treatment

Back 16

Fixation or revision of fixation

Front 17

Stiffness: causes

Back 17

Prolonged immobilization
Inadequate rehabilitation

Front 18

Stiffness: Treatment

Back 18

Physiotherapy
Splinting
Surgical release (if adhesions, heterotopic ossification)

Front 19

Infection: causes

Back 19

Open fractures
Open reduction
Hematogenous

Front 20

Infection: Treatment

Back 20

Drainage
Debridement
Antibiotics
Secondary surgery (if necessary)

Front 21

Compressive neuropathy: nerves commonly affected

Back 21

Median
Ulnar
Common peroneal

Front 22

Compressive neuropathy: Treatment

Back 22

Surgical release

Front 23

Tendon rupture: associations

Back 23

Distal radial fracture

Front 24

Reflex sympathetic dystrophy: definition

Back 24

Autonomic dysfunction of limb that is often (but not always) preceded by fracture
May cause permanant stiffness

Front 25

Late Complications

Back 25

Avascular necrosis
Post-traumatic degenerative arthritis

Front 26

Avascular necrosis: associated fractures

Back 26

femoral neck

Front 27

Avascular necrosis: treatment

Back 27

Arthroplasty

Front 28

Post-traumatic degenerative arthritis: assocations

Back 28

Intra-articular fractures

Front 29

Post-traumatic degenerative arthritis: symptoms

Back 29

Stiffness
Pain

Front 30

Post-traumatic degenerative arthritis: treatment

Back 30

Arthrodesis (stiffen joint)
Arthroplasty