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