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मंगलवार, 28 दिसंबर 2010

OUTLINE OF FRACTURES

OUTLINE OF FRACTURES
• classification of fractures- caused by sudden injury, fatigue or stress fracture, pathological fractures
• Closed fracture, open fracture with & without wound
• Pattern of fracture- transverse, oblique, spiral, comminuted, impacted, compressed, greenstickoccurs below 10
• Repair phases- stage of hematoma> stage of proliferation> stage of calus> stage of consolidation> stageof remodeling
• Rate of union is high in children & slow as get older
• Sites of stress fracture -metatarsal, tibia & fibula
• Common causes of pathological fracture - cancer, bone cyst, paget’s disease
• Clinical features of fracture- deformity, swelling, visible bruises, local tenderness, impairment of function, abnormal motility.
• Treatment of fracture- reduction, immobilization, rehabilitation
• Reduction- manipulative, mechanical reduction, operative reduction
• Internal fixation- plates & screws, bone graph, compression screw plate, circumferential wires & bands
• Open fracture- contaminated & non contaminated
• Complications of fractures- infection, mom union, mal union, a vascular necrosis, shortening
• Nerve injury- neuropraxia, axonotmesis, neurotmesis
• post traumatic ossification= myositis ossificants
• Post traumatic osteodistrophy = reflux sympathetic dystrophy syndrome
• Growth occurres away from the elbow & towards the knee
• Fracture of capitulum of humerrus may lead to non union even in children
• Avulsion injury does not cause premature union of epiphysis
• Dislocation can’t occur without ligament injury
• Strain - incomplete rapture of ligament
• Sprain- acute ligament injury
• In extension subluxations of spine, anterior longitudinal ligament is ruptured
• Automatic emptying of urinary bladder when full after3 months of cord injury- automatic bladder
• Commonest fracture - collie’s fracture
• In shoulder dislocations- anterior dislocation is common
• Rotator cuff include- supra spinous, infra spinous, sub scapularis
• Immobilization is not needed if fracture of humerous is impacted
• Volkmann’s ischemic contracture occurs if supracondylar fracture block brachial artery
• Montegia fracture- fracture of upper end of ulna with radial head dislocation
• Galeazzy fracture- fracture of radial shaft with inferior radio ulnar dislocation
• Collies fracture- fracture of lower end of radius -fracture occurres 2 cm below the articular surfaces lower end displaced backwards reverse to colli - Smith fracture
• Scaphoid fracture is most complicated fracture in it, proximal part is prone to a vascular necrosis
• Rapture of urethra in hip fracture is on the membranous part
• Pott’s fracture- fracture of bones relates to ankle
• Ankle sprain - injury to medial & lateral ligament of ankle

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