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TRANSCRIPT
FRACTURES
Dr Deepaka Weerasekera
Fracture
A complete or incomplete break in the
continuity of bone
Results in shortening, angulation and/or
rotation of bone
Aetiology
Trauma
Stress/Fatigue
Pathological – e.g Bone tumours
Patterns of Fracture
Stages of fracture healing
1. Haematoma
2. Sub-periosteal & endosteal cellular
proliferation
3. Callus formation
4. Consolidation
5. Remodeling
Clinical features Pain
Visible or palpable deformity
Local swelling
Visible bruising (ecchymosis)
Marked local tenderness
Marked impairment of function
Investigations
X-rays
Isotope Scans
CT Scans
Principles of fracture management
Immediate Management
– Initial Resuscitation –ABC
– Control bleeding
– Immobilize the fractured limb (splinting)
– Analgesia
– Tetanus Toxoid
– Appropriate antibiotics (for compound fractures)
Treatment of uncomplicated closed fractures
Reduction
Immobilization (Maintenance of
reduction)
Rehabilitation
Reduction
Closed Reduction
Mechanical traction
Operative reduction
Immobilization
External Splints e.g. Casts, Collar etc.
Continuous traction
External Fixation
Internal Fixation
What is the probable fracture ?
Traction
Skin traction
Bone Traction
Skin Traction
What is the name of the pin used for bone traction ?
Fixation
External
When do you use External fixation ?
Internal
Rehabilitation Is important in order:
to preserve function as far as possible
when the fracture is uniting
to restore function to normal when the
fracture is united
Complications of fractures
Early Complications
Massive haemorrhage and hypovolaemia
Neurovascular damage
Infection
Injuries to viscera
Injuries to soft tissues
Fracture blisters
Compartment Syndrome
Late Complications Delayed union
Non-Union
Mal-Union
Shortening
Fat embolism
Avascular Necrosis
Post-traumatic ossifications
Sudeck’s post-traumatic osteodystrophy
Osteoarthritis
THANK YOU