In extreme case gangrene. 5 Simple Knee Injury Prevention Exercises. At this stage it is sometimes difficult to decide what constitutes malunion ; acceptable norms differ from one site to another . vascular injury forearm compartment syndrome resulting in volkmanns, LATE COMPLICATIONS OF FRACTURES - . principles of fractures definition. 13. 2. A differential pressure (P) the difference between diastolic pressure and compartment pressure of less than 30 mmHg is an indication for immediate compartment decompression A split/ wick catheter. delayed union non-union malunion joint stiffness myoisitis ossificans avascular. Fractures are common: most people will experience at least one during a lifetime. An arterial injury may result from laceration, thrombus, embolus, intimal tear, or pseudoaneurysm . Acute complications occur as a direct result of the trauma sustained and can include damage to vascular structures, nerves, or soft tissue. * Even if its outward appearance is normal, the intima may be detached and the vessel blocked by thrombus, or a segment of artery may be in spasm. The pressure within the affected compartment increases, resulting in muscular fibrosis and neurological damage. Femoral supracondylar fracture (Femoral artery). Late complications of fractures - Outlines. Compartment syndrome. . CLINICAL DIAGNOSIS OF FRACTURE AND GENERAL PRINCIPLE OF MANAGEMENT OF FRACTURE, Dr. Vitthalrao Vikhe Patil Foundation's College of Physiotherapy, Ahmednagar, Fractures, bone healing & principles of tx. spiral fracture. INFECTION Causes: Open fracture (common) Use of operative method in the Tx of # Wound becomes inflamed and starts draining seropurulent fluid. Wound becomes inflamed and starts draining seropurulent fluid. Create stunning presentation online in just 3 steps. In closed injuries nerve is seldom severed and spontaneous recovery should be awaited. Local complications Early 1. Confirmation of the diagnosis is by measuring the intra compartmental pressures. bld flow coz Ischemia leads to tissue death & peripheral gangrene. The median nerve is most at risk with . Muscle contracture. Treatment: Shortening of upper limbs goes unnoticed For lower limb treatment depends upon the amount of shortening:1. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. These are a relatively uncommon complication of fractures (2.9% of fractures admitted to hospital in one series) in areas where skin adheres tightly to bone with little intervening soft tissue cushioning. Oestrogen-containing hormone therapy (although this may be a proxy for osteoporosis). These include vascular damage such as disruption to the femoral artery or its major branches by femoral fracture, damage to the pelvic arteries by pelvic fracture. Compartment syndrome. classification of fractures. classification of fractures. Early: 1. However, fractures are associated with a range of complications. It is a common complications of fractures and results from:- 1.Mal union of the long bones 2.Crushing: Actual bone loss 3.Growth defects: growth plate or epiphyseal injuries. if the clinical signs are soft, the limb should be examined at 30-minute intervals and if there is no improvement within 2 hours of splitting the dressings, fasciotomy should be performed. Associated systemic illness . fractures of teeth. (8) surgical intervention, If fill-judged, is another cause . Outcome of surgically treated acetabular fractures: risk factors for postoperative complications and for early conversion to total hip arthroplasty 3. *Septic shock. feinstein october 2009. simple. Thrombo-embolism. Early. Treatment :- CONSERVATIVE or OPERATIVE 1- Conservative :- Non-union is occasionally symptomless, needing no treatment as it might cause slight instability and is best left untreated ,or at most, (a) a removable splint. This is particularly important during the first 3 weeks, when the situation may change without warning. It appears that you have an ad-blocker running. Fascia separate groups of muscles in the arms and legs from each other. Exacerbation of underlying diseases such as diabetes or coronary artery disease (CAD). 1- Blood loss 2- Shock *Hypovolemic or hemorrhagic shock. Free access to premium services like Tuneln, Mubi and more. delayed union and nonunion avascular necrosis of bone reaction . 5- Crush syndrome. Type I open fracture can be managed with non-operative approach and closed reduction. This takes until week 4-8 post-injury and is not visible on X-ray. Joint stiffness. View 2.Complications of Fractures.pdf from SDGSG 6474 at Jordan University of Science & Tech. InjuryVessel First rib fracture/clavicle Subclavian artery Shoulder dislocation Axillary artery Humeral supracondylar fracture Brachial artery Elbow dislocation Brachial artery Pelvic fracture Presacral and internal iliac artery Femoral supracondylar fracture Femoral artery Knee dislocation Popliteal artery Proximal tibial Popliteal artery or its branches Temporal/ parietal middle meningeal artery, Clinical features - paraesthesia or numbness in the toes or the fingers. Local . Tendon lesions. In the forearm and leg a single-bone fracture may be held apart by an intact fellow bone. Delayed complications may occur after initial treatment or in response to treatment. Management involves delay in surgical intervention and casting. Proximal tibia (popliteal or its branches). Plaster and pressure sores. -by agent causing fracture Acute nerve compression -Distinct from a direct injury, with fractures or dislocations around the wrist. Where normal bone meets the necrotic segment a zone of increased radiographic density may be produced by new bone formation. 3. 2. Acute complications occur as a direct result of the trauma sustained and can include damage to vascular structures, nerves, or soft tissue. Clinical features :- The deformity is usually obvious, but sometimes the true extent of malunion is apparent only on x-ray . Thrombo-embolism. bone breaks cleanly but does not penetrate the skin. Therefore, reevaluation at regular intervals during . 2022 SlideServe | Powered By DigitalOfficePro, - - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -. Click here to review the details. closed. In hypertrophic non-union the bone ends are enlarged, suggesting that osteogenesis is still active but not quite capable of bridging the gap. Tap here to review the details. Closed nerve injuries -The nerve is seldom severed. 4. Medications may impair healing of fractures. Version 2.0 Fracture Complications 19/05/2012 Early complications Local: Vascular injury causing haemorrhage, internal or external Visceral injury causing damage to structures such as brain, lung or bladder Damage to surrounding tissue, nerves or skin Haemarthrosis Compartment syndrome (or Volkmann's ischaemia) 2- Operative :- each case should be treated on its merits; however, if union is delayed for more than 6 months and there is no sign of callus formation, internal fixation and bone grafting are indicated. Presentation Transcript. Healing rates vary by person, and are likely to be compromised by the risk factors above and by age and comorbidity. Local . Major complications of fracture repair include ost Union by primary bone healing is slow, but provided stability is maintained throughout, it does eventually occur. 5. Rotational deformity of the femur, tibia, humerusor forearm may be missed unless the limb is compared with its opposite fellow. 6- Multiple organs failure syndrome (MOFS). 45. fall 2011. risk factors. Possible complications of open fractures. General complications 1- Blood loss 2- Shock *Hypovolemic or hemorrhagic shock. A few guidelines are offered:- 1. delayed unioun non, Complications of Supracondylar Fractures - . C- Periosteal stripping over-enthusiastic stripping of periosteum during internal fixation is an avoidable cause of delayed union . Clinical features :- Avascular necrosis causes : intractable non union , disabling osteoarthritis or total disorganization of a joint . Haemarthrosis Fractures involving a joint, leads to accumulation of blood. , Treatment: Antibiotic Excising all devitalised tissue If Sx of acute infx and pus formation : tissue around the fracture should be opened & drained. Source : bone marrow more common in patients with multiple fractures. 14. Infection may be superficial, moderate (osteomyelitis), severe (gas gangrene). We've updated our privacy policy. 4. Neurogenic shock. GAS GANGRENE Produced by anaerobic orgs : Clostridium sp infections. Myositis ossificans. Excessive traction (creating a fracture gap) or excessive movement at the fracture site will delay ossification in the callus. This contrasting appearance has led to non-union being divided into hypertrophic and atrophic types. 4- Pulmonary embolism. Wound Infection more common for open fractures. NONUNION OF FRACTURES - Introduction:. In the last two decades there have been major changes in the management of lower limb long bone fractures, where resources permit, surgical management of open . General complications. Fracture complications such as excessive bleeding or soft tissue compromise, infection , neurovascular injury, presence of complex bone injury, such as crushing or splintering, and severe soft tissue trauma will clearly prolong and possibly hinder or prevent this healing process. Description: Is an area of the body encased by bone or fascia . outlines. Clinical features :- Movement can be elicited at the fracture site and pain diminishes ; the fracture gap ( cavity between the bone ends ) becomes a type of pseudoarthrosis. Fasciotomy Compartment pressure, A vicious cycle cont. fractures of alveolar, Complications of Sinusitis - . In adults, fractures should be reduced as near to the anatomical position as possible. Complications of Fractures: 1-General complications: shock..etc 2-Local complications: Early Late. . Revascularization 3.Excision of the avascular segment 4.Total joint replacement. age under 17 over 35 gravida and parity socioeconomic, Complications of Pregnancy - . Looks like youve clipped this slide to already. objectives. Fracture complications include: Acute. Visceral injury (the lung, the bladder, the urethra, and the rectum). The most difficult recovery happens in this type of fracture. types of fractures:. Complications of Diabetes, Diabetes Complications, Long-term complications of diabetes, major complications of - Do, Principles of fractures - . Septic shock. Fracture : Diagnosis, Complications and Prevention. While age-adjusted incidence is decreasing, the overall prevalence of hip fractures has increased globally with the aging population [1, 2].The number of hip fractures is projected to more than triple between 1990 and 2050, with an estimated 4.5 million cases expected per year globally []. Elbow dislocation (Brachial artery). A recent motor vehicle accident (one month or less prior to fracture). 5. Both biology and stability are affected by active infection: not only is there bone lysis, necrosis and pus formation, but implants which are used to hold the fracture tend to loosen. There are no symptoms associated with avascular necrosis, but if the fracture fails to unite or if the bone collapses the patient may complain of pain. The watchword is patience; however ,there comes a point with every fracture where the ill-effects of prolonged immobilization outweigh the advantages of non-operative treatment. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. 5. Causes:- When dealing with the problem of non-union, four questions must be addressed. Fasciotomy is performed. Nerve Trauma Effect Axillary Dislocation of shoulder # of humerus Deltoid paralysis Pointing index Sciatic Supracondylar # of humerus # medial epicondyl humerus Post dislocation of hip Common peroneal Knee dislocation # neck of fibula Foot drop Radial Median Ulnar Wrist drop Claw hand Foot drop. 1. with the end of the lecture. There are, of course, also biological and patient-related reasons that may lead to non-union: (1) distraction and separation of the fragments, sometimes the result of interposition of soft tissues between the fragments (there is muscle or ligament covering the broken ends and preventing them from touching each other) (2) excessive movement at the fracture line (the two ends are still mobile ) . Slides: 23. Complex regional pain syndrome. orbital (60-75%) intracranial (15-20%) bony (5-10% ) radiography. frango, 3. fregi, fractum to break, Complications of Pregnancy - . Tx : the blood should be aspirated before dealing with the fracture. Nerve damage may result in motor and sensory loss. Crush syndrome. outlines. Inside each layer of fascia is a confined space, called a compartment, that includes the muscle tissue, nerves, bones and blood vessels. EARLY COMPLICATION Local Visceral Injury Vascular Injury Nerve Injury Compartment Syndrome Haemarthrosis Infection Gas gangrene, LOCAL VISCERAL INJURY Fracture around the trunk are often Cx by injury to the adjacent viscera : Pelvic fracture Bladder and urethral rupture Rib fracture penetration to the lungs Pneumothorax, VASCULAR INJURY Most commonly knee, femoral shaft, elbow, and humerus. 2. Complications of fractures. three main categories. age under 17 over 35 gravida and parity socioeconomic status, Complications of Exodontia - . Fat embolism. Crush syndrome. Loss of initial reduction or fixation Nerve damage may result in motor and sensory loss. *These injuries require emergency treatment. ABG and Urinalysis There is no test for fat embolism Management -supportive -oxygen -stabilization of long-bone fractures -analgesia -corticosteroids for severe multiple injuries(methylpredinosolone to maintain oxygen tension) -heparin or dextran ( improve capillary flow), Crush syndrome when a limb is compressed for extended periods underperfusion - myonecrosis - release of toxic metabolites reperfusion injury - Membrane damage and capillary fluid reabsorption failure swelling - may lead to compartment syndrome - more tissue damage from ischaemia. Shoulder dislocation (Axillary artery). a- immediate or operative complications. They may be clear or haemorrhagic, and they may lead to chronic ulcers and infection, with scarring on eventual healing. (d) osteoporotic bone . Fibrous tissue in the fracture gap, as well as the hard, sclerotic bone ends is excised and bone grafts are packed around the fracture. X-ray The fracture is clearly visible but the bone on either side of it may show either exuberant callus or atrophy. A complication of shoulder fracture or . Early preventing : limb elevation Dx : confirmed by direct intracompartmental pressure measuring > 40 mm. With modern medical and surgical care most heal without problems or significant loss of function. Smoking . Vascular injury * The fractures most often associated with damage to a major artery are those around the knee and elbow, and those of the humeral and femoral shafts. Compartment syndrome 6. Patient complains from : - intense pain - swelling around the wound - brownish discharge - gas formation - little or no pyrexia - characteristic smelling - toxaemic coma death the prime site for infection is a dirty wound with dead muscle that has been closed without adequate debridement, Gas gangrene---characterized by myonecrosis Anaerobic cellulitis in which superficial gas formation is abundant but toxaemia usually is slight. FES is most commonly associated with long-bone and pelvic fracture, whereas acute compartment syndrome is often associated with tibia or forearm fracture. Aim: To analyze the early complications associated with preoperative external traction fixation in the staged treatment of tibial fractures. High-risk injuries are fractures of the 1- elbow 2- forearm bones 3- proximal third of the tibia 4- multiple fractures of the hand or foot 5- crush injuries and circumferential burns. Life-threatening complications. Complications of Diabetes, Diabetes Complications, Long-term complications of diabetes, major complications of - Do, Principles of fractures - . 3- Fat embolism. Clinical features :- Fracture tenderness persists and, if the bone is subjected to stress, pain may be acute . age under 17 over 35 gravida and parity socioeconomic status, Complications of Exodontia - . Injuries to adjacent structures. 7. -The limb should be nursed flat (elevating the limb causes a further decrease in end capillary pressure and aggravates the muscle ischaemia). Neurogenic shock. . Complications of Fractures: - . ( algodystrophy). Malunion. However , the clinical and radiological effects are not seen until weeks or even months later, the avascular bone gradually loses its rigid trabecular structure , in this state the bone crumbles easily and under stress imposed by the muscular tone or body weight it will eventually collapse which may be sometimes very slow. 1- VISCERAL INJURY Fractures around the trunk are often complicated by injuries to underlying viscera, the most important being 1- penetration of the lung with life-threatening pneumothorax following rib . General complications Shock Hypovolemic or hemorrhagic shock. * The artery may be cut, torn, compressed or contused either by the initial injury or subsequently by jagged bone fragments. Tetanus. They have given rise to the acronym CASS: 1. Patients with multiple rib fractures may develop pneumothorax, flail chest and respiratory compromise. 4. Impossible. Early complications. 1- Biological cause :- A-Inadequate blood supply A badly displaced fracture of along bone will cause tearing of both the periosteum and interruption of the intramedullary blood supply . In open fractures complete lesion(neurotmesis) : the nerve is explored during wound debridement and repaired. Shock; hemorrhagic, neurogenic or septic, Complications of Fractures: 1-General complications: shock..etc 2-Local complications: Early Late, General complications Shock; hemorrhagic, neurogenic or septic Crush syndrome: fracture muscle damage acid myoglobin release in the circulation precipitate in renal tubules and vasoconstriction of renal arteries renal tubular necrosis and failure DVT, PE and FPE Fat embolism Tetanus and gas gangrene ARDS, Local complications Early: Visceral injuries Vascular injuries Nerve injuries; neuropraxia, axonotomesis, neurotomesis Compartment syndrome Haemarthrosis infection, Local complications Late: Delayed union, Causes Inadequate blood supply Severe soft-tissue damage Periosteal striping Movement at fracture site Imperfect splinting Infection, Local complications Non-union, either hypertrophic or atrophic CAUSES Excusive soft-tissue loss/damage Bone loss Intact fellow bone Soft-tissue interposition Poor blood supply Poor haematoma formation Infection Pathological fracture Poor splintage or fixation Impatience Patient- immence, immpatient, impossible, immovable, Local complications Malunion, either angulation, rotation or shortening Avascular necrosis osteoarthritis pain Growth disturbance Bed and cast sores Myositis ossificans, heterotophic ossification Rupture of tendons Nerve compression by callus, or streching by deformity Muscle contracture Jiont instability from lig., bone or mm weakness Joint stiffness, extra-, peri-, or intra-articular cause Allgodystrophy (complex regional pain syndrome) Sudecks atrophy Osteoarthrosis joint degeneration, 2022 SlideServe | Powered By DigitalOfficePro, - - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -. (b) failure to hold reduction while healing proceeds . However, it seems likely that malalignment of more than 15 degrees in any plane may cause asymmetrical loading of the joint above or below and the late development of secondary osteoarthritis; this applies particularly to the large weightbearingjoints. description. 9. In advanced cases, amputation may be essential, Fracture blisters Two distinct blister types are seen after fractures: clear fluid-filled vesicles and blood-stained ones. maja roman vanja niki mentor: a. mega horvat. A rise in pressure within these compartments may jeopardize the blood supply to the muscles & nerves within the compartment. Skin necrosis 2. Post-traumatic wound infection is now the most common cause of chronic osteitis. The affected bone must have an adequate blood supply. If the zone of necrosis is extensive, as might occur in highly comminuted fractures, union may be interrupted . Bleeding, oedema or inflammation (infection) may increase the pressure within one of the osseofascial compartments- reduced capillary flow- muscle ischaemia oedema- greater pressure - more profound ischaemia swelling of a limb inside a tight plaster cast. . Rotational deformity of a metacarpal fracture is detected by asking the patient to flatten the fingers onto the palm and seeing whether the normal regular fan-shaped appearance is reproduced . delayed uniounnon unionmalunion avascular necrosisosteoarthiritisshortening. Complaints of numbness or paraesthesia in the distribution of the median or ulnar nerves should be taken seriously and the patient monitored ; if there is no improvement within 48 hours of fracture reduction or splitting of bandages around the splint, nerve should be explored and decompressed, Compartment Syndrome Fractures of the arm or leg can cause ischaemia, even if there is no damage to a major vessel. x-rays of fractures for salter harris, Fractures - . http://hastaneciyiz.blogspot.com. OPEN FRACTURES COMPLICATIONS: OSTEOMYELITIS, RAD 422 Fractures Types, Complications, and management - . General . The wound should be left open and inspected 2 days later. Fracture blisters. Enjoy access to millions of ebooks . Period of active resuscitation. Venous thrombosis 7. maja roman vanja niki mentor: a. mega horvat. Complications of fractures Done by: Selena abboud Rand Alshayeb RahafHasanain, COMPLICATIONS OF FRACTURES General Local Early Late. Early complications include shock, fat embolism, compartment syndrome, deep vein thrombosis, thromboembolism ( pulmonary embolism ), disseminated intravascular coagulopathy, and infection. introduction. Bed sore. (e.g. OPEN FRACTURES COMPLICATIONS: OSTEOMYELITIS, RAD 422 Fractures Types, Complications, and management - . Infection. dr. abdulrahman algarni , md, ssc (ortho), abos assist. Nerve damage may result in motor and sensory loss. *Management -ABC -Oxygen -fluids -Inotropes/vasopressors: if the patient remains hypotensive despite adequate fluid resuscitation -systemic support for other organs. 10. 1-general complications: shock..etc 2-local complications: early late. Failure to recognize the difference may lead to unnecessary amputation for the non-lethal cellulitis, swelling around the wound, brownish discharge gas formation, Prevention Deep, penetrating wounds in muscular tissue are dangerous; they should be explored, all dead tissue should be completely excised and, if there is the slightest doubt about tissue viability, the wound should be left open. Excision of dead muscle must be radical to avoid sepsis. (5) infection (particularly osteomyelitis ) . 7. General complications Shock; hemorrhagic, neurogenic or septic Crush syndrome: fracture- muscle damage- acid myoglobin release in the circulation- precipitate in renal tubules and vasoconstriction of renal . Get powerful tools for managing your contents. 1-General complications: shock..etc 2-Local complications: Early Late. feinstein october 2009. simple. Done by: S elena abboud Rand A lshayeb Rahaf H asanain. Treatment First removed all the bandages & dressing. If no recovery by the expected time, and if nerve conduction studies fail to show evidence of recovery, the nerve should be explored. principles of fractures definition. *Clinical features Early warning signs of fat embolism (usually within 72 hours of injury) are 1- slight rise of temperature and pulse rate. Hg is an indication of compartment decompression and fasciotomy. Delayed complications. Accurately speaking, this is an early complication of bone injury, because ischaemia occurs during the first few hours following fracture or dislocation. Lateral Patellar Instability | MPFL Repair | Patellar Knee Injuries. Compartment syndrome (or Volkmanns ischaemia). RAD 422 Fractures Types, Complications, and management - Rad 422 fractures types, complications, and management. Alignment Was the fracture adequately aligned , to reduce shear? age under 17 over 35 gravida and parity socioeconomic, Complications of Pregnancy - . If compartment syndrome develops, and is confirmed by pressure measurements, then a fasciotomy is indicated. Activate your 30 day free trialto unlock unlimited reading. clinically: - should be tested by stretching the muscles when the toes or fingers are passively hyperextended there is pain in the calf or forearm. closed. 3- Pathognomonic signs are petechiae on the trunk, neck, axillae and conjunctiva. Silver sulfadiazine seemed in one review to promote re-epithelialisation. On x-ray, the fracture line remains visible and there is very little or incomplete callus formation or periosteal reaction. Visceral injury causing damage to structures such as the brain, lung or bladder. (3) poor soft tissues (from either the injury or surgery) . Pelvic fracture (presacral and internal iliac). of ulna and radius. They are believed to result from large strains applied to the skin during the initial fracture deformation, and they resemble second-degree burns rather than friction blisters. 5% of long bone fractures will result in nonunion and even more in delayed union. (c) Pulsed electromagnetic fields and low-frequency, pulsed ultrasoundcan also be used to stimulate union . Many fac-tors influence the speed with which fractures heal (Chart 69-3). By accepting, you agree to the updated privacy policy. Use of non-steroidal anti-inflammatory drugs (NSAIDs) within 12 months. If they are displaced, surgery is often needed to set them properly. -Skin sensation repeatedly checked- Ischaemic muscle is highly sensitive to stretch. x-rays of fractures for salter harris, Fractures - . With atrophic non-union, fixation alone is not enough. Complications of fractures. The features at this stage are essentially those of ARDS. mohammad ararawi. -mainstay of treatment is prompt decompression of the wound and removal of all dead tissue. Complications usually happen more in open than in closed . Early. Number of Views: 3789. Late. fall 2011. risk factors. Fat embolism Circulating fat globules occlude small blood vessels, occur after closed fractures of long bones and traces of fat can be found in the lungs and other internal organs. hemothorax occur from displaced clavicular fracture. may lead to irreversible damage of the life supporting organs.Thirst, rapid shallow breathing, the lips and skin are pale and the extremities feel cold,if the compansation fails.. impaired renal function test and decreased urinary output. While a plaster sore is developing the patient feels localized burning pain. Complications Current trends Conclusion . MALUNION When the fragments join in an unsatisfactory position (unacceptable angulation, rotation or shortening) the fracture is said to be malunited. This is visible on X-ray and should fill the fracture by weeks 8-12 post-injury. You can read the details below. Nerve injury. Fracture Healing and Complications (Early and Delayed) Weeks to months are required for most fractures to heal. One of the most serious and most common complications of a bone fracture is called malunion. frango, 3. fregi, fractum to break, Complications of Pregnancy - . Principles of Fractures - . First rib or clavicle fracture (subclavian artery). Stimulation Was the fracture sufficiently stimulated? - Very little is known of the long-term effects of small angular deformities on joint function . Haemoarthrosis. Contact Was there sufficient contact between the fragments? The risk of complications varies with the particular fracture, its site, circumstances and complexity, with the quality of management, with patient-specific risk factors such as age and comorbidities, and with post-fracture activities such as air travel and immobility. These include vascular damage such as disruption to the femoral artery or its major branches by femoral fracture, damage to the pelvic arteries by pelvic fracture. Hip fractures, particularly in elderly patients, lead to loss of mobility which may result in pneumonia, thromboembolic disease or rhabdomyolysis. NONUNION OF FRACTURES - Introduction:. what's fracture of ulna and radius? In children, angular deformities near the bone ends (and especially if the deformity is in the same plane as that of movement of the nearby joint) will usually remodel with time; rotationaldeformities will not. 4. General complications. Acute long bone fractures primarily result from significant trauma. by encouraging weightbearing). Complications clearly vary with fracture site and nature and with quality of surgery but many also vary with patient attributes such as age, nutritional status, smoking status and alcohol use. The bone ends are rounded with no suggestion of new bone formation. If there is significant die-back, this will require more extensive excision and the gap is then dealt with by bone advancement using the Ilizarov technique. professor consultant orthopedic and, FRACTURES - . 8. It is important to set bones properly to avoid malunion. The SlideShare family just got bigger. Complications of fractures Types Early - General - Local Late - General - Local Early general Mal union of the long bones 2. This article highlights 2 important complications of fracture: acute compartment syndrome and fat embolism syndrome (FES). Done by: S elena abboud Rand A lshayeb Rahaf H asanain. ? Fractures are associated with a range of potential complications. type causes investigation symptoms, Fractures - . Common vascular injuries may associate with the following fractures. Certain body sites are more common for nonunion because of poor blood supply including the fifth metatarsal, tibia, hamate and scaphoid bones. FRACTURES
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. Nerve is capable of regeneration but muscle, once infarcted, can never recover and is replaced by inelastic fibrous tissue (Volkmanns ischaemic contracture). The compromised limb is pulseless,red, swollen,blistered; sensation and muscle power may be lost. of fractures, narayan shree homeopathic medical college, Tibia and fibula diaphysis, ankle and foot injuries, Lecture ucmc pilon plafond fracture distal tibia, ortho 03 principle of closed reduction in fracture and dislocation, Orthopedics 5th year, 9th lecture (Dr. Ali A.Nabi), Rhinology - The New EPOS Guidelines for CRS - Prof Valerie Lund.pdf, Pathology of common ocular and orbital tumors, International Information Resource Centre, First dose size in humans and non linear pharmacokinetics.pptx, Anatomy of Vertebral column for physioterapy (4).ppt, holiday assignment science covid ppt.pptx, Rethinking nicotine: illusions, delusions and some conclusions, PNS- radiological anatomy (wecompress.com) (1).pptx, No public clipboards found for this slide. (( open wound then this should be managed)) . (Actually this is an early complication however the clinical and radiological effects are not seen until weeks or even months)<br />No clinical feature of avascular necrosis but if there is a failure to unite or bone collapse-pain<br /> . Intima may be detached, thrombus block, artery spasm Effect ? 3. Age . The causes of circulatory shock can be classified as abnormalities of cardiac output, of systemic vascular resistance, or a combination of both HYPOVOLAEMIC SHOCK: Reduced circulating volume causing a reduction in venous return and cardiac output (e.g.haemorrhage) Neurogenic shock : when spinal cord injury at a cervical or high thoracic level leads to loss of sympathetic tone and peripheral vasodilatation, venous pooling and reduced venous return. Artery may be cut, torn, compressed or contused. 15-3 ). (7) non-compliance on the part of the patient . -The injured limb is cold, pale, or slightly cyanosed. Have u ever tried external professional writing services like www.HelpWriting.net ? Pt complains: - intense pain - swelling around the wound - brownish discharge - gas formation - pyrexia - characteristic smelling - PR - toxaemic coma death Inability to recognize may lead to unnecessary amputation for the non-lethal cellulitis. In the case of the leg, fasciotomy means opening all four compartments through medial and lateral incisions. Nerve compression and entrapment. medical ppt. *Neurogenic shock. Vascular injury. 4- Severe cases: respiratory distress and coma, due to brain emboli and hypoxia from involvement of the lungs. Patients with multiple rib fractures may develop pneumothorax, flail chest and respiratory compromise. Avascular necrosis. Get powerful tools for managing your contents. However, the bone ends are notsclerosed nor atrophic. Even if symptoms are present, operation is not the only answer; with hypertrophic non-union, (b) functional bracing may be sufficient to induce union, but splintageoften needs to be prolonged. These orgs can survive in O 2 tension Toxins produced will destroy the cell wall and leads to tissue necrosis C/feature: within 24 hr. 5% of long bone fractures will result in nonunion and even more in delayed union. fractures of teeth. Gas gangrene---characterized by myonecrosis, There are, of course, also biological and patient-related, 3. 2. Delayed complications may occur after initial treatment or in response to treatment. - In more advanced cases, there may be decreased sensation, weakness, and, Injuries with a high risk of developing Compartments synd: # of the elbow # of the forearm bone # of the proximal third of the tibia, THE VICIOUS CYCLE OF VOLKMANNS ISCHAEMIA Arterial ischaemia blood flow 5 Ps Pain Damage Pallor Paraesthesia Pulseless Paralysis Direct injury oedema . dr. abdulrahman algarni , md, ssc (ortho), abos assist. careless selection of ring size, excessive fixed traction, and neglect can lead to pressure sores around the groin and iliac crest, Late complications 1-DELAYED UNION 2-NON-UNION 3-MALUNION 4-AVASCULAR NECROSIS 5-GROWTH DISTURBANCE 6-BED SORES 7-MYOSITIS OSSIFICANS 8-TENDON LESIONS 9-NERVE COMPRESSION 10-MUSCLE CONTRACTURE 11-JOINT INSTABILITY 12-JOINT STIFFNESS 13-COMPLEX REGIONAL PAIN SYNDROME (ALGODYSTROPHY) 14-OSTEOARTHRITIS, DELAYED UNION If the time in which a fracture may be expected to unite and consolidateis prolonged, the term delayed union is used .It must never be relied upon in deciding when treatment may be discontinued . Late 1. In extreme case gangrene Treatment -Decompression of the compartment. This result in ischaemic muscle necrosis and nerve damage. Enter your email address to subscribe to this blog and receive notifications of new posts by email. Complications of fractures fall into two categories: early and delayed. 4. Gas gangrene. Principles of Fractures - . Skin loss is present and extensive, muscles are severely damaged, tendons and other tissues are also affected. This is a tabulated compilation for complications of fractures in general which can be immediate, early or delayed and local or generalized/systemic. delayed unioun non, Complications of Supracondylar Fractures - . Fracture is a medical condition which leads to break in the continuity of the bone. There is no advantage to puncturing the blisters (it may even lead to increased local infection) and surgical incisions through blisters, whilst generally safe, should be undertaken only when limb swelling has decreased, Plaster and pressure sores Plaster sores occur where skin presses directly onto bone. a vicious circle that ends after 12 hours or less, in necrosis of nerve and muscle within the compartment. Bone remodelling the bone remodels to correct deformities in the shape and loading strength. 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