Complications Of Fractures | Cheat Sheet

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

66

Pages:

2
Author:

Mariam A.

Complications of fractures Local and immediate e.g. infection with compound fracture     Haemorrhage – usually life threatening only if there is a large vessel in the adjacent soft tissue. Infection – particularly with compound fractures with gross contamination by soil or the road surface. Soft tissue injury: o Usually coincidental to the event that caused the fracture (e.g diffuse brain injury accompanying a hairline fracture of the skull, rupture of abdominal viscera with fractures of the ribs or pelvis) o Less frequently, broken bone ends can damage soft tissue directly (e.g. ends of broken ribs can tear the lung and produce a pneumothorax) Ischaemic necrosis – can arise where the fracture transects the arterial blood supply to a region of bone (e.g. fracture through the neck of the femur impairs the supply of blood to the femoral head, fracture through the waist of the scaphoid causes ischaemia of its proximal half) General and immediate e.g. fat embolism   Fat embolism – usually only occurs with extensive/multiple fractures o Fragments of marrow, mostly fat but sometimes with haemopoietic tissue, in the venous circulation o Many lodge in the pulmonary circulation (pulmonary embolism) o May pass through pulmonary circulation and lodge in the central nervous system to produce neurological effects Thrombotic embolism – common in other post-traumatic situations Local and remote e.g. delayed fracture union     Delayed fracture union – causes include a foreign body, necrotic bone, poor blood supply, infection and poor nutritional status Failure of fracture healing (non-union) – causes include interposition of soft tissue, wide separation of the fractured ends, inadequate immobilisation or an underling pathological process (e.g. neoplasm) o In non-union, the fragments are connected by scar tissue instead of bone and the bone ends are covered by dense fibrous tissue which may convert to fibrocartilage. False joint – a consequence of non-union in which a cavity forms in the fibrous tissue which becomes lined by synovium Osteoarthritis when the line of fracture has passed through the overlying articular cartilage which does not repair in contrast to the underlying bone  Complications of chronic osteomyelitis following an infected compound fracture (e.g. discharging sinus occasionally with late development of carcinoma) General and remote e.g. osteoarthritis in joints distant from the fracture site   Osteoarthritis in joints distant from the fracture site, a consequence of abnormal weight bearing due to poor realignment of the fractured bone Systemic complications secondary to chronic osteomyelitis (e.g. amyloidosis, metastatic abscess)