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20 Cards in this Set
- Front
- Back
Conservative treatment is based:
- on fracture reduction, fixation and retention - after fixation removal subsequent physiotherapy to restore function - fixation in a plaster cast - analgesics to relieve pain, application of ice |
Conservative treatment is based:
- on fracture reduction, fixation and retention+ - after fixation removal subsequent physiotherapy to restore function+ |
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Conservative treatment of fractures is characterized by:
- indirect (secondary) healing with callus formation - is indicated for the majority of pediatric fractures - longer period of treatment, due to the plaster fixation - cannot carry out physiotherapy |
Conservative treatment of fractures is characterized by:
- indirect (secondary) healing with callus formation+ - is indicated for the majority of pediatric fractures+ |
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For primary direct healing of fractures is typical:
- non forming of the periosteal and endosteal callus - occurs after perfect anatomical reduction and stable internal fixation - must be ensured by plaster of Paris - does not occur in older patients |
For primary direct healing of fractures is typical:
- non forming of the periosteal and endosteal callus+ - occurs after perfect anatomical reduction and stable internal fixation+ |
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Typical advantages of the conservative method of treatment are:
- possibility of adequate therapy if contraindication of surgery for medical reasons - non-interference in internal environment of the body - occurrence of fewer complications - less painful treatment for the patient |
Typical advantages of the conservative method of treatment are:
- possibility of adequate therapy if contraindication of surgery for medical reasons+ - non-interference in internal environment of the body+ |
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Typical disadvantages of the conservative method of treatment are:
- tendency toward frequent displacement of some fractures - discomfort of patients due plaster or other fixation - cannot be used for active patients middle-aged - higher incidence of long lasting effects after fractures |
Typical disadvantages of the conservative method of treatment are:
- tendency toward frequent displacement of some fractures+ - discomfort of patients due plaster or other fixation+ |
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Among the most serious complications of conservative therapy include:
- compartment syndrome, Volkmann's ischemic contracture, plaster sores - deep venous thrombosis (DVT), pulmonary embolism PE - weight of plaster - injuries of visceral organs |
Among the most serious complications of conservative therapy include:
- compartment syndrome, Volkmann's ischemic contracture, plaster sores+ - deep venous thrombosis (DVT), pulmonary embolism PE+ |
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Prevention of venous thromboembolism is performed:
- of all hospitalized patients in bed - patients with plaster fixation of the lower limbs - only of patients with a history of PE or DVT - only of patients with diabetes |
Prevention of venous thromboembolism is performed:
- of all hospitalized patients in bed+ - patients with plaster fixation of the lower limbs+ |
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The essence of treatment with the skeletal traction consists in:
- achieving gradual reduction of fracture by continuous traction - long-term traction serves also to retention of reduced fracture (up to bone union) - traction improves blood circulation in the limb fracture - long-term bed rest |
The essence of treatment with the skeletal traction consists in:
- achieving gradual reduction of fracture by continuous traction+ - long-term traction serves also to retention of reduced fracture (up to bone union)+ |
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Absolute indications for surgical treatment are:
- fractures with neuro-vascular injury - open fractures grade II. and grade III. (Gustilo-Anderson) - unstable fractures and significantly displaced fractures - all fractures of polytraumatised patients |
Absolute indications for surgical treatment are:
- fractures with neuro-vascular injury+ - open fractures grade II. and grade III. (Gustilo-Anderson)+ |
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Surgical treatment of fractures is characterized by:
- anatomical reduction and gentle surgical technique - stable fixation and early, active mobilization - direct access to the injured bones through muscles - use the maximum amount of osteosynthesis material to achieve stability |
Surgical treatment of fractures is characterized by:
- anatomical reduction and gentle surgical technique+ - stable fixation and early, active mobilization+ |
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Treatment of infection after internal fixation of fracture consists in:
- radical surgical revision (debridement), conversion to external fixation - lavage and targeted systemic administration of antibiotics - oral antibiotics, local wound care - ensuring position in plaster, analgesics and antibiotics |
Treatment of infection after internal fixation of fracture consists in:
- radical surgical revision (debridement), conversion to external fixation+ - lavage and targeted systemic administration of antibiotics+ |
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Nonunion (pseudoarthrosis) is characterized by:
- occurring as typical complication only after conservative treatment - occurrence in both conservative and surgical treatment, classify non-union of bone after 6 months treatment of fracture - distinguish nonunion into hypervascular (vital) and avascular (avital) type (mechanical or biological problem) - standard treatment algorithm is: blockade of sympathetic, pharmacotherapy (Protazin, Plegomazin, Secatoxin, calcitonin, calcium), followed by hydrotherapy |
Nonunion (pseudoarthrosis) is characterized by:
- occurrence in both conservative and surgical treatment, classify non-union of bone after 6 months treatment of fracture+ - distinguish nonunion into hypervascular (vital) and avascular (avital) type (mechanical or biological problem)+ |
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The main clinical symptoms of compartment syndrome are:
- severe pain in the affected area, out of proportion with the injury and no response to analgesics (opioids) - increased pressure in the leg (greater than 30-40 mm Hg) - peripheral edema (fingers), color changes and limited mobility, then whole limb edema - no palpable pulsating arteries, impaired motor function |
The main clinical symptoms of compartment syndrome are:
- severe pain in the affected area, out of proportion with the injury and no response to analgesics (opioids)+ - increased pressure in the leg (greater than 30-40 mm Hg)+ |
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Compartment syndrome is:
- set of symptoms, resulting from increased pressure in a closed anatomical space (compartment, loge), leading to local ischemia - increase the pressure above 30–40 mmHg in the space defined by the skeleton and muscles or intermuscular septa - long-term compression of muscles, then accumulation of myoglobin in the kidney can cause renal failure - primary nerve injury (failure occurs after injury and not changed in time) |
Compartment syndrome is:
- set of symptoms, resulting from increased pressure in a closed anatomical space (compartment, loge), leading to local ischemia+ - increase the pressure above 30–40 mmHg in the space defined by the skeleton and muscles or intermuscular septa+ |
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Pathophysiology of compartment syndrome:
- is an increase of pressure in the compartment (bleeding, inflammation, burns) - reduction in the compartment's volume (tight bandage, plaster incorrect fixation, scarring of the skin) - is caused by a failure of the arterial supply and venous collapse - increased pressure must last at least 48 hours to cause damage |
Pathophysiology of compartment syndrome:
- is an increase of pressure in the compartment (bleeding, inflammation, burns)+ - reduction in the compartment's volume (tight bandage, plaster incorrect fixation, scarring of the skin)+ |
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Determine the diagnosis of compartment syndrome:
- is a clinical diagnosis, taken from history of patient and clinical symptoms - additional investigations: oximetry, measurement pressure in compartment - is present tight bandage or plaster and peripheral edema - no palpable pulse in the peripheral arteries |
Determine the diagnosis of compartment syndrome:
- is a clinical diagnosis, taken from history of patient and clinical symptoms+ - additional investigations: oximetry, measurement pressure in compartment+ |
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Treatment of compartment syndrome is based on:
- reduction of tissue pressure before irreversible ischemic changes (up to 6 hours) - removing causes of compartment syndrome: removal of plaster, the timely implementation of fasciotomy - pharmacotherapy (anti-edematous therapy, enzyme therapy, vasodilators, analgesics) - positioning of limbs in a raised position above the level of the heart to control the soft tissue |
Treatment of compartment syndrome is based on:
- reduction of tissue pressure before irreversible ischemic changes (up to 6 hours)+ - removing causes of compartment syndrome: removal of plaster, the timely implementation of fasciotomy+ |
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Fasciotomy is indicated if:
- present clinical signs, pressure in compartment more then 30–40 mmHg (for children more than 30 mmHg) - suspicion of compartment syndrome and primary fracture treatment can be carried out with preventive fasciotomy - operative treatment of fracture is indicated - occurs primary injury of nerve and acute arterial occlusion |
Fasciotomy is indicated if:
- present clinical signs, pressure in compartment more then 30–40 mmHg (for children more than 30 mmHg)+ - suspicion of compartment syndrome and primary fracture treatment can be carried out with preventive fasciotomy+ |
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Typical example of Sudeck syndrome (Complex regional pain syndrome) is:
- disability of upper limb after insignificant soft tissue trauma - fracture in the forearm after the removal of "tight" plaster - after common ankle fracture, treatment with walking cast - after treatment of fracture of the femoral neck with skeletal traction |
Typical example of Sudeck syndrome (Complex regional pain syndrome) is:
- disability of upper limb after insignificant soft tissue trauma+ - fracture in the forearm after the removal of "tight" plaster+ |
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Complex regional pain syndrome (CRPS), formerly Sudeck's atrophy we divide into:
- acute phase (reduced sympathetic activity), dystrophic phase (increased sympathetic activity), atrophic stage (irreversible) - CRPS type I (reflex sympathetic dystrophy) and CRPS type II (causalgia) - acute (to 6 months) and chronic - juvenile and adult form |
Complex regional pain syndrome (CRPS), formerly Sudeck's atrophy we divide into:
- acute phase (reduced sympathetic activity), dystrophic phase (increased sympathetic activity), atrophic stage (irreversible)+ - CRPS type I (reflex sympathetic dystrophy) and CRPS type II (causalgia)+ |