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Complications of Fractures
Complications of Fractures
FRACTURES
COMPLICATION OF FRACTURE
General Local
Early Late
General complications
Shock
Hypovolemic or hemorrhagic shock.
Septic shock.
Neurogenic shock.
Fat embolism.
Pulmonary embolism.
Crush syndrome.
Multiple organs failure syndrome (MOFS).
Thrombo-embolism.
Tetanus.
Gas gangrene.
Local complications
Early
1. Visceral injury (the lung, the bladder,
the urethra, and the rectum).
2. Vascular injury.
3. Nerve injury.
4. Compartment syndrome.
5. Haemoarthrosis.
6. Infection.
7. Gas gangrene.
8. Fracture blisters.
9. Plaster and pressure sores.
Late
1. Delayed union.
2. Non-union.
3. Malunion.
4. Avascular necrosis.
5. Growth disturbance.
6. Bed sore.
7. Myositis ossificans.
8. Muscle contracture.
9. Tendon lesions.
10.Nerve compression and entrapment.
11.Joint instability.
12.Joint stiffness.
13.Complex regional pain syndrome. ( algodystrophy).
14.Osteoarthritis.
EARLY COMPLICATION
Nerve Injury
Compartment Syndrome
Haemarthrosis
Infection
Gas gangrene
LOCAL VISCERAL INJURY
Pneumothorax
VASCULAR INJURY
Hallmark Symptoms:
- severe pain that does not respond to
elevation or pain medication.
- In more advanced cases, there may be
decreased sensation, weakness, and
paleness of the skin.
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
VOLKMANN’S ISCHAEMIA
Arterial ischaemia blood flow 5P’s
Pain
Damage Pallor
Paraesthesia
Pulseless
Paralysis
Direct ………….....
oedema .……………. Fasciotomy
injury
Compartment
pressure
A vicious cycle cont. until the total vascularity of the
muscles and nerves is jeopardized.
gas formation
Prevention:
deep penetrating wound in muscular tissue are
dangerous;should be explored, all dead tissue should be
completely excised, and if there doubt about the tissue
viability should left open the wound
Treatment:
Early Dx is life saving
General measures:
Fluid replacement & IV Antibiotic (immediate)
Hyperbaric O2 (limiting the spread of gangrene)
Mainstay : prompt decompression & remove dead tissue
Thank You