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
1.
Inadequate blood supply
2.
Severe soft-tissue damage
3.
Periosteal striping
4.
Movement at fracture site
5.
Imperfect splinting
6.
Infection
Local complications
Non-union, either hypertrophic or atrophic
CAUSES
1.
Excusive soft-tissue loss/damage
2.
Bone loss
3.
Intact fellow bone
4.
Soft-tissue interposition
5.
Poor blood supply
6.
Poor haematoma formation
7.
Infection
8.
Pathological fracture
9.
Poor splintage or fixation
10.
Impatience
11.
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) Sudeck’s
atrophy
Osteoarthrosis – joint degeneration
