Complications of Fractures

This is a tabulated compilation for complications of fractures in general which can be immediate, early or delayed and local or generalized/systemic. This topic is commonly tested in exams.

fracture
LocalSystemic
Immediate1. Soft tissue injuries (Skin, Nerve, Vessels, Muscle-tendon)
2. Physeal injury
3. Hemarthrosis
4. Local visceral injury
1. Hemorrhagic shock
2. Aseptic traumatic fever
3. Injury to remote organs
Early1. Skin necrosis
2. Fracture blisters
3. Gas gangrene
4. Gangrene of limb
5. Compartment syndrome
6. Venous thrombosis
7. Loss of initial reduction or fixation
8. Iatrogenic: Pressure ulcers, Pin tract infections, Pin loosening of breakage, Neurovascular damage due to pin placement
1. Fat embolism
2. Pulmonary thromboembolism
3. Crush syndrome
4. Pneumonia
5. Tetanus
6. Delirium tremens
7. ARDS
8. Septicemia
9. Myocardial infarctions and postoperative arrhythmia
10. Exacerbation of Diabetes
Delayed1. Nerve: Tardy ulnar nerve palsy
2. Muscle: Myositis ossificans, Volkmann ischemic contracture, Sudeck’s dystrophy
3. Bone/fracture: Malunion, Nonunion, Delayed union, Growth disturbance, Cross union, Chronic osteomyelitis, Avascular necrosis (AVN)
4. Joint: Stiffness, Osteoarthritis

1. Loss of work/occupation
2. Loss of independence
3. Mobility problems (elderly patients generally go down 1 level of ambulation function after a significant fracture)

References:

  1. Manipal Manual of Orthopaedics By Vivek Pandey
  2. Shortcut to Orthopaedics By Dr. Robert Perlau


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