Fracture Complications

Early
Local compartment syndrome neurologic injury vascular injury infection implant failure # blisters
Systemic sepsis deep vein thrombosis (DVT) pulmonary embolus (PE) acute respiratory distress syndrome (ARDS) hemorrhagic shock
Late
mal/non-union avascular necrosis (AVN) osteomyelitis heterotopic ossification (HO) post-traumatic arthritis complex regional pain syndrome (CRPS) (vitamin C 500mg OD may ? incidence)

Heterotrophic Ossification (HO)

the formation of bone in abnormal locations, secondary to pathology e.g. burns, electrical injury, frostbite, head trauma, hip #, etc.

Avascular Necrosis (AVN)

1.) Defined:

disruption of blood supply to bone resulting in ischemia
occurs in bones extensively covered in cartilage which rely on intra-osseous blood supply (femoral head) or in bones with a distal ? proximal blood supply (proximal pole of scaphoid, body of talus, femoral head)
changes on XR are typically late and therefore MRI is more sensitive for diagnosing early AVN

2.) Risk Factors:

steroid use, chronic alcohol use, post-traumatic fracture/dislocation, septic arthritis, sickle cell disease, storage disease (e.g. Gaucher’s disease), dysbarism (Caisson’s disease “the bends”), idiopathic (Chandler’s disease)

XR Features of AVN
reactive sclerosis of adjacent bone subchondral fracture flattening of weightbearing zones with eventual collapse