Open fractures and their management MCQs(Gustilo classification)

What is an open fracture? A) A fracture where the skin is intact B) A fracture with a break in the skin C) A fracture with no displacement D) A fracture that heals without treatment Answer: B) A fracture with a break in the skin What is the primary concern in managing open fractures? A) Stabilizing the fracture B) Preventing infection C) Pain management D) Restoring mobility Answer: B) Preventing infection What classification system is used for open fractures? A) AO Classification B) Gustilo Classification C) Neer Classification D) Salter-Harris Classification Answer: B) Gustilo Classification In the Gustilo classification, what does Type I indicate? A) A fracture with a large soft tissue injury B) A clean wound less than 1 cm C) A fracture with extensive damage D) A fracture with an associated vascular injury Answer: B) A clean wound less than 1 cm What is characteristic of a Type II open fracture in the Gustilo classification? A) A wound greater than 2 cm with moderate soft tissue damage B) A clean wound less than 1 cm C) A fracture with bone loss D) A fracture with a contaminated wound Answer: A) A wound greater than 2 cm with moderate soft tissue damage Which Gustilo classification type includes fractures with extensive soft tissue loss? A) Type I B) Type II C) Type IIIA D) Type IIIB Answer: D) Type IIIB What defines a Type IIIA open fracture? A) Contaminated with extensive tissue loss B) No soft tissue coverage over bone C) Adequate soft tissue coverage despite extensive injury D) A clean wound less than 1 cm Answer: C) Adequate soft tissue coverage despite extensive injury In the management of open fractures, what is the first step after injury? A) Administer antibiotics B) Clean the wound C) Stabilize the fracture D) Obtain imaging Answer: A) Administer antibiotics What is the recommended timing for surgical intervention in open fractures? A) Within 24 hours B) Within 6 hours C) Within 48 hours D) As soon as possible Answer: D) As soon as possible Which of the following is a common complication of open fractures? A) Osteoporosis B) Nonunion C) Malunion D) Infection Answer: D) Infection What is the role of irrigation in the management of open fractures? A) To stabilize the fracture B) To remove debris and reduce contamination C) To promote healing D) To manage pain Answer: B) To remove debris and reduce contamination What type of fixation is often used for Type III open fractures? A) Intramedullary nailing B) External fixation C) Casting D) Plate and screws Answer: B) External fixation What is an essential part of post-operative care for open fractures? A) Regular dressing changes B) Complete immobilization C) Early mobilization D) Avoiding weight-bearing activities Answer: A) Regular dressing changes What is the preferred antibiotic regimen for open fractures? A) Broad-spectrum antibiotics B) Only topical antibiotics C) No antibiotics needed D) High-dose steroids Answer: A) Broad-spectrum antibiotics In the Gustilo classification, what characterizes Type IIIB fractures? A) Adequate soft tissue coverage B) Severe soft tissue damage with exposure C) Clean wound with minimal damage D) Complicated by neurovascular injury Answer: B) Severe soft tissue damage with exposure What is the role of tetanus prophylaxis in open fractures? A) To prevent infection B) To reduce pain C) To promote healing D) To prevent tetanus infection Answer: D) To prevent tetanus infection Which imaging technique is most commonly used to evaluate open fractures? A) X-ray B) MRI C) Ultrasound D) CT scan Answer: A) X-ray What is the typical duration for antibiotic therapy in open fractures? A) 24 hours B) 48 hours C) 3-5 days D) 7-10 days Answer: C) 3-5 days What is a potential long-term complication of poorly managed open fractures? A) Osteoarthritis B) Osteoporosis C) Fracture dislocation D) Chronic pain Answer: D) Chronic pain What does the term ‘wound classification’ refer to in the context of open fractures? A) The type of fracture B) The extent of soft tissue damage C) The patient’s age D) The fracture’s healing time Answer: B) The extent of soft tissue damage Which factor is not included in the Gustilo classification? A) Wound size B) Vascular status C) Bone exposure D) Patient’s age Answer: D) Patient’s age What is the main goal of surgical intervention in open fractures? A) To remove all foreign material B) To achieve optimal healing C) To restore function immediately D) To prevent any complications Answer: B) To achieve optimal healing In the context of open fractures, what does the term ‘debridement’ refer to? A) A type of fixation B) The process of removing devitalized tissue C) The surgical repair of bone D) The application of antibiotics Answer: B) The process of removing devitalized tissue What is a key indicator of successful management of an open fracture? A) Immediate pain relief B) Radiological signs of union C) No visible scarring D) Normal range of motion Answer: B) Radiological signs of union What role do bone grafts play in managing open fractures? A) They stabilize the fracture B) They promote healing in non-unions C) They replace lost tissue D) They prevent infection Answer: B) They promote healing in non-unions Which type of fracture has the highest risk of infection? A) Closed fracture B) Open fracture C) Stress fracture D) Pathological fracture Answer: B) Open fracture What is the significance of the “Golden Hour” in trauma management? A) The time for rehabilitation B) The time frame for surgical intervention C) The best time for diagnosis D) The ideal time for imaging Answer: B) The time frame for surgical intervention Which of the following is a typical symptom of an open fracture? A) Swelling and bruising B) Numbness and tingling C) Bone protruding through the skin D) Fever and chills Answer: C) Bone protruding through the skin What should be done if a patient with an open fracture presents with signs of shock? A) Delay treatment for imaging B) Prioritize fluid resuscitation and stabilization C) Only provide pain relief D) Perform surgery immediately Answer: B) Prioritize fluid resuscitation and stabilization In open fracture management, why is early mobilization encouraged after surgery? A) To prevent muscle atrophy B) To promote fracture healing C) To reduce pain D) To facilitate rehabilitation Answer: A) To prevent muscle atrophy What is a common mistake in the management of open fractures? A) Delaying surgery B) Immediate irrigation C) Administering antibiotics D) Stabilizing the fracture Answer: A) Delaying surgery What is the most critical factor affecting the prognosis of an open fracture? A) Type of fracture B) Timing of treatment C) Patient’s age D) Location of the fracture Answer: B) Timing of treatment What is the ideal method for dressing an open fracture? A) Tight bandage B) Moist wound dressing C) Dry gauze D) No dressing Answer: B) Moist wound dressing What is a common misconception about open fractures? A) They heal faster than closed fractures B) They are always complicated by infection C) They require immediate surgical intervention D) They can often be managed conservatively Answer: A) They heal faster than closed fractures What should be monitored closely after the management of an open fracture? A) Wound healing and signs of infection B) Blood pressure only C) Mobility of the limb D) Nutritional status Answer: A) Wound healing and signs of infection What is the impact of soft tissue injury on the management of open fractures? A) It has no impact B) It determines the classification and treatment approach C) It only affects recovery time D) It makes the surgery easier Answer: B) It determines the classification and treatment approach What role does follow-up care play in the management of open fractures? A) It is not necessary B) It helps in monitoring healing and complications C) It is only for psychological support D) It is only for physical rehabilitation Answer: B) It helps in monitoring healing and complications

Open fractures and their management MCQs(Gustilo classification)
By: Prof. Dr. Fazal Rehman | Last updated: September 28, 2024

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