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14 Cards in this Set
- Front
- Back
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Three things you want to know when someone comes to ER with orthpedic injury
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Mechanism of injury?
Post-injury performance? Elapsed Time since injury? |
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Emergency physical exam components (5)
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Inspection (rule out open fracture)
Gentle palpation Neural status Vascular status (check pulse) Soft tissue injuries |
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Reasons for immobilization of limb (ie-splinting) (4)
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Relieve pain
Safe transportation Prevent further injury (ex-from radiologist) Minimize blood loss |
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Components of fracture diagnosis
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History
Physical 2x Xrays that include joint above and below injury |
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Components of fracture description
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Which bone
Which part of bone (distal, proximal) Displacement (Y or N) Description of displacement Fracture morphology (comminuted? spiral? impaction?) |
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Types of fracture displacement (4)
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Angulation (Varus vs. Valgus)
Translation (degrees and direction WRT proximal fragment) Rotation (degrees and direction WRT proximal fragment) Impaction |
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Indication for Fracture Reduction
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Intra-articular fracture with unacceptable displacement
Never in non-displaced fracture |
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Fracture Reduction Methods
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Closed
Open |
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Inidcations for open fracture reduction
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Displaced intra-articular fracture
Deformity that needs fixing Need early mobilization Need to treat open wounds |
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Advantages/Disadvantages of open reduction
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Advantages: more accurate, more rigid fixation, earlier mobilization
Disadvantages: anesthetic risk, infection, intra-operative injury, additional scarring |
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Principles of Fracture Treatment (3)
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Reduction
Immobilization Rehabilitation |
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Types of fracture immobilization
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Cast
Traction External skeletal fixation Internal fixation (plates, wire/pins, screws, intramedullary nails) |
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Initial treatment of open fractures
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Culture wound and splint limb
Tetanus prophylaxis Antibiotics Transfer to OR (an emergency) Debride and irrigate wound Fix fracture |
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Classification of Open Fractures
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Type 1 - small pinhole
Type 2 - open wound Type 3 - Large/gaping open wound |
