21 - Trauma of the Musculoskeletal System Flashcards
ABCDE of advanced trauma life support
Airway + C-spine Breathing and ventilation Circulation + haemorrhage Disability + AVPU Exposure + environment
Upper limb or lower limb more severe?.
Upper limb rarely life threatening but much more complex
Possible blood loss from pelvis in first 2 hours
2000ml
pelvic fractures are most likely to cause haemorrhage
Possible blood loss from femur, tib or fibular in first 2 hours
500ml
What do pelvic fractures mainly affect?
the posterior venous plexus (<85%)
less than 10% arterial
What is de-gloving?
Ripping off the skin
What is Neurapraxia
No axonal discontinuity
Axonotmesis
axoplasmic disruption endoneural sheath intact(can regenerate)
Neurotmesis
axon disrupted loss of tubules, support cells destroyed (usually a laceration, requires reinnervation)
Absolute indications for operative treatment for a fracture
Open fractures Close to a joint Non-union Pathological fractures Fractures w/ vascular injury or compartment syndrome
Clinical union
(defined by no pain/tenderness or movement at fracture site)
Adult fracture healing time
Upper limb - 6 to 8 wks
Lower limb - 12 to 16 wks
Child fracture healing time
Upper limb - 3 to 4 wks
Lower limb - 6 to 8 wks
6 Ps of musculoskeletal assessment
Pain Pallor Polar Paralysis Paresthesias Pulseless
Normal tissue pressure
0-10mmHg
