3.3.2 Injuries of the Lower Extremity Flashcards
What are the 6 Ps of compartment syndrome?
Want to address the concern during the presentation of pressure and pain. If you get to the other four Ps, the horse has already left the stable.
What is the main vascular supply to the head of the femur?
Terminal branch of the medial circumflex femoral (MFC) - ~80%
Artery of ligamentum teres and lateral femoral cutaneous provide some supply
What type of emergency is a joint dislocation?
relative emergency
What type of emergency is an open fracture?
Absolute emergency
What is this type of fracture?
Open book pelvis fracture
What is the standard of care for all femoral neck fractures in elderly patients?
Operative
What is this the definition of?
Compartment syndrome
What is the goal in caring for a patient with an open fracture?
Convert a contaminated open fracture to a clean, stablized limb
What does ATLS stand?
Advanced trauma life support
There is a great amount of pressure and pain in this pt. What might they have?
Compartment syndrome
A fracture along this line is called what?
A femoral neck fracture
What is the goal of care in a crush injury?
Viable, stable, sensate extremity
What can preclude a good outcome in a crush injury?
Neurovascular injury
What is the treatment for compartment syndrome?
Emergent Fasciotomy!
What are the different types of fixation available for long bone fractures?
intramedullary, external, internal
What is the treatment recommendation for young patients with non-displaced femoral neck fractures?
Urgent ORIF (open reduction and internal fixation)
Why are hip fractures increasing in incidence?
Incidence of hip fractures doubles with each decade beyond age 50, and more people are reaching older ages
What are some of the common causes of mortality in open book pelvis fractures?
Hemorrhage w/ shock (75%), urogenital injury (12%)
60-80% of pts w/ high energy pelvic fractures have other MSK injuries
What is the treatment recommendation for displaced femoral neck fractures in young patients?
Emergent ORIF - risk of AVN
What type of leg rotation is seen with open book fractures?
External hyper rotation
What type of shear pattern regarding femoral neck injuries have a lower rate of success?
High Pauwels Angle (vertical shear pattern)
