4th Year Trauma Flashcards
define polytrauma
more than one major long bone is injured or where a major fracture is associated with significant chest or abdo trauma
three types of nerve injuries associated with fractures
- neurapraxia
- axonotmesis
- neurotmesis
what is neurapraxia?
temporary compression causes temporary conduction block/ demyelination
should resolve in 28 days
what is axonotmesis?
sustained compression causes nerve cell death distal to injury (Wallerian degeneration). regenerates 1mm per day
NCS gives prognosis
what is neurotmesis?
complete transection of the nerve
needs grafts or tendon transfers
what does a bumper injury to the lateral knee risk?
common peroneal nerve injury
what nerve do supracondylar fractures risk injuring?
brachial artery
ulnar nerve
classification for supracondylar fractures
Gartland classification
Gartland classification
1= undisplaced 2= displaced with intact cortex 3= completely displaced 4= multidirectional instability
what criteria must be met to clear a C-spine?
no history of LOC
GCS 15 with no alcohol
no significant distracting injury e.g. head, chest, other fractures
no neurological symptoms
no midline tenderness on palpation of C-spine
no pain on neck movement
what to do if C-spine criteria not met?
get XR or CT
how to assess pressure in compartment syndrome?
needle manometry
initial management of compartment syndrome
escalation to reg or consultant
remove external bandages or dressings
elevate leg to heart level
maintain good BP
what are thoracolumbar fractures associated with?
wedge insufficiency in elderly
burst fractures in the young
what does diagnosis of a fracture require?
2 XR views
