5- injured limbs & basic fracture management

Question 1

what is AMPLE mnemonic for basic trauma history?

Answer 1

A = Allergies
M = Medications
P = Past medical
L = Last meal
E = Events leading to injury

Question 2

what motor tests for upper limb nerves can be done?

Answer 2

• ok sign (test strength) = median nerve
• abduct fingers - look at 4th&5th (starfish with fingers) = ulnar
• thumbs up (thumb extension strength test) →radial

Question 3

what is compartment syndrome?

Answer 3

increased pressure in muscle compartment

compartment pressure = perfusion pressure = ischaemia, necrosis & death

• it’s surgical emergency, no delay = fasciotomy

Question 4

what are most common compartments for compartment syndrome?

Answer 4

• anterior & deep posterior compartment of leg
• volar compartment of forearm

Question 5

what are the important clinical signs of compartment syndrome?

Answer 5

4 P’s!!

• pain (even passive)
• paraesthesia
• pallor
• pulselessness (late sign)

Question 6

what is basic fracture care? (2 main basic principles)?

Answer 6

splint limb & analgesia

Question 7

what is positive vs negative for hemiarthroplasty vs total arthroplasty for hip replacement?

Answer 7

hemiarthroplasty →replace femoral head (nothing to cup) - bigger head so less chance of dislocation, quick operation, not as good mobility as wears out

total arthroplasty →replace cup & ball, ball smaller though so chance of dislocation higher. better mobility

= intracapsular management