Chapter 29: Orthopedic Injuries

Question 1

Discuss

Splinting objective for long bone fx

Answer 1

Stabilize the joint above and below the fx

Question 2

Discuss

When do we correct a gross deformity with traction in the field?

Answer 2

When there is no distal PMS (with the exception of femor fx’s)

Question 3

Discuss

Tx: strains and sprains?

Answer 3

Treat any as a fx, since you never know. Assume pt has fx.

Question 4

Discuss

What’s articular cartilage?

Answer 4

Cartilage on the ends of bones in a joint.

Question 5

Discuss

What’s a subluxation?

Answer 5

An incomplete disclocation; disruption of the joint is not complete.

Question 6

Discuss

Types of fx’s

Answer 6

Greenstick, Comminuted, Pathologic, Epiphyseal, Oblique, Transverse, Spiral, Incomplete

Question 7

Discuss

What’s a greenstick fx?

Answer 7

Fx passes only partway through bone but can still cause angulation. Predominantly in children.

Question 8

Discuss

What’s a communited fx?

Answer 8

Bone broken into more than two fragments

Question 9

Discuss

What’s a pathologic fx?

Answer 9

A fx of a weakened or diseased bone

Question 10

Discuss

What’s an epiphyseal fx?

Answer 10

A fx that occurs in the growth section of a child’s bone and may result in growth abnormailities

Question 11

Discuss

What’s an oblique fx?

Answer 11

The fracture line is at an angle across the bone

Question 12

Discuss

What’s a transverse fx?

Answer 12

A fx that goes straight across the bone

Question 13

Discuss

What’s a spiral fx?

Answer 13

A fx caused by twisting

Question 14

Discuss

What’s an incomplete fx?

Answer 14

A nondisplaced partial crack. Difficult to distinguish from a contusion.

Question 15

Discuss

What effect might an anterior shoulder dislocation have on nerves?

Answer 15

May compress the axillary nerve causing a numb spot on the lateral shoulder.

Question 16

Discuss

Tx for dislocation?

Question 17

Discuss

What’s a sprain?

Answer 17

Tearing and damage to the articular cartilage, capsule, ligaments, or tendons. May resul in dislocation if tearing is complete.

Question 18

Discuss

What’s a strain?

Answer 18

Tearing or stretching of muscle that causes pain, swelling, and bruising of surrounding soft tissue.

Question 19

Discuss

How to do muscoulskeletal assessment?

Answer 19

6 P’s: Pain, Paralysis, Paresthesias (numbness or tingilng), Pulselessness, Pallor, Pressure. Assess pulse, cap refill, sensation, and motor function.

Question 20

Discuss

Hip dislocation

Answer 20

Almost always posterior. Anterior dislocation may interfere with sciatic nerve which control muscles in posterior thigh and below the knee along with sensation in leg and foot.

Question 21

Discuss

What are life threatening orthopedic injuries (survival probable)?

Answer 21

Multiple closed fx’s, Limb amputations, Bilateral femur fx’s

Question 22

Discuss

What are critical orthopedic injuries (survival uncertain)?

Answer 22

Multiple open fx’s, Suspected pelvic fx’s with hemodynamic instability

Question 23

Discuss

What’s a pelvic binder?

Answer 23

Device that provides stabilization to fractured pelvis, meant to reduce hemorrhage from bone ends.

Question 24

Discuss

What’s the most reliable indicator of an underlying fracture (in cases where it’s possible there isn’t one)?

Answer 24

Point tenderness