ED 2 Lower Extremity Flashcards
what is the only type of stable pelvic fracture?
ramus fracture; the only one treated without surgery
how will most patients with a pelvic fracture present?
groin pain, inability to walk following blunt trauma
what must you ensure before you insert a foley catheter into your patient with an unstable pelvic fracture?
make sure no blood at meatus or urethra
what are the four types of hip fractures?
1) femoral head
2) surgical neck
3) intertrochanteric
4) subtrochanteric
how will patient with a hip fracture present? how will their leg be positioned?
leg pain
leg shortened and EXTERNALLY rotated
how do we manage hip fractures?
ALL get admitted for surgery!
foley catheter, pain control
most common cause of hip dislocation? how will patient’s leg look when they present?
MVA
leg shortened and INTERNALLY rotated
how do we manage hip dislocations in the ED? reduction techniques?
SEDATE THEM!
1) hold pressure down on pelvis, other person pulls affected leg hard towards them
2) yank hard upwards while un top of person and stabilizing pelvis
a femur fracture in a young kid should make you concerned for what?
abuse
as with all long bone fx
what is the hallmark splint used for a femur fracture that can relieve pain and help neurovascular function?
traction splint (hare)
femur fractures always get what?
surgical fixation
which knee injury is considered a very high liability due to poor healing and outcomes?
tibial plateau fracture
why is diagnosing a tibial plateau fracture difficult? when should you consider it?
often non-displaced and difficult to see on x-ray
they will have pain out of proportion to exam, get a CT!
at which site is the fibula most common fractured? what is the most common mechanism of injury?
classically lateral malleolus
usually second to inversion injury
if you find a fibular fracture, what must you be absolutely sure to do?
check upwards for a maisonneuve injury! often the distal fracture radiates up and spirals, breaking the proximal fibula
treatment for a fibular fracture?
splint/non-weightbearing
this is a stable joint! but do have them FU with ortho
what do we worry most about with bimalleolar/trimalleolar injuries?
mortise disruption (widened mortise) – be sure to reduce
treatment for bimalleolar/trimalleolar injuries?
admit them! surgical TX definitive TX (unstable once mortise disrupted)
a positive thompson’s test is pathognomonic for what?
achilles tendon rupture
in what position do we splint an achilles tendon rupture?
splint in full PLANTAR flexion
a fall from a height puts you at risk for what?
calcaneal injury
