FEMUR FRACTURE

Question 1

DOCUMENTATION

Answer 1

INSPECTION
Circumferentially – check for “open”
Compare to opposite side

PALPATION
Neurovascular exam of every compartment
Exam joints above and below
Thoroughly feel the entire bone to r/o multiple injuries Point of maximal tenderness

ROM:
Joint or limb prior to the XRAY

NEUROLOGICAL EXAM LOWER LIMB:

XRAY:
Order proper series
Order 2 views (min)

CT if unclear

FRACTURE DISCRIPTION
Open or closed
Location: proximal, middle, distal thirds
Fracture Pattern: Transverse, Oblique, Spiral, Comminuted; Angulation
Dislocation / Subluxation: direction of dislocation, distal anatomy relative to proximal
Displacement: degree of displacement, distal anatomy relative to proximal
Angulation: Deviation from the mid like, volar vs. dorsal, distal relative to proximal

Question 2

DDX: NORMAL XRAY

Answer 2

DDx: SCARED OF

Septic
Compartment Syndrome
Abuse
Referred Pain / Report is False
Dislocated / Subluxation
Operative Soft Tissue Injury
Fracture

Question 3

MANAGEMENT

Answer 3

OPEN FRACTURE
Cefazolin 2 g IV

ZIMMER SPLINT