fracture management Flashcards
basic trauma care
A-E assessment
pelvic fractures are potentially life threatening - haemorrhage control
haemorrhage control from open fracturess
pain meds
assess distaal neuro-vascular status
restore pulses by realigning fractures and dislocations
refer x-ray
stabilizing splint
ortho referral
fast for surgery
diagnosis of fracture
look - deformity, swelling, bruising, colour
feel - tenderness, tension, crepitus, sensation, pulses
move - fracture site, adjacent joints
x-ray - two veiws at 90 degrees to ech other, joint above and below
salter-harris 1
through the epiphyseal plate
salter-harris 2
through the metaphhysis and the epiphysel plate
salter-harris 3
through the epiphyseal plate and into the joint
salter-harris 4
through the metaphysis and the epiphysis and also into the joint
salter-harris 5
crushing the epiphyseal plate
compartment syndrome
increased pressure in aa muscle compartment
perfusion jeopardised
emergency
signs of compartment syndrome
severe pain
pain on passive stretching of muscle
pain on palpation
tense and shiny compartment
decreased sensation
paresis
treatment of compartment syndrome
remove plaster and dressings
do not elevate limb
call senior
measure compartment pressure
preapre for surgery
fasciotomy
open fracture management
antibiotics, tetanus
wash wound with saline
bandage with saline packs
early operation within 6 hours
what operation do you need for open fracture
washout and debridement of the wound
further assess damage
early fracture stabilisation
how to stabilise the fracture
- traction
- external fixation as plaster of paris
- internal fixation as intramedullary nailing, plates and screws, K-wires
difference between extra-articular and intra-articular fractures
anatomical reduction is more important in intra-articular
complications of fractures
neurological
vascular
compartment syndrome
DVT
fat emboli
infection
malunion, delayed, non-union due to poor blood supply of poor stability and motion of fracture
