Fracture Management Flashcards
What are the regions of long bones?
- Epiphysis (outcrop/after the physis)
- Physis (growthplate)
- Metaphysis (neck)
- Diaphysis (long/middle part)
What are the three types of fracture lines?
- Transverse
- Oblique
- Spiral
What is six extra ways to describe fractures?
- Intra-articular
- Comminuted
- Segmental
- Impacted
- Avulsion
- Compression
How to describe anterior/posterior and medial lateral?
- Volar and dorsal
- Ulnar and Radial
Basic fundamental of imaging fractures?
ALWAYS get AP and lateral views at 90 degrees from eachother
**if initial films negative, but suspicion still high, obtain CT/MRI vs repeat interval films
What should you always give for someone with open traumatic wounds? thing vaccination
Tetanus booster
Who needs a tetanus booster and who doesn’t?
Everyone with open wounds unless you know its been less than 5 years since their last booster. If unknown if they ever got vaccinated in the first place and dirty wound, booster + tetanus immunoglobulin
What are main components of initial examination?
AWLS/ATLS for primary survey and rule out other more threatening conditions. After, look at neurovascular status above and below injury and document it.
When should you suspect an open fracture?
Any break in the skin overlying a fracture..even if you don’t see bone, cause sometimes they pull back after breaking the skin
Who needs immediate referral?
- Arterial injury
- Nerve injury
- Open fractures
- Tenting of skin
- Compartment syndrome
- Extensive soft tissue damage
- Multiple fractures
- Intra-articular fractures
- Fracture-dislocations
- Growth plate fractures
What is a SAMPLE history?
- signs/symptoms
- allergies
- meds
- pertinent past med history
- last meal
- events leading up to incident
How to examine a fracture?
-palpate the entire bone and joints above and below the fracture
Practical acute management?
- Immobilization; splinting most cases
- Pain management; tylenol/meloxicam, opioids, ketamine, peripheral nerve block, hematoma block
- Ice and elevation!!!
Greenstick fracture?
-pediatric, break of only one cortex; bowing/plastic deformity
Types of physeal injuries?
Type 1 = parallel along growth plate
Type 2 = along growth plate and then up proximal
