fractures Flashcards
quand on examine une fracture, 2 choses à éval (énoncé)
neuroasc
articulation en desssous et dessus
fractures qui peuvent avoir un Xray nég au début (4)
scaphoid fractures in wrist injuries,
elbow fracture,
growth plate fracture in children,
stress fractures
pt âgé qui ne peut pas marcher avec xray N quoi faire
si suspicion clinique
SCAN
high risk complications with fracture
1) open fracture
2) unstable cervical spine
3) compartment syndrome
ottawa ankle rules for xray (cheville) et pied 44 55 66
1) dlr malléole médiale (ou malléole interne) à 6 cm
2) incapable de mettre du poids (MEC) tout de suite après ou à ED
1) flr 5e méta ou naviculaire
2) incapable de MEC - 4 pas tt de suite ou à l’ED
Patients need an X-ray only if:
4 Unable to do 4 steps immediately AND
4 Unable to do 4 steps in the emergency department
or
5 Has pain at the base of the 5th metatarsal
5 Has pain at the 5caphoid (navicular)
or
6 Tenderness in 6 cm posterior edge of lateral malleolus
6 Tenderness in 6 cm posterior edge of medial malleolus
canadian c-spine rules for xray (superieur au nexus)
XRAY obligatoire:
- plus de 65 ans
- méchanisme dangéreux
- paresthésies
- incapable de rotate 45 degrès
inaplicable si glasgow en bas de 15
ottawa knee rules for xray (5)
aged 55 years or over
tenderness at the head of the fibula (lateral side)
isolated tenderness of the patella
inability to flex knee to 90 degrees
inability to bear weight (defined as an inability to take four steps, ie. two steps on each leg, regardless of limping) immediately and at presentation
atypical fracture in elderly and kids R/O
ABUSE
ortho emergency (VONCHOP)
Vascular compromise
Open fracture
Neuro compromise (Cauda equina syndrome) or potential neuro compromise (unstable C-spine fracture)
Compartment syndrome
Hip dislocation
Osteomyelitis / Septic arthritis
Unstable Pelvic fracture
what to give pt
analgesia
antibio prn
tetanus D2T5 prn
wrist most common injuries 4
- scaphoid fracture
- Perilunate injuries
- Scapholunate dissociation
- perilunate dislocation
- lunate dislocation - DRUJ injury
(distal radius ulnar joint)
shoulder injuries (2)
dislocation anétrieure - 97%
postérieure = convulsions
foot injuries ne pas oublier 1
lisfranc
méchanisme dangereux trauma (xray c spine) 5
fall more than 3 feet or 5 stairs (marches)
axial load to head (driving)
motor vehicle high speed - 100km. rollover, ejection
motorized recreational vehicles
bicycle stuck or collision
nexus c spine (hint: NSAID)
NSAID
neurological deficit
spinal tenderness
altered mental status
intoxication
distracting injury
