Fractures/dislocations Flashcards
Looking for?
Feeling for?
Look: skin tenting, wounds, deformity
Feel: apex, continuous, assess neurovascular status
Critical to document?
NVS post intervention
What is the safe anatomical position?
elbow 90 degrees/thumbs up, knee at 30, elbow at 90
Sternoclavicular fracture
high energy. If posterior can affect lungs.
Broad arm sling
Acromioclavicular dislocation
skin tenting
Broad arm sling
Clavicular fracture
skin tenting
broad arm sling
How different is squaring off in shoulder dislocation vs ACM dislocation?
Squaring off more lateral in shoulder dislocation
Common nerve palsy in shoulder dislocation
Axillary nerve
uncommon - brachial plexy
Tx: cunningham method/ broad arm sling
What is laxation erecta?
Inferior dislocation of shoulder
Proximal humeral fracture?
Very common elderly osteoporotic
Tx conservatively with collar and cuff unless young/v displaced/v high energy
Midshaft humeral fracture?
tends to be radial due to bone proximity - document pre and post radial nerve examination. Treat with - collar and cuff or benecast or humeral brace
Distal humerus fracture?
nasty, near growth plates
NV status. DO not manipulate, usually need surgery.
Commonest nerve injury is anterior interossus median nerve injury - fpl, dfp in index.
Elbow dislocations
f complex: evulsion injury or articular injury.
Need traction and counter traction - difficult (fatigue muscle), use thumbs to flip it back by pushing.
Forearm fractures prehosp?
DO NOT MANIPULATE.
Can worsen
Require surgery
Common posterior hip dislocation mechanism?
RTA/fall
