Fractures - Upper body Flashcards
Depressed skull # can be managed by elevation. Extra care should be taken when # occurs in what location of the skull, why?
Midline depressed skull #
Elevation attempt may tear the sagittal sinus causing profuse and fatal bleeding
Simple, basic principle to detect fractures?
Axial compression, holding the proximal and distal ends of the suspected bone
Raccoon eyes are seen is which kind of #?
Base of the skull#
Bleeding from ear, nose, throat
Oto/Rhinorrhoea when dura matter is torn
Will all the base of skull# lead to otorrhoea/rhinorrhoea?
No
Dura matter tear leads to oto/rhinorrhoea
Circum-ocular hematoma, depression of infra orbital margin is seen in what fracture? What are other clinical features?
Malar/Zygomaticomaxillary complex#
Other C/F:
1. Swollen cheek
2. Subconjunctival haemorrhage
*3. Infra-orbital nerve damage - cheek
parasthesia
4. Infra-orbital margin- palpable step
5. Loss of malar prominence
6. Jaw opening - difficult
Which malar fracture requires reduction under general anaesthesia?
Displaced malar fracture
Method: Elevation by intra-oral or temporal approach
May require interosseous wiring, pinning or plating
Healing in 3-4 wks
Mandible fracture management
First aid: 4 tailed bandage
Rx: Internal fixation
Heals by 6-12wks
Dislocated jaw management
Downward traction with thumbs, additional reinforcement by rotating upwards with fingers
Which spinal fracture is associated with Kidney rupture?
L1
Stable spinal fractures
<50% compression of vertebral height
Laminar/minor fractures
Complete immobilisation (only in spinal#, tolerated mobility advised in other spinal problems)
Spinal brace, physio
Heals in 6-12 wks
DEXA/Bone density test in old for osteoporosis
Do unstable spinal fractures lead to partial or complete paraplegia?
Both
Rib fracture
Very painful
Rx: Analgesics, intercostal nerve block, elastic rib belt
Pneumothorax, spleen, hepatic, kidney injury (check)
Heals in 3-6wks
Clavicle fracture
- Fall on outstretched hand/direct blow
- Medial 1/3# mc
- C/F: Pain with shoulder movement, supports arm at elbow, clasped to chest
- Rx:
St Johns elevated brace/figure of 8 brace - even with over-riding of #, <2cm compression
Open reduction in >2cm shortening, denting of skin - Heals in 4-8wks
Check orthobullets for pics