Joint Injuries

Question 1

What are the types of joint injury?

Answer 1

Sprain
Fracture
Subluxation
Dislocation
Fracture dislocation/subluxation
*fractures are said to be open or closed depending on whether the skin is pierced.

Question 2

What must you always check before intervention with a joint injury?

Answer 2

Check for neurovascular damage.

Question 3

What are some common examples of joint injury and neurovascular damage?

Answer 3

Axillary nerve and shoulder dislocation.

Median nerve and colles fracture.

Question 4

What are some examples of how you would see joint injuries.

Answer 4

Two x rays (anterior to posterior view)
Arthrography (uses coloured dye)
MRI scan
CT scan
Aspiration

Question 5

What is an MRI scan good for looking at?

Answer 5

Soft tissues.

Question 6

What is a CT scan good for looking at?

Answer 6

Bone.

Question 7

What is aspiration of a joint?

Answer 7

Extracting fluid from the joint. The colour of the fluid can be clinically useful.

Question 8

What is the general course of treatment for a joint injury?

Answer 8

ATLS
Take photo
Open injury needs cleaning, irrigation and reduction.

Question 9

What would you do if a patient had an open joint injury?

Answer 9

Do a wash out, IV antibiotics, check the tetanus status and cover the wound.

Question 10

What dressing would you never use to cover cartilage?

Answer 10

A Betadine dressing.

Question 11

What is a sprain?

Answer 11

Damage to a ligament. Forces stress the ligaments eg lengthen.
Can be complete or partial.
Damaged fibres with continuity intact.
Common sites are the ankle and knee.

Question 12

How would you treat a sprain?

Answer 12

Rest it, put ice on it, compress it and elevate it - RICE

*for more severe injuries can have anterior cruciate ligament reconstruction.

Question 13

What is dislocation?

Answer 13

Complete loss of continuity of the articulating surface of the joint.
Eg finger, shoulder.

Question 14

What is subluxation?

Answer 14

Partial loss of continuity of the articulating surfaces of the joint.
Shows that the capsule isn’t very good.

Question 15

What is a fracture?

Answer 15

A break in the continuity of the bone.

Question 16

What causes fractures.

Answer 16

Stress, trauma, a deficiency eg osteoporosis or pathological eg tumour or infection.

Question 17

What are the treatments of joint injuries?

Answer 17

Conservative and support
Manipulation and cast
Manipulation and wires
Open reduction, internal fixation - screws, plates and wires
External fixation - Ilizarov
Arthroplast - hemi or total (replace)
Excision - remove
Osteotomy - breaking and straightening
Amputation - done only if no blood supply or infection
Arthrodesis - stiffening

Question 18

How cold you treat a hip fracture?

Answer 18

With a hip replacement - ball or screws

In severe cases can remove the head of the femur.

Question 19

What are the 2 types of hip fractures?

Answer 19

Extracapsular and intracapsular.