Lower body Fractures

Question 1

Pelvic # mx

Answer 1

Stable - analgesics, bed rest
Unstable - pelvic wrap, angio, Prophylactic embolisation of internal iliac arteries

Question 2

Common type of dislocation of hip, c/f

Answer 2

Posterior dislocation
1. Very painful, shortened
2. Adducted, medially rotated, slightly flexed
3. Mx -
●Analgesics, xray
●Early reduction (↓A) v imp to prevent
AVASCULAR NECROSIS OF FEMORAL HEAD
●Xray: confirm reduction, other # missed before
●CT - intra articular bone fragments

Question 3

Tibial #

Answer 3

No displacement - full length cast
Displaced - Reduction (↓GA), cast

Long time to heal: immobilisation for
16wks - adults
8wks - children

Question 4

Foot stress #

Answer 4

1. Atheletic pts
2. Navicular, calcanium, metatarsals
3. Localised pain esp when wt bearing
4. Swelling
5. Xray - 50% misses the #, repeat in 2-3wks
6. Confirm with nuclear bone scan