Lower Limb Flashcards
What normally causes pelvic soft tissue injury, and how is it treated?
Trauma to superficial structures
Treated with RICE
What causes a pelvic fracture, and how are they classified?
High energy impact (energy decreases with age ie osteoporotic fractures)
Pelvic is a bony ring made up of different bones
High energy -> disruption of bony ring -> fracture
Classified via Young-Burgess system:
I- anteroposterior compression (front to back)
II- Lateral compression → side to side forces
III- Vertical shear → vertical forces
APC and LC are ranked I-III; stable, rotation unstable but vertically stable, and fully unstable
LC III is known as ‘windswept’ appearance
VS isn’t ranked as they’re always severe
How do pelvic fractures present?
Localised pain, swelling, bruising
Weight bearing issues
Possible signs of internal bleeding
How are pelvic fractures investigated and treated?
X-ray to asses injury and CT to investigate any associated injuries in surrounding sites
MRI in low energy injury as X-rays are often normal
Stable -> conservative management
Unstable -> pelvic binders, or ORIF
What causes a femoral shaft fracture, and how are they classified?
High energy and major trauma (or osteoporotic/pathological)
Classified by location (proximal mid or distal) and type, ie transverse, oblique, spiral, or comminuted
How does a femoral shaft fracture present and what are the complications?
Severe pain swelling and bruising
Deformity
Weight bearing issues
Signs of hypovolaemic shock
Complications-
Fat embolism
Heavy blood loss
How is a femoral shaft fracture managed?
Thomas splint for initial stabilisation
Operative for long term- ORIF, IM nails, or plating
What causes a tibial shaft fracture?
What are the 4 subtypes?
High energy- direct force
Low energy- indirect torsion
Transverse, oblique, spiral, butterfly
How do tibial shaft fractures present and what are the complications?
Pain, inability to weight bear, deformity
30% ish present with an associated fibula fracture
Compartment syndrome is common
How are tibial fractures investigated and managed?
X-ray- often obvious
Can be managed via conservative closed reduction, or nailing/ORIF in more severe cases
