LOWER LIMB FRACTURE Flashcards
1
Q
Mechanism of LLF
A
High energy injury
- fall from height
- direct blow
- tackling injury
- motor vehicle injury
Low energy injury
- pathological fractures
- periprosthetic fractures
2
Q
Associated Injury - Compartment syndrome
A
risk of Compartment Syndrome - increased bleeding (pressure) causing nerve and muscle ischaemia (reduced blood flow) - seen when pain is disproportionate to injury suffered
Indication - 5 Ps
- Disproportionate pain
- paraesthesia (pins and needles)
- Pallor
- Paralysis
- Pulseless (lack of arterial supply)
3
Q
Types of fractures
A
- Greenstick
- Transverse
- Spiral
- Oblique
- Comminuted
- Compression
4
Q
Fracture Stability
A
- type of fracture
- location of fraction in relation to joint
- displacement of fracture
- consider effect on muscle action
5
Q
Fracture Classification
A
Weber A - fracture below tibiotalor joint - stable, undisplaced
Weber B - level with talor dome
- variable stability
- ORIF potentially required
Weber C - Fracture above the level of the syndesmosis
- Usually need ORIF
6
Q
Conservative physio management of fracture
A
- immobilise patient, provide walking aids depending on severity and type of patient
- provide advice and educate, ex. swelling management
- Provide isometric based exercises to maintain muscle strength
- 2/52 reevaluate WB status, following this, work on mobilisation on joints
7
Q
surgical physio management
A
- depends on whether limb is immobilised in cast
- 3-7/7 required of POP applied to wait for swelling to go down
- may perform AROM
-
When POP removed
- AROM can be commenced ASAP
- hydrotherapy helps ROM, muscle retraining and cardiovascular maintenance
8
Q
Calcaneal fracture
A
- fall from a height
- results in lumbar vertebral body burst fracture
- e.g. keep spine in neutral position, avoid contraction of abdominal muscles
- risk of neurological injury? test sensation, motor control, etc.
