MSK procedures Flashcards
S/S of fx
Pain Swelling Deformity Eccymosis LOF
what is the most reliable sign of a fx?
PAIN
Open fx
a fracture that has communicated with the outside environment.
Regardless of size
Salter Harris classification
fx in child,
evaluate integrity of growth plate
higher number is worse px
SH I
S=Slipped
slip of growth plate
Transverse fx thru growth plate
slight widening of the plate at either side
SH II
ABOVE
fx thru Metaphysis only
MCC (70%)
SH III
LOWER
fx just thru epiphysis and growth plate
SH IV
THROUGH
fx thru epihysis and metaphysis and thru the growth plate
SH V
compression of growth plate (or ate least part of it)
“rammed and ruined”
worst possible outcome
1% of all fx
Colles Fracture
fx of distal radius
may involve the ulnar styloid
caused by falling on outstretched hand
dinner fork deformity
Trimalleolar fx
fx of the lateral malleolus
medial mallolus and the posterior tibia
landing flat on the heal form a height very unstable (ORIF)
Compartment Syndrome
complication of fx
The pressure inside the facial compartment exceeds the blood pressure.
Causes compromise of the circulation to the soft tissue, ischemia and necrosis.
Irreversible damage can occur in 8 hours.
tx w/ fasciotomy
systemic complications of fx
Fat embolism (think long bone or pelvic fx) or throboembolism
myositis ossificans
calficiations and bony masses can form in muscle
especially if there was a lot of bleeding
algodystrophy
regional pain syndrome
CHRONIC PAIN IN AREA OF FX
fracture blisters
vesicles or bullae arise in swollen skin directly over a fx
24-48h post injury
fluid or blood filled
can increase infection rate
Grade III Sprain
may need to immobilize
Severe pain–>NO PAIN
Diffuse swelling
Complete laxity of ligaments (lateral)
how long does it take for fx to heal
6-8 weeks
think delayed union
Grade I sprain
mild pain, little swelling, joint stiffness w/o laxity
ATF- brace
Grade II sprin
partial tear of lateral ligaments
moderate pain w/ loss of function
long vs short arm cast
Long arm cast PREVENTS supination and pronation
if fx is in the shaft… you need to do the long arm
short arm is OK for Colle’s
