Muscculo-Skeletal Trauma Flashcards
Polytrauma
Trauma to several body areas or organ systems
Are upper or lower limb fractures more life threatening and disabling
Upper more disabling
Lower more severe injuries
Haemorrhage in which region of the body is most severe
Pelvis
Where does blood come from in a pelvic haemorrhage
Posterior pelvic venous plexus
Cancellous bone surfaces
Arteries less commonly
How is a pelvic fracture stabilised
External fixation for 8wks
Crush syndrome
medical condition characterized by major shock and kidney failure after a crushing injury to skeletal muscle.
Compartment syndrome
condition in which increased pressure within one of the body’s anatomical compartments results in insufficient blood supply to tissue within that space
Vasospasm
sudden contraction of the muscular walls of an artery. It causes the artery to narrow, reducing the amount of blood that can flow through it.
Neurapraxis
nerve demyelinated with no injury or disruption to the axon or its surroundings.
temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks
Axonotmesis
damage to the axon and its myelin sheath, myelin sheath compressed but not severed
Neurotmesis
Complete severance of nerve
Characteristics of a muscle suitable for muscle transfer
Superficial
Another muscle can take over function
What is the acronym for treating soft tissue trauma
PRICE
protect rest ice compression elevate
3 types of fracture reduction
Closed / manipulation
Traction
Open reduction internal fixation ORIF
Reduction
Returning a fracture to correct alignment
Closed reduction
manipulation of the bone fragments without surgical exposure of the fragments
When is Traction used
When fracture/dislocation needs slow reduction
Open reduction internal fixation
Fracture procedure to return bones to alignment and fix with screws, rods, and plates
What is a rigid and a semi rigid way to hold a reduction
Rigid - internal fixation
Semi rigid - plaster
Intra medullary nail
metal rod that is inserted into the medullary cavity of a bone and across the fracture in order to provide a solid support for the fractured bone
Absolute indications for operative treatment of a fracture
Displaced intra articular fractures
Open fractures
Vascular injury
Compartment syndrome
Pathological fractures
Non union
Pathological fracture
bone fracture caused by weakness of the bone structure that leads to decrease mechanical resistance to normal mechanical loads
Relative indication for operative treatment of a fracture
Loss of position or poor functional result with closed treatment
Poor blood supply
Medical indications
Clinical union
Bone moves as 1
Radiological union
At least 3/4 cornices healed on 2 views
Fat embolism
Fat enters bloodstream and blocks blood flow
How can a fracture lead to a fat embolism
Fat enters blood from injury
6 Ps of MSK assessment
Polar
Pallor
Pain
Pulseless
Paralysis
Paraesthesia
What happens when the pressure in an anatomical compartment exceeds the perfusion pressure of te compartments
Collapse of venues and capillaries
What compartment pressures are normal, elevated, and emergency
Normal - 0-10mmHg
Elevated - 20-30mmHg
Emergency - 30+mmHg
How is compartment syndrome diagnosed
Clinical presence
Pressure monitoring
Compartment syndrome treatment
Fasciotomy
Triad of symptoms from fat embolism
Neurological - fat lodges in white matter
Pulmonary - fat acts like PE
Petechiae - fat lodges in blood vessels
Does fat embolism lead to white specs in white or grey brain matter on MRI
white matter
Fat embolism treatment
Fluids
Oxygen
Albumin
Why is albumin given to treat fat embolism
Binds fat
Does venules or capillaries shut first when compartment pressure increases
Venules
Venoules shut at 20mmHg
Capillaries shut at 30mmHg
Paraesthesia
Pins and needles sensation with loss of light touch, vibration, and discriminatory touch
How does compartment syndrome present
Shiny skin
Cold
Painful
Bulging
