Musculoskeletal trauma and emergency orthopaedics Flashcards
Define polytrauma
Trauma to several body areas/ organ systems
Are upper or lower limb fractures or dislocations associated with more severe injuries
Lower limb
Are injuries to upper or lower limb more likely to be disabling
Upper
Are lower or upper limb transplants better
Lower
Where is blood most lost from
Pelvis (a litre an hour)
How much blood can be lost in two hours from
a) tib/ fib
b) femur
Both 500ml in 2 hours
What blood vessel structure is most affected by pelvic fracture
Posterior pelvic venous plexus (85%)
How much of pelvic bleeding following a fracture is arterial
<10%
What is the mortality rate of a pelvic fracture
10%
Complications post pelvic fracture
Chronic pain (25-30%)
What is immediate treatment of pelvic fracture
Immobilise and stabilise
Tape the feet to stop them from moving
How long should external fixation frame be left on for
8 weeks
What soft tissue injuries can affect the skin
Open fractures
De-gloving
Ischaemic necrosis
What type of injuries are more likely to ischaemic necrosis
Crushing injuries
What soft tissue injuries can affect vessels
Vasospasms
What is neurapraxias
No axonal damage, but axon compressed for short while before pressure is released
What is axontmesis
Axon damaged, but endoneuronal CT is intact
What is neurotmesis
Laceration where axon and everything is broken
What is usually done with open reduction
Internal fixation
What does ORIF stand for
Open reduction internal fixation
What are the risks of ORIF
Infection
Can slow healing if too rigid
When is traction used
Fractures or dislocations requiring slow reduction
What 2 ways can a reduction be held
Plaster- semi rigid
Rigid- internal fixation
What are the disadvantages of treating fracture non-operatively
Slow rehab
Joint stiffness
Higher risk of malunion
Higher risk of non-union
