Orthopedic Injuries Flashcards
The blood supply in each UE originates from the :
subclavian artery
The blood supply in each LE originates from the :
iliac artery
abduction
movement AWAY from midline
adduction
movement TOWARD the midline
Pathologic fracture
Fx caused when a medical condition weakens bone
Injuries that commonly occur w/ scapular fx
rib fx
pulmonary contusion
pneumothorax
Injuries that commonly occur w/ scaphoid fx
wrist, elbow, or shoulder fx
Injuries that commonly occur w/ pelvic fx
lumbosacral spine and long bone fx
intra-abdominal and GU injury
Injuries that commonly occur w/ hip dislocations
acetabulum or femoral head fx
Injuries that commonly occur w/ femoral fx
dislocation of ipsilateral hip
Injuries that commonly occur w/ patella fx
fx-dislocation of ipsilateral hip
Injuries that commonly occur w/ knee dislocation
tibial fx (distal pulse may be absent)
Injuries that commonly occur w/ calcaneal fx
ankle, leg, hip, pelvis, spine, and other calcaneus fx
comminuted fx
bone broken into two fragments
epiphyseal fx
occurs in growth section of child’s bone
greenstick fx
incomplete fx passing partway through the shaft but may cause substantial angulation
incomplete fx
does not run completely through the bone
oblique fx
broken at an angle across the bone; usually sharp, angled blow
spiral fx
caused by twisting or spinning force, causing a long, spiral-shaped brak
transverse fx
straight across the bone; direct blow injury
s/s of fx
deformity shortening swelling bruising point tenderness pain guarding crepitus false motion locked joint exposed bone ends
What is a sprain?
Stretch or torn ligaments
s/s of sprains
Point tenderness Swelling Ecchymosis Pain Joint instability
What is a strain?
Injury to muscle and/or tendon resulting from a violent muscle contraction or excessive sweating.
s/s of strain
Swelling Severe muscle weakness Point tenderness Pain Exacerbation of pain w/ passive movement of injured extermity
s/s Achilles tendon rupture
Pain from heel to calf and sudden inability to plantar flex the foot.
Moderate musculoskeletal injuries
Open fx of digits
Nondisplaced long bone and pelvic fx
Major sprains of major joint
Serious musculoskeletal injuries
Displaced long bone fx Multiple hand and foot fx Open long bone fx Displaced pelvic dx Dislocation of major joints Multiple digit amputations Lacerations of major nerves or blood vessels
Severe life-threatening musculoskeletal injuries
Multiple closed fx
Limb amputations
b/l femur fx
Critical musculoskeletal injuries
Multiple open fx of limbs
Suspected pelvic fx w/ hemodynamic instability
6 Ps of musculoskeletal assessment
Pain Paralysis Paresthesia Pulselessness Pallor Pressure
Hazards associated w/ improper stabilization of splints
Compression of nerves, tissues, and blood vessels
Delay in transport of a pt w/ light-threatening injury
Reduction of distal circulation
Aggravation of the injury
Injury to tissue, nerves, blood vessels, or muscles due to excessive movement of bone or joint
Do not use PASG if any of the following exist :
Pregnancy Pulmonary edema Acute heart failure Penetrating chest injuries Groin injuries Major head injuries
Management of compartment syndrome
Elevated extremity
Ice packs
Opening or loosening constrictive clothing and splint material
Administer oxygen
IV access. Crystalloid solution as needed
Immediate transport
Management of crush syndrome
Assess ABCs
Supplemental oxygen as needed
Consider bolus of crystalloid solution to increase intravascular volume
s/s of DVT
Swelling in extremity
Discomfort that worsens with use
Warmth and erythema of extremity
s/s PE
sudden onset of dyspnea pleuritic CP tachypnea tachycardia right sided heart failure shock cardiac arrest
s/s of fat embolism
Appear 12-72 hours after injury tachycardia dyspnea tachypnea pulmonary congestion fever petechiae AMS organ dysfunction
How to manage an elbow injury if limb is pulseless?
Apply gentle manual traction. If pulse does not return after one attempt, splint the limb in the most comfortable position. If pulse is restored, splint in whatever position allows the strongest pulse.
lateral compression pelvic ring disruption
Internally rotated around the sacrum
Volume of pelvis decreases
Other regions of body injured
open book pelvic fracture
anterior-posterior compression pelvic ring disruption from head-on injuries
significant blood loss
vertical shear
Major force applied to the pelvis from above or below.
Anterior components : fx of rami or disruption of symphysis pubis
posterior component : fx of ilium or sacrum or disruption of sacroiliac joint
shortening of affected side
massive hemorrhage into pelvis
straddle fx
Fall when a person lands in the region of the perineum and sustains b/l fx of interior and superior rami
open pelvic fx
life-threatening
laceration of skin in pelvic region, vagina, or rectum
high-velocity injury w/ subsequent massive hemorrhage
Management of pelvic fx
Monitor ABCs Immobilize spine IV access ( two if possible) Seek medical direction Stabilization of pelvis Immobilize to long board Transport to trauma center
signs of posterior dislocated hip
foot drop
hip joint flexed
internal rotation
signs of anterior dislocation hip
Extended straight out
Externally rotated
splinting dislocated hips
position of deformity
supine on scoop stretcher
support affected limb w/ pillows or rolled blankets
secure limb to backboard
Management of femur fx
Assess CMS Splint LE Oxygen as needed Establish IV access 20-mL/kg bolus of isotonic crystalloid solution to maintain radial pulses
