Osteo, Avulsions & Degloving Injuries, Wound Infections

Question 1

common approximately 4 days post injury
initial symptoms is pain with or without swelling
progresses to tenderness, erythema, warmth and swelling
may indicate retained foreign body (consider wound exploration/imaging)

Answer 1

cellulitis

Question 2

palpable, tender, warm fluctuant mass that may progress to swelling and drainage

nearly always indicative of retained foreign body or MRSA
requires I&, followed by wound packing and loose dressing
ABX if signs of cellulitis or MRSA

Answer 2

abscess

Question 3

initial symptom is pain (usually > 7 days post injury)
examination and x-rays likely to be normal in early stages (MRI may be required)
elevated ESR and CRP
requires immediate surgical referral (abx may be withheld until bone cultures obtained in surgery)

Answer 3

osteomyelitis