Session 4 - Joint injury Flashcards
What is ABC when assessing open wounds?
- Adequate skin cover
- Bone exposed
- Circulatory comprimise
What are the stages of gustillo & anderson staging?
- i-> >1cm, moderately contaminated
- iii-> High velocty, farmyard
What is a manipulation?
-When you move things out of place back into place under gas and air, sedation or local aaethetic
What is the most important thing to check for before preforming a manipulation?
-Neurovascular damage
Name some classic nerve and joint injury associations?
- Shoulder dislocation and axillary nerve
- Knee dislocation and arterial injury
- Hip dislocation and sciatic nerve
- Colles fracture and median nerve
How can joint injurys be investigated?
- Xray anterior and lateral view, stress views
- Arthrography-> radiolucent dye inserted into joint for smoothness
- MRI and CT
- Aspiration -> examine joint fluid; clear ok, bloody-> ?fracture?ligament damage, fatty-> ?broken
What are the ATLS pronciples?
A-airways
B-Breathing and ventilation
C-Circulation
What is the first way to treat an open injury?
- Clean and irrigate with saline
- Reduction
- IV antibiotics
- Tetanus states
- Cover
What is a sprain?
-Damage to ligament via stress
What is a grade 4 sprain?
-A complete sprain with requires surgery
What are the most frequent sites of sprain?
-Knee, ankle and thumb
Define dislocation
-A complete loss of continuity of the articulating surfaces of a joint
Which joints are most frequently dislocated?
-Shoulder, Finger, elbow
What is a sublaxation?
-Partial loss of continuity of the articulating surfaces of a joint
Define fracture
-A break in the continuity of the bone
How do you assess a fracture involving a joint?
- Open vs closed
- Position/displacement
- Depression
- Comminution (fragments)
- Bone quality
How can you treat a fracture involving a joint?
- Conservative and support -> bandage/break
- Manipulation and cast or wires
- Open reduction internal fixation -> screws plates etc
- External fixation -> frame
- Arthroplasty (replace)
- Excision -> remove all fragments and leave to heal
- Osteotomy-> realignment when healing hasnt occured properly
- Amputation
- Arthrodesis ->fusion of bones by surgical means
When is the appropriate time to assess an open wound injury?
-When damaged tissue has been removed in surgery
