Suspected Breaks or Soft Tissue Injury

Question 1

PILSDUCT

Answer 1

Pain
Irregularity
Loss of movement
Swelling
Deformity
Unnatural movement
Crepitus
Tenderness

Question 2

Neurovascular Assessment

Answer 2

Sensation
Movement
Capillary refill under two seconds
Temperature
Colour
Pulse

CHECK WITH 5 P’s

Question 3

Ottowa Ankle Scale

Answer 3

1. Palpate for tenderness at the medial and leteral malleoli, the big boney bit poking out
   Start distally and move six cm upwards
2. Palpate for pain or tenderness at the navicular bone - not pokey out bone on top of foot, one step in
3. Palpate fifth metatarsal
4. Ask patient to walk four consecutive steps

If 1/3 is positive there is 25% chance of fracture, x-rays indicated
If none are positive nearly impossible for fracture to be present.