Trauma

Question 1

Mangled limb:

Answer 1

Limb with injury to at least 3 out of 4 systems:
- soft tissue
- bone
- nerve
- vessels

Question 2

Tourniquet definition

Answer 2

A constricting / compressive device to control venous & arterial blood flow to extremity for a period of time, to create bloodless surgical field & reduce perioperative blood loss

Question 3

Tourniquet length & width:

Answer 3

Should be individualized considering the different size & circumference of the patient’s limb

Length - overlap btw 3 to 6inches

Question 4

Proximal humerus fracture, predictors of humeral head ischaemia:

Answer 4

Hertel criteria:
1. <8mm medial calcar length attached to articular segment (vascularity of the articular segment likely to be preserved if >8mm of calcar is attched to the articular segment

2. Disrupted medial hinge
3. Increase fracture complexity
4. Displacement >10mm
5. Angulation >45 degrees

Predictors of humeral ischaemia DOES NOT predict subsequet AVN