Trauma principles (Dr. Smith)

Question 1

What are the principles/ goals when treating a patient with open fractures?

Answer 1

1) convert a contaminated wound into a clean wound
2) restore function
3) obtain cosmetic result if possible

Question 2

What are the principles of internal fixation?

Answer 2

1) atraumatic technique (avoid damaging nerves or anything else that’s important)
2) anatomic reduction (importance of anatomy)
3) rigid internal compression (goal of internal fixation is compression)
4) early mobilization (internal fixation helps with this, minimizes muscle atrophy from cast)

Question 3

What protocols exist when treating patients with a gunshot wound?

Answer 3

1) debride and irrigate wound
2) remove bullet fragments that are easily visible, near neurovascular structures or in joints
3) stabilize any fractures

Question 4

If a wound is exposed for more than 6 - 8 hours…

Answer 4

it’s considered infected and should not be closed during initial visit. You should give antibiotics, wait a few days, and have patient return to assess the infection level.
* only close when you are comfortable that there is no longer infection present.

Question 5

Open fractures will always require…

Answer 5

multiple surgeries.

* minimum of two.

Question 6

1 cause of calcaneal fractures

Answer 6

falls from a height.

* lateral wall blowout fracture was example in class.