5.2 Common Orthopedic Trauma &Management Flashcards
(31 cards)
Strain vs sprain vs contusion
-Injury to Tendon and muscle
-Tendon and ligament
-Small blood vessels rupture, bleed into soft tissue
Management of soft tissue injury
RICE
Rest
Ice (<20min)
Compression
Elevation
CryoCuff Cold therapy system
By gravity exchange cold water between cooler and cuff
Dislocation vs subluxation
Complete vs partial displacement
Medical management of dislocation
Immobilize the affected joints
-RICE
-Analgesia, muscle relaxants
-Closed reduction, fail then open
-Splint, brace, cast, traction after reduction
ROM exercise outcome
Restore original ROM
Reduce stiffness and muscle waste
Fracture definition
A break in the continuity of bone
Consequence of fracture
Soft tissue edema, hemorrhage into muscle and joint, joint dislocation, ruptured tendons, damage blood and nerve vessel
Affect mobility and sensory perception
Type of fracture
Pathologic fracture (spontaneous)
Stress fracture(excessive strain/stress)
Compression fracture (vertebrae)
Open fracture
Closed fracture (skin intact)
Open fracture grading
The Gustilo-Anderson classification
- Type I- <1cm, clean wound
- Type II- 1-10cm, minimal soft tissue injury, no flaps or avulsion
- Type II- >10cm, highly contaminated, extensive soft tissue damaged, involve vascular injury or traumatic amputation
Flaps or avulsion
甩皮
Direction of fracture line
Transverse (straight)
Spiral (S)
Oblique (斜)
Greenstick
Depressed
Avulsion
Comminuted
Impacted
Driven inward
扯裂性(by tendon or attachment)
粉碎性
Into another bone fragment
Complication of fracture
Acute compartment syndrome
Hypovolemic shock
*Fat embolism syndrome
Venous thromboembolism
Infection
Ischemia necrosis and delayed union
Definition of reduction
Restoration of bone fragment into anatomic realignment and positioning with immobilisation
How to immobilize injury part after reduction
Close reduction: traction/splint/cast/orthoses
Open reduction: internal fixation
Orthoses
矯正器
Type of traction
Skin traction
Skeletiontraction
Purpose of skin traction and skeletal traction
Skin traction:
Short term treatment (wait surgery)
Decrease muscle spasms
Apply tape, boots, splints
Pulling force 5-10pounds
Skeletal traction:
Long term pull
Pin or wire insert into bone
Counter traction, 5-45pounds
Clean pin site of traction with
Chlorhexidine, rinse with sterile saline, dry with sterile gauze
External fixation
-Device: direct fixation
-Metal pins and wires Insert into the bone and compress fracture fragment
-Use when cast or traction not appropriate
Cast: POP vs fiberglass
Pop- keep it dry
Fiberglass- dry it with dryer or cool setting
Possible complication of cast
Increase pain despite elevation, ice
Swelling under pain and dislocation
Pain during movement
Burning and tingling 刺痛
Sores or foul odor
Indication of amputation
-Peripheral vascular disease e.g. DM—> ischemia
-Trauma
-thermal injury, tumors, osteomyelitis, congenital limb disorder
