Fatigue fractures or March fractures can commonly be called
Stress fractures
Signs of a fracture include the following
Deformity Shortening Swelling Guarding Tenderness Crepitus
A fracture that is parallel to the long axis of the bone
Linear fracture
A fracture that is straight across a bone at right angles to each cortex
Transverse fracture
A fracture at an angle across the bone
oblique Fx
More than two fracture fragments in one Area of bone
Comminuted Fx
Less than two fracture fragrance but breaks occur in different parts of the bone
Segmental fracture
Displaced fracture
Ends of the fracture move from their normal position
Avulsion fracture
Muscle contraction causes the insertion site of the muscle to be fractured off of the bone
Can a LBB to be used as a full body splint
Yes
When should you complete full assessment of musculoskeletal injuries in a critical patient
In route
What is typically your greatest concern with a fracture
Hypoperfusion
Treat for possible shock if pale cool or clammy
The 6 P’s of musculoskeletal assessment
Pain Paralysis Paresthesia Pulselessness Pallor Pressure
What are you attempting to identify with palpation at an injured site
Instability, deformity, abnormal joint continuity, displaced bones, Crepitus, Distal pulses
Potential blood loss from the pelvis fracture
1500 to 3000 mL
Potential blood loss for a femur fracture
1000 1500 mL
Potential blood loss for humorous, tip fib, ankle or elbow fracture
250 to 500 mL
Potential blood loss for a radial or ulna fracture
150 to 250 mL
What to drug classifications can help reduce pain and a fracture site
Analgesics an antispasmotics such as diazepam and lorazepam
Cold packs should be used during what time frame
Initial 48 hours
What timeframe should you avoid using hot packs
The initial 48 to 72 hours
What are the benefits of splinting
Reduces further damage two muscles, nerves, vessels, skin
Allows clots to form
What is the best way to stabilize multiple fractures
Long backboard
What are ossification centers
Growth plates
What are the types of injuries that a blood vessel can sustain due to a fracture
Contusion, Laceration, kink or band, pseudo aneurysms or a thrombosis
One of the most devastating consequences of musculoskeletal injury
Compartment syndrome
Open are safe from developing compartment syndrome
False
Signs and symptoms of compartment syndrome
Disproportional localized searing pain not relieved by medication Firm to the touch Pallored skin Paresthesia Burning numbness Pulselessness is a late sign
Management of compartment syndrome
Elevate extremity to heart level
Cold packs
Openly losing constrictive clothing and splinting
High flow oxygen
Bolus of fluid to help kidneys flush toxins due to Rhabdo
A prolonged compressive force that impairs muscle metabolism and circulation
Crush syndrome
What are the primary substances of concern and crush syndrome
Lactic acid, potassium, and myoglobin
Treatment to take before releasing the compressive force in a crush injury patient
High flow oxygen
Bolus of fluid
EKG monitoring for hyperkalemia
Albuterol treatment to protect against potassium overload
After extrication in a crush injury patient, if an EKG shows hyperkalemia what is the treatment
Calcium chloride and sodium bicarbonate
Signs and symptoms of a DVT
Disproportionate swelling of an extremity discomfort that worsens with use
Warmth and erythema
What is Volkman ischemic contracture
A condition in which muscles of the forearm degenerate from prolonged ischemia
What is a major complication of the scaphoid fracture
Avascular necrosis
What is the functional position for an injured hand splint
The wrist and 30° of dorsiflexion with fingers slightly flexed
Three types of pelvic fractures
Lateral compression
Vertical sheer
Anterior posterior compression
Does the pelvic volume increase or decrease in the lateral compression fracture
Decrease
Does the pelvic volume increase or decrease In an anterior posterior compression pelvic fracture
Increases
A.k.a. open book pelvic fracture
Does the pelvic volume increase or decrease in a vertical sheer pelvic fracture
Increase
Is a patient with the vertical sheer pelvic fracture likely to display a significant shortening of The affected limb side
Yes
Should you reassess pelvic stability more than once
No
Management of a unstable pelvic fracture
Two large bore IVs and fluid administration to maintain adequate tissue perfusion
Pelvic binder
ABC’s
Spinal stabilization
What can a hip fracture consist of
Femoral head, femoral neck, intertrochanteric region or proximal for moral shaft
What are fractures of the for moral head usually associated with
If this location
Intertrochanteric fractures are usually associated with what population
Geriatric due to falls
What is a common presentation for a displaced hip fracture
An externally rotated and shortened leg
Management of a femoral fracture
Treat for shock Spinal mobilization IV access Traction splint Pain medication
Common complications of a tib/fib fracture
Compartment syndrome, neurovascular injury, infection, poor healing, And chronic pain
A calcaneus fracture is often associated with what other fractures
Knee pelvis and spine
Requires spinal stabilization particularly if it is a bilateral calcaneous fracture
Why is a sternoclavicular dislocation a possibly life threatening injury
Due to possible damage of the trachea, esophagus, jugular vein, subclavian artery, Carotid artery
Common cause of a shoulder dislocation
Falling on an outstretched abducted and externally rotated arm
