Fractures and soft tissue injuries Flashcards
week 2
In reaching a diagnosis of soft tissue injury/fractures, what should you consider?
- History
- Past medical history incl medications
- Physical examination
- Imaging
What is involved in the management of injuries?
- Immediate management (resus, prophylactic protection)
- MSK history and exam
- Diagnostic tests
- Definitive management (treatment)
- Rehabilitation
Soft tissue injury
Acute connective tissue injury. May involve: skin, subcutaneous tissue, muscle, ligament, tendon, nerve, blood vessel, capsule, cartilaginous structures.
What should you look out for when assessing soft tissue injuries in children?
Signs of child abuse
Signs of child abuse with soft tissue injuries
Bruising in unusual places (e.g. inner thigh, under arms) Burns Multiple injury sites Fractures in children under 1 Atypical fracture patterns given context
Age related changes to the skin and soft tissue can include:
Thinning Loss of strength Loss of elasticity of skin Loss of subcutaneous tissue Blood vessels more fragile
First degree soft tissue injury
Minor contusion with bleeding
Minimal pain/brusing
Minimal functional impairment
Second degree soft tissue injury
Moderate contusion, some tearing of fibres. Overalls structure in tact.
Bruising, muscle spasms, pain
Joint is stable although painful, some loss of muscle power/range
Third degree soft tissue injury
Structural disruption
Severe bruising, muscle spasm and pain
Instability and/or loss of muscle function
Immediate management of soft tissue injuries uses the acronym…
PRICE
PRICE =
Protection Rest Ice Compression Elevation
What are the key physical signs of a fracture?
Local bone tenderness Crepitus Deformity Swelling Loss of function
Ways to image fractures and soft tissue injuries
X-ray, CT, MRI, ultrasound
What imaging technique is best for soft tissue?
MRI
Skin intact, fracture uncontaminated
Closed/simple fracture