Stabilization of Fractures
Must be done after the fracture is reduced in order to maintain reduction. This can be in the form of a cast, pins, external fixation, plates and screws, or IM nailing.
Early - neurovascular injury, infection, compartment syndrome, hardware failure, fracture of soft tissue or blisters.
Late - malunion, nonunion, avascular necrosis, osteomyelitis, arthritis, complex regional pain syndrome.
Fracture failing to heal by 6 months or failure to show progression over 3 months. Certain bones are more prone to non-union than others, usually because of poor arterial blood flow such as the tibia and scaphoid.
Smoking and NSAIDs drastically affect healing.
Bones that have healed, but not in the desired pattern. This may lead to arthritis of adjacent joints or altered function of the bone. This is usually treated with corrective osteotomy if it is clinically significant.
How Many X-Rays to Order
You need a minimum of 2.
More is better.
The middle portion of a long bone
The region of the long bone near the end
The region of the long bone at the end (after the growth plate)
You refer to the distal fragment section when describing the fracture.
For example, if a leg is broken and the lower fragment is more medial than the upper fragment, you would describe the fragment as, "medial displacement".
Apex Angulation of Fracture
When the fracture is in the middle of a long bone and the limb is bending in or out.
If bending inwards, it is known as an apex medial angulation
If bending outwards, it is known as an apex lateral angulation
Break of the ulna with dislocation of the radial head.
A - airway
B - breathing
C - circulation with hemorrhage control
D - disability
E - exposure / environment
If you make it to D and E, you have won!
In trauma, assume a C-spine injury until proven otherwise.
When dealing with the airway, do a chin-lift or a modified jaw thrust.
Can also utilize an OPA or an NPA.