Flashcards in Trauma and Emergency Orthopaedics Deck (17)
What are the six elements to advanced trauma life support?
• Airway & C-spine Control
• Breathing & Ventilation
• Circulation & Haemorrhage Control
• Disability & AVPU (alert, voice, pain, unresponsive)
• Exposure & Environment Control
What are the 6 P's of a musculoskeletal assessment?
Pain, pulse, pallor, polar, paralysis, paraesthesia
What is the possible quantity of blood loss from a pelvic fracture in the first two hours?
Where does bleeding from a pelvic fracture come from?
o Bleeding is mostly from the posterior pelvic venous plexus and bleeding from the cancellous bone surfaces and less than 10% of the bleed is arterial. This is because the pre-sacral venous plexus overlies the sacroiliac joint, and therefore a fracture disrupts the SI joint and leads to the tearing of veins and therefore bleeding.
What quantity of blood may be lost from a femur, tibia or fibular fracture in the first two hours?
Temporary, non-severe damage to a nerve that will heal
Where axons and their myelin sheath are damaged, but Schwann cells, the endoneurium, perineurium and epineurium remain intact
This is the most serious nerve injury in the scheme. In this type of injury, both the nerve and the nerve sheath are disrupted.
What are the absolute indications for fracture operations?
o Displaced intra-articular fractures
o Open fractures
o Fractures with vascular injury or compartment syndrome
o Pathological fractures
o Non-union fractures
Define 'clinical union' with regard to fracture healing
Where the bone moves as one but can be tender when stressed
Define 'radiological union' with regard to fracture healing
At least 3 out of 4 cortices are healed on two views, with bridging callus formation and the facture line often still present but evidence of bone remodelling
What is the approximate fracture healing time for adults?
Upper limb = 6-8 weeks
Lower limb = 12-16 weeks
What is the approximate fracture healing time for children?
Upper limb = 3-4 weeks
Lower limb = 6-8 weeks
What are the potential early complications from fracture surgery?
Other injuries, PE, infection, plaster sores, infection, neurovascular injury, compartment syndrome
What are the potential late complications from fracture surgery?
Chest infection, UTI, bed sores, non-union, mal-union, AVN, tendon rupture, nerve compression, Volkmann contracture
What are the signs of a fat embolism?
ABG shows mild hypoxemia, and the chest X-ray is normal, with multiple hyperintense punctuate lesions throughout the cerebral white matter. With widespread petechiae over the chest and arms developing later