Initial Treatment
Elijah suffered a fracture to his left tibia and has not received his normal vaccinations. This immunization is critical in proper fracture treatment.
What is the tetanus vaccine?
Dr. Jeremiah decided to use internal fixation on his patient's ulnar fracture. The objectives of internal fixation include adequately exposing the fracture site, obtaining a reduction of the fracture, stabilizing/maintaining reduction & also this impact on soft-tissue.
What is minimizing soft-tissue stripping?
Dr. Kelli knows that external fixation provides fracture stabilization at a distance from the fracture site and also achieves this without requiring casting.
What is maintains bone length, alignment, and rotation?
Claudia fractured her femur and the bone broke through her skin causing her to bleed. This is the most important step in her initial management.
What is restoring hemostasis?
Kenta fractured his left femur and his doctor put him in a splint. Immobilization serves these 2 major purposes.
What is relieving symptoms & preventing further injury?
Priya experienced nonunion following fracture of her right tibia & underwent internal fixation. List another indication for internal fixation.
What is
Unable to obtain an adequate reduction
Displaced intra-articular fractures
Certain types of displaced epiphyseal fractures
Major avulsion fractures where there is loss of function of a joint or muscle group
Re- implantations of limbs or extremities
Max has a severely comminuted fracture & is treated by external fixation. List another indication for external fixation.
What is
Stabilization of severe open fractures
Correction of extremity malalignments and length discrepancies
Initial stabilization of soft tissue and bony disruption in poly trauma patients (damage control orthopaedics)
Closed fracture with associated severe soft tissue injuries
Severely comminuted diaphyseal and periarticular lesions
Temporary transarticular stabilization of severe soft tissue and ligamentous injuries
Pelvic ring disruptions
Certain pediatric fractures
Arthrodesis
Ligamentotaxis
Osteotomies
Open fractures that have significant soft tissue disruption (e.g., type II or III open fractures)
Soft tissue injury (e.g., burns)
Acetabular and pelvic fractures
Severely comminuted and unstable fractures
Fractures that are associated with bony deficits
Limb-lengthening procedures
Fractures associated with infection or nonunion
Dr. Dennis is unable to obtain an adequate reduction of his patient's fracture after several tries. This is the procedure indicated in this situation.
What is internal fixation?
Alexa's physician notes a clean skin opening <1cm of her left wrist fracture. This antibiotic should be commenced.
What is Cefazolin?
Dr. Lilo was reluctant to use Kirschner wires (K-wires) in her patient who is a gymnast for the following reason. K-wires have poor resistance to these forces.
What is torque & bending?
Liza recently fractured her right radius & is also HIV positive so external fixation puts her at risk for these complications.
What is pin-tract infection & sepsis?
Gilbert was admitted with a grade III fracture of his left tibia. His is bp 90/60. This is the next step in management.
What is managing shock & achieving hemodynamic stability?
Zachary has an open fracture to his right radius after falling off of his horse. This antibiotic regimen should be commenced immediately.
What is Cefazolin, Gentamicin, Penicillin?
Derik has hemophilia and currently has a platelet count <90,000 so his physician cannot use internal fixation. List another contraindication of internal fixation.
What is hemorrhagic shock, hypothermia, peripheral lesions?
External fixation was used on Emilia's forearm fracture but she experienced malalignment because the fixator was poorly placed. List another complication of external fixation.
What is pin tract infection, pin loosening or breakage, interference with joint motion, malalignment caused by poor placement of the fixator, delayed union, and malunion?
Marquis presents to the emergency room with a fractured pelvis. This procedure is indicated.
What is external fixation?
Dajah has a type III fracture to her left ulna. This volume of irrigation fluid is commonly used.
What is 9L?
Leo had a plate & screws inserted into his fracture. Plates & screws are particularly important in the management of fractures in these locations.
What are articular fractures?
Maria was cooking homemade chips when she tripped carrying a pan of hot oil and fractured her wrist. This type of injury makes her a candidate for external fixation.
What is soft-tissue injury?
Niah presents to the ER following a motorcycle accident. She has severe pain in her right tibia & radius. Imaging reveals displaced intra-articular fractures in both locations. This procedure is likely to be implemented.
What is internal fixation?