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Trauma

Trauma. Spring 2012 FINAL. Some Trauma Stats. Most common cause of death for those 1-44 years of age Medical costs for trauma 200 billion annually Mostly results from MVA, unintentional accidents, gunshot wounds, stabbing, fights, domestic violence. Trimodal Distribution.

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Trauma

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  1. Trauma Spring 2012 FINAL

  2. Some Trauma Stats • Most common cause of death for those • 1-44 years of age • Medical costs for trauma • 200 billion annually • Mostly results from MVA, unintentional accidents, gunshot wounds, stabbing, fights, domestic violence

  3. Trimodal Distribution ImmediateEarly Late

  4. Immediate Deaths Lacerations of the brain and spinal cord Lacerations of the heart or great vessels

  5. Early Deaths • Within first 4 hours • Intracranial hemorrhage • Lacerations of liver or spleen • Significant blood loss Liver laceration with extravasation

  6. Late Deaths • Weeks after injury • Infection and multiple organ failure

  7. Level 1 Usually in large metro areas and serve as both primary and tertiary care institutions Must be avail 24 hrs Must treat 1200 admissions or 240 major trauma patients per year Level II Can transport to level I when necessary Serve smaller cites and towns Must be avail 24 hrs Level III Remote and rural areas On call on nights and weekends Level I, II & III Trauma Centers

  8. Skeletal Trauma

  9. Fracture Classifications

  10. FRACTURE TYPES

  11. Closed reduction

  12. Open Reduction

  13. OPEN FRACTURES

  14. Open Fracture • Bone has penetrated skin • May lead to infection • Precautions must be taken to prevent infection from setting into the bone

  15. Closed Fracture • Skin is not penetrated • Fractures can be classified by the mechanics of the stress that caused the break • Torsion • Transverse linear • Spiral

  16. Closed Fracture- Clavicle

  17. Forearm Closed fracture

  18. Impacted Fracture- Wrist • When the fractured bone is jammed into the cancellous tissue of another fragment

  19. Impacted Fracture- Hip

  20. Fibular Impacted Fracture

  21. Comminuted Fracture • Do not represent the full thickness of the bone. • Usually extensively shattered • Particularly apt to be open fractures

  22. Comminuted Fracture

  23. Comminuted Fracture

  24. Non-Comminuted Fracture

  25. Non-Comminuted Fracture • Complete fracture in which the bone is separated into to fragments • Can be classified according to the direction of its fracture line • Spiral or oblique • Transverse

  26. Avulsion Fracture • Fragment of the bone is pulled away from the shaft • Occur around the joints because of ligaments, tendons, muscles, associated with sprain or dislocation

  27. Avulsion Fracture

  28. Avulsion Fracture

  29. Incomplete Fracture • Part of bony structure gives way with little no displacement • Common example is a greenstick fracture • Torus fracture

  30. Greenstick :Incomplete Fracture • Cortex breaks on one side without separation or breaking of the opposite cortex • Found almost exclusively in children under the age of 10

  31. Incomplete Fracture

  32. Greenstick Fracture

  33. Greenstick Fracture

  34. Greenstick Fracture

  35. Torus: Incomplete Fracture • AKA Buckle Fracture • It is a greenstick fracture • Cortex bulges outward producing a slight irregularity

  36. Torus Fracture

  37. Growth Plate Fracture • Involve the end of the long bone • Not visible unless displacement occurs • Classified according to severity • Salter-Harris System • I-IV • Based on degree of epiphysis involvement

  38. Growth Plate Fracture

  39. Growth Plate Fracture

  40. Stress Fracture • Results from an abnormal degree of repetition • Generally found where muscle attachments are • EX: runners at tib/fib • Not always seen on plain x-ray

  41. Stress Fracture

  42. Stress Fracture

  43. Occult Fracture • Gives clinical symptoms without radiologic evidence • 10 days later may show repairing itself or displacement

  44. Occult Fracture

  45. Occult Fracture

  46. Colles Fracture • Fracture through distal inch of the radius • Distal fragment angled backward on the shaft • Impaction along dorsal aspect • Avulsion fx of the styloid process

  47. Colles Fracture

  48. Boxer’s Fracture

  49. Monteggia’s Fracture Fx of the proximal 1/3 of the ulnar shaft

  50. Galeazzi Fracture Occurs at proximal radius with a dislocation of the distal radial-ulnar Joint

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