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Lower Extremity Injuries. All You Need to Know. Asses CSM Immobilize Injury Transport. Introduction . Epidemiology of Ski Injuries Types of Knee Injuries Sprains/ligament tears Fractures Dislocations Other Lower Extremity Injuries Prehospital Care Questions.

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Presentation Transcript
all you need to know
All You Need to Know
  • Asses CSM
  • Immobilize Injury
  • Transport
introduction
Introduction
  • Epidemiology of Ski Injuries
  • Types of Knee Injuries
    • Sprains/ligament tears
    • Fractures
    • Dislocations
  • Other Lower Extremity Injuries
  • Prehospital Care
  • Questions
epidemiology of ski injuries
Epidemiology of Ski Injuries
  • 1970s: 5 to 8 per 1000 skier days
  • 1990s: 2 to 3 per 1000 skier days
  • Lower Ext. Injury:Upper Ext. Injury
    • 4:1 in 1980
    • 2:1 in 1990
epidemiology of lower extremity injuries
Epidemiology of Lower Extremity Injuries
  • in Ankle Injuries
  • in ACL Injuries
  • Knee sprains most common (30% of all injuries in adults)
types of knee injury
Types of Knee Injury
  • Sprains
  • Dislocations
  • Fractures
sprains
Sprains
  • Injury to ligaments supporting a joint
  • Secondary to abnormal motion of the joint
  • Range from minor tearing to complete disruption
anterior cruciate ligament
Anterior Cruciate Ligament
  • Prevents tibia from

moving forward on the

femur

  • Involved in 40% of sprains
  • Usually injured by

deceleration, flexion and rotation

dislocations
Dislocations
  • Loss of continuity between articular surfaces
  • Patellar dislocation
  • Knee dislocation
patella dislocation
Patella Dislocation
  • Secondary to twisting

injury on an extended

knee

  • Patella is displaced

laterally

  • Usually easily reduced

by hyperextending knee

and flexing hip

knee dislocation
Knee Dislocation
  • Secondary to hyperextension, and rotary or direct force
  • Associated ligamentous and possibly artery and nerve injury
  • May reduce spontaneously but will be grossly unstable
fracture
Fracture
  • Can occur secondary to direct trauma or forceful twisting.
  • Incidence has been declining
    • between 1972 and 1994 there was an 89% decrease in adult tibial fractures
other lower extremity injuries
Other Lower Extremity Injuries
  • Pelvis
  • Hip
  • Femur
  • Tibia/Fibula
  • Ankle
  • Foot
pelvis fracture1
Pelvis Fracture
  • Direct Blow - Skier vs Tree
  • Many Types
  • Potential for Significant Injury
    • Laceration of blood vessels
    • Proximity of other organs
  • Examination
  • Treatment
hip injuries
Hip Injuries
  • Relatively Uncommon
  • Fracture
    • Shortened and externally rotated
  • Dislocation
    • Hip and knee flexed, thigh internally rotated
femur fracture
Femur Fracture
  • Direct Blow or Violent Twisting
  • Possibility of Significant Blood Loss
  • CSM assessment
  • Traction Splint
  • Reassess
  • Transport
tibia fibula fracture
Tibia/Fibula Fracture
  • “Boot-Top Fracture”
  • Frequently Angulated and/or Rotated
  • Re-alignment
    • Painful
    • Reduce bleeding and preserve function
    • Allows splint placement
ankle injuries
Ankle Injuries
  • Snowboarders and Telemarkers
  • Sprains
  • Fractures
  • Dislocations
  • CSM Assessment
  • Splint
    • Realignment
slide24
Foot
  • Uncommon in Snowsports
  • Falls From Heights
  • Heel Fx Associated with Back Injury
prehospital care
Prehospital Care
  • Assess neuro-vascular status
  • Realignment
    • especially if greater than 1 hour from help
  • Immobilize
  • Transport