1 / 22

General Principles Of Fractures Treatment

General Principles Of Fractures Treatment. Re-written by: Daniel Habashi. Management of major injuries. Emergency treatment at the scene of the accident and during transport to the hospital Resuscitation and the evaluation in the accident department

zamir
Download Presentation

General Principles Of Fractures Treatment

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. General Principles Of Fractures Treatment Re-written by: Daniel Habashi

  2. Management of major injuries • Emergency treatment at the scene of the accident and during transport to the hospital • Resuscitation and the evaluation in the accident department • Early treatment of visceral injuries and cardio-respiratory complications • Provisional fixation followed by definitive treatment of musculoskeletal injuries • Long term rehabilitation

  3. Individual Patient • Obtain access (I’m guessing it’s IV) • Establish an airway but protect the cervical spine • Ensure ventilation • Arrest haemorrhage and combat shock • Give analgesia (morphing, but Fentanyl is faster and better) • Splint fractures • Transport

  4. Examination • Pulse • Measure capillary filling • Observe respiration • Palpate the head, chest, abdomen and limbs

  5. Secondary Morality Peak • Death from hypoxia or hypovolemic shock • At risk for further damage to cervical spine, thoracolumbar, brain • The Golden Rule (effective Resuscitation) • Advanced Trauma Life Support Programme

  6. Primary Survey • A- Airway maintenance • B- Breathing and oxygenation • C- Circulation and control of bleeding • D – Disability • E – Exposure and avoidance of hypothermia

  7. Disability • Glasgow Coma Scale (GCS)

  8. Blood Loss • 1-4 unites from humerus • 2-4 Costal and surrounding region • 2-6 from pelvic fractures • 2-4 Femoral • 2-4 Tibial and that region

  9. Chest Injuries • Tension Pneumothorax • Sucking chest wounds • Flail chest • Cardiac Tamponade • Massive haemothorax

  10. Complications Of Major Trauma • Tetanus • ARDS • Fat embolism syndrome • DIC (disseminated intravascular coagulation) • Crush syndrome (release of enzymes from muscles leading to Renal Failure) • MSOF – prevention (Multi System Organ Failure)

  11. How Fractures Happen • A single traumatic incident • Repetitive stress • Bla blabla ;)

  12. Mechanism Of Injury • Spiral twisting • Short oblique • Bending – Triangular “butterfly” fragment • Transverse • *** some pictures of how those mechanisms work, but I guess the most interesting is the butterfly fragment that looks like a horizontally flipped Y shaped fracture)

  13. The weakest part of the bone is during torsion (forces are in twisting opposite directions) • More and more pictures of how the fractures are divided, and then further divided and I believe that’s something we don’t really have to know cuz he’s not really going into too much detail bout them

  14. Principles Of Treatment • Anatomical reduction • Stable internal fixation • Preservation of blood supply • Early mobilization

  15. Implant types • Pin and wire fixation • Screw fixation • Plate and screw fixation • Intramedullary • And 1 more type...

  16. Fracture healing • Primary • Secondary • Haematoma • Inflammation • Callus • A kind of bone that forms from a haematoma(? That’s what he said ) • Consolidation • Remodelling

  17. Open fractures - Classification

  18. Open fractures • Wound debridement • Antibiotic prophylaxis • Stabilization of the fracture • Early wound covering

  19. Complications Of fractures • Early: • Visceral injury • Vascular injury • Nerve injury • Compartment syndrome • Haemarthrosis • Infection • Gas gangrene • Fracture blisters • Plast and pressure sores

  20. Complications Of Fractures • Late: • Delayed union • Non-union • Avascular necrosis • Bed sores • Myositis ossificans • Tendon lesion • Nerve compression • Muscles contracture • Joint instability • Join stiffness • Algodystrophy RSD • osteoarthritis

  21. Compartment Syndrome • Pain • Paraesethesia • Pallor • Paralysis • Pulslessnes

  22. Volkmann’s Ischemia • One of the complications of compartment syndrome • Death of the muscle • Arterial damage  ischemia  oedema (or direct injury leading to that)  increased compartment pressure  reduced blood flow and fasciotomy which leads to painful, pale, pulseless and paraesthetic limb

More Related