Name the 4 components of the mangled extremity severity score
- Skeletal/soft tissue injury 1-4
- limb ischaemia 1-3
- shock 0-2
- age 0-2
Which score of the mangled extremity severity score predicts an eventual need for amputation?
> 7
Name 3 early complications hip dislocation
- Sciatic nerve injury 10-20%
- vascular injury (sup gluteal artery )
- associated shaft fracture
Name 3 complications knee dislocation
- Vascular injuries 40-50%
- nerve injury common peroneal 25%
- fractures 60%
Complication of untreated supra condylar fracture?
Gun stock deformity
Name 10 indications for ORIF
- Intra-articular fractures: salter Harris 3 and 4
- fail to achieve reduction
- failure to maintain reduction
- neck femur fracture
- lateral condyle humerus,
- supra condylar fracture,
- avulsion fracture
- poly trauma
- multiple fractures
- Bilateral femur fractures
- floating knee
- humerus and forearm fracture
- Compound fractures
- neurovascular compromise or injury
- pathological fractures
Treatment of shoulder dislocation?
Urgent closed reduction
Management of most proximal humerus fractures?
Analgesia and sling immobilisation
When should a proximal humerus fracture be referred to Ortho for surgery? (4)
- Neurovascular injury
- open
- associated dislocation
- markedly displaced
Which neurovascular structures should be examined in humerus shaft fractures?
Radial nerve (cross distal to spiral groove of humerus ) Brachial artery (medial to humerus proximally, then move ant to lie between epicondyles of humerus)
Treatment of forearm fractures?
ORIF because all are unstable!
Label fracture patterns picture 28
See picture 29
Which organism causes gas gangrene?
Clostridium perfringens
Treatment of gas gangrene? (2)
Debridement and iv penicillin
