Fractures, Dislocations, and Sprains Quiz

Fractures and Dislocations

• Fractures can occur due to direct or indirect injury, such as twisting or violence to bones.
• Clinically, fractures can be either closed (skin intact) or compound (break in the overlying skin).

Dislocation

• Dislocation is a complete displacement of a bone from the joint.
• It often results from injuries away from the affected joint, such as elbow dislocation after falling on an outstretched hand.

Sprains

• A sprain is a partial disruption of a ligament or capsule of a joint.

Immediate Management of Fractures

• Halt any external hemorrhage by pressure bandage or direct pressure.
• Immobilize the affected area.
• Provide pain relief.

Clinical Assessment

• Obtain complete patient history, including circumstances and method of injury.
• Enquire about anticoagulant use, such as warfarin.
• Perform standard clinical observations.
• Examine and record:
  • Color, warmth, movement, and sensation in hands and feet of injured limb(s)
  • Any wounds or swelling
  • Color of the whole limb (especially paleness or blue color)
  • The skin over the fracture
  • Range of movement and joint function above and below the injury site
  • Check whether the limb is out of shape, warm, swollen, throbbing, or getting bigger
  • Peripheral pulses are palpable

Management of Fractures

• Splint the site of the fracture/dislocation using a plaster back slab to reduce pain.
• Elevate the limb (sling for arm injuries, pillow for leg injuries).
• If in doubt over an injury, treat it as a fracture.
• Administer analgesia to patients in severe pain, preferably morphine or fentanyl if allergic.
• Consider compartment syndrome where pain is severe and unrelieved by splinting and elevation or two doses of analgesia.

Drug Therapy Protocol

• Authorized Indigenous Health Worker (IHW) must consult a Medical Officer (MO) or Nurse Practitioner (NP) for drug therapy.
• Scheduled Medicines Rural and isolated Practice Registered Nurse may proceed.