Shoulder Dislocations and Rotator Cuff Injuries

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Questions and Answers

What percentage of unintentional injuries are attributed to musculoskeletal trauma?

40%

60% (correct)

80%

70%

What is the typical management of 3rd degree strains?

Surgical repair of the torn tendon or muscle (correct)

RICE protocol

Immobilization for 2-4 weeks

Antibiotic therapy

What is a crucial assessment to perform distal to the affected joint in a joint dislocation?

Neurovascular checks (correct)

Neurological checks

Musculoskeletal checks

Vascular checks

What is the classification of a sprain based on?

Severity of injury Signup and view all the answers

What is the primary cause of sprains?

Excessive stretching of ligaments Signup and view all the answers

What is the typical immobilization period for 3rd degree sprains?

4-6 weeks Signup and view all the answers

What is the purpose of RICE protocol in managing strains and sprains?

To reduce pain and inflammation Signup and view all the answers

What is the primary method of diagnosis for joint dislocation?

History and physical examination Signup and view all the answers

What is the potential complication of joint dislocation?

Neurovascular damage Signup and view all the answers

What is the purpose of PWB in managing 2nd degree sprains?

To immobilize the affected joint Signup and view all the answers

What is the main difference between a closed fracture and an open fracture?

A closed fracture does not break through the skin surface, while an open fracture disrupts the skin integrity. Signup and view all the answers

What is the primary purpose of neurovascular assessment in patients with mobility injuries?

To identify any neurovascular compromise or increased risk of compartment syndrome. Signup and view all the answers

What is the goal of immobilization techniques in fracture management?

To provide proper bone alignment and reduce muscle spasms. Signup and view all the answers

What is the first step in emergency care protocols for patients with extremity fractures?

Perform a quick head-to-toe assessment to identify any other injuries. Signup and view all the answers

What is the primary complication of fat embolism?

Pulmonary embolism. Signup and view all the answers

What is the primary goal of surgery in hip fracture management?

To reduce the fracture and prevent further complications. Signup and view all the answers

What is the primary purpose of traction in fracture management?

To provide proper bone alignment and reduce muscle spasms. Signup and view all the answers

What is the primary complication of compartment syndrome?

Limb loss. Signup and view all the answers

What is the primary purpose of casting in fracture management?

To immobilize the affected area and promote healing. Signup and view all the answers

What is the primary goal of nursing care in patients with fractures?

To maintain skin integrity and prevent infection. Signup and view all the answers

Study Notes

Unintentional Injuries and Musculoskeletal Trauma

60% of unintentional injuries arise from musculoskeletal trauma, a leading cause of disability in the US.
Common musculoskeletal injuries include sprains, strains, and fractures.

Soft-Tissue Musculoskeletal Injuries

Sprains: Excessive stretching of ligaments due to falls or sports; severity classified as 1st, 2nd, or 3rd degree.
Strains: Caused by overstretching muscles or tendons, categorized into 1st, 2nd, or 3rd degree based on severity.
Common Injuries:
- Ligament tears (e.g., ACL)
- Meniscus tears
- Tendon ruptures (e.g., Achilles tendon)
- Patellofemoral pain syndrome (runner's knee)
Management includes RICE (Rest, Ice, Compression, Elevation) for mild strains/sprains; 3rd-degree injuries may require immobilization and surgery.

Joint Dislocation

Joint dislocations are caused by trauma, leading to severe pain, deformity, and limited motion.
Subluxation denotes a partial dislocation.
Commonly dislocated joints include the shoulder.
Treatment requires neurovascular checks and potential closed or surgical reduction.

Rotator Cuff Injuries

Symptoms include pain, difficulty abducting the arm, and reduced mobility.
Diagnosis confirmed via imaging (X-ray, MRI, CT).
Conservative treatment includes NSAIDs and physical therapy; surgery may be necessary.

Fractures

Manifestations include pain, swelling, deformity, and loss of function.
Types of fractures:
- Closed (simple) – does not break skin.
- Open (compound) – disrupts skin integrity.
- Complete and incomplete fractures classify bone integrity.
- Displaced and non-displaced fractures relate to alignment of bone fragments.

Emergency Care for Extremity Fractures

Perform ABC checks and a quick head-to-toe assessment.
Apply pressure to bleeding areas, remove restrictive clothing, and maintain extremity stability.
Monitor neurovascular status frequently and immobilize the fracture.

Management of Fractures

Diagnosis confirmed through radiography or CT.
Treatment options include analgesics, surgical interventions, and monitoring for complications.
Surgical approaches encompass open reduction and internal fixation (ORIF) or external fixation.

Traction Techniques

Skeletal traction involves direct application to bones, typically with weights of 15-30 lbs.
Skin traction employs weights applied to splints or bandages, using lighter weights (5-10 lbs).
Nursing interventions focus on ensuring proper alignment, assessing for complications, and maintaining pin care.

Complications of Fractures

Compartment Syndrome: Occurs from pressure due to edema, risking circulation; signs include pain and pulselessness.
Fat Embolism: Most common post-hip fracture; presents with respiratory distress and petechiae.
Deep Vein Thrombosis (DVT): Blood clots can lead to pulmonary embolism; treated with anticoagulants and leg elevation.

Specific Fractures

Rib Fractures: May result in lung or organ punctures; complications include flail chest and pneumonia.
Hip Fractures: Commonly caused by falls in older adults, with osteoporotic patients at higher risk. Symptoms include pain, inability to walk, and leg shortening.
Treatment: Emphasizes early surgical intervention within 24 hours to mitigate complications, with precautions post-op to prevent dislocation and enhance recovery.

Nursing Care Goals

Focus on maintaining skin integrity, preventing infection, promoting circulation, alleviating pain, and improving mobility through rehabilitation exercises.

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Description

Test your knowledge on shoulder dislocations, their treatment, and rotator cuff injuries. Learn about the common causes, symptoms, and diagnosis of these injuries. Assess your understanding of the conservative and surgical treatment options available.