PHTH1110 008 Open Fractures - Wright PDF
Document Details
Uploaded by BoomingPeninsula
University of the West Indies
Dean Everett Wright
Tags
Summary
This document discusses open fractures, defining them as fractures where the bone and/or fracture hematoma are exposed to the external environment. It covers mechanisms, epidemiology, and complications like hypovolemic shock and compartment syndrome, and associated treatments like fasciotomy. The document appears to be medical/orthopedic notes.
Full Transcript
OPEN FRACTURTES Dr Dean Everett WRIGHT DEFINITION DEFN ➤fractured bone and/or fracture hematoma are exposed to the external environment via a traumatic violation of the soft tissue and skin. The skin wound may lie at a site distant to the fracture and not directly over it. MECH ➤ DIRECT HI ENERGY IN...
OPEN FRACTURTES Dr Dean Everett WRIGHT DEFINITION DEFN ➤fractured bone and/or fracture hematoma are exposed to the external environment via a traumatic violation of the soft tissue and skin. The skin wound may lie at a site distant to the fracture and not directly over it. MECH ➤ DIRECT HI ENERGY INJURY MVA/ FFH / VIOLENCE ➤ INDIRECT HI ENERGY TORSION EPID ➤ DIAPHYDSIS > METAPHYSIS ➤ TIBIA (25%) > FEMUR > FOREARM > ARM COMPONENTS ➤ FRACTURE ➤ SOFT TISSUE ➤ NEUROVASCULAR ➤ CONTAMINATION PATHOLOGY ➤ POOR TIISUE OXYGEN ➤ DEVITALIZED TISSUES ➤ > 2 weeks BACTERIAL MEDIUM NOSOCOMIAL ORGANISMS GNB/ PSEUD CLASSIFICATION 4 MESS SCORE ➤(MESS) is a scoring system that can be applied to mangled extremities and help one determine which mangled limbs will eventually come to amputation COMPLICATIONS Table 1 COMPLICATIONS Hypovolemic shock Compartment syndrome Fat embolism ARDS Neurovascula Infection 11 r injuries HYPOVOLEMIC SHOCK ➤emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body Table 1 Hypovolemic shock - management Two large- bore IV lines should be started. Once IV ac cess is obtained, ini tia l fluid re... COMPARTMENT SYNDROME Table 1 Compartment syndrome Classicall y 5 "Ps" compartment syndrome: 1) Pain out associated with — of propor tion to wha t is expe... TREATMENBT ➤ FASCIOTOMY FAT EMBOLISM VASCULAR INJURY MANAGEMENT
