2. acute complications of fractures
what are some acute complications of fractures? -__1__, including __2__ and PE, esp with __3__ extremity trauma -soft tissue __4__ (__5__). can be skin __6__, __7__ wound abscesses, or due to __8__ used to repair fracture -bone __9__ -HAIs (__10__ -acute compartment syndrome: __11__ pressure within areas of __12__, __13__, and __14__ which compromises __15__ to lower leg or forearm -Fat embolism syndrome
1. VTE 2. DVT 3. lower 4. infection 5. wound infections 6. infections 7. deep 8. hardware 9. infection 10. MRSA 11. increased 12. muscle 13. blood vessels 14. nerves 15. circulation
what does fat embolism syndrome result from
1. from fractures/fracture repair 2. can occur due to pancreatitis, osteomyelitis, blunt trauma, or sickle cell disease
earliest signs/symptoms of FES?
1. low arterial oxygen level (hypoxemia) 2. dyspnea 3. tachypnea 4. headache, lethargy, agitation, confusion, decreased LOC, seizures, vision changes
what can result from unresolved ACS?
cyanosis, paresthesia, numbness, paresis, and necrosis
what happens during acs?
edema increases pressure on nerve endings and causes severe pain (more than expected, due to injury) -affected area is tense to palpation -perfusion is reduced, color of tissue pales, pulses weaken (but do not usually disappear)
treatment for ACS
fasciotomy or in extreme cases amputation
What is fat embolism syndrome (FES)?
gobules released from yellow bone marrow into blood stream 12-48 hrs post injury. these clog small blood vessels that supply vital organs, such as the lungs (compromise perfusion)
what are longterm problems with ACS
infection, persistent weakness in affected extremity, contracture,
why is FES so serious?
it can result in respiratory failure, or death, often from pulmonary edema it is serious, but not common
late signs of FES
non-palpable, red-brown petechiae-macular, measles-like rash on neck, upper arms, and or chest
what are the 6 Ps
pain, pressure, paresthesia, pallor, paralysis, pulselessness
what is ACS
pressure to compartment can be from sources which are internal (blood or fluid in the compartment) or external (dressings or casts)--> typically a fracture is present!
what can cause ACS?
severe burns, extensive insect or snake bites, or massive infiltration of IV fluids
what is a fasciotomy
surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle due to ACS
