Chapter 38 Orthopedic Trauma

How would you expect to find the leg if a hip is fractured at the femoral head and neck?

Externally rotated and shortened

Boxer's fracture

5th metacarpal fracture

What is the stretching or tearing of ligaments called?

sprain

What is the best treatment for injuries that are isolated to the digits?

use a foam-padded flexible aluminum splint for an isolated digit injury.

How should you manage a dislocated shoulder?

Put the arm in a sling and tie it against the chest with a triangular bandage.

Nursemaid's elbow

Annular ligament displacement

Which type of fracture occurs when the bone is broken in more than two fragments in a localized area?

Comminuted

You are assessing an adult male who dislocated his knee during a football game in the park. There is obvious displacement of the lower leg and the patient does not have a distal pulse in the extremity. What should you do?

Consult with medical control for stabilization instructions.

A 45-year-old patient who fell off a ladder reports that they landed on their feet. Upon assessing the patient, you suspect a pelvic fracture. Which type of injury did the patient experience?

Indirect

comminuted fracture

fracture in which the bone is splintered or crushed

Colles fracture

fracture of the distal radius at the wrist, angulated.

You arrive to the scene of an MVC and encounter a patient with a sustained pelvis fracture. How many mL of blood could the patient potentially lose from this injury?

1500-3000mL

Closed bilaterally fractured femurs can result in internal blood loss of up to:

1500mL

Heat therapy should generally be avoided how many hours after a musculoskeletal injury because it may increase pain and swelling during this period?

48-72hrs

Straddle fracture

A fracture of the pelvis that results from landing on the perineal region.

Vertical sheer pelvic fracture

Caused from a fall from great height, not common but almost always unstable

A 71 year old man slipped on wet grass and landed on his left side. He denies losing consciousness before or after the fall and is presently conscious and alert. He complains of pain to his left hip and in his neck. Your assessment reveals a hematoma to the left side of his head and an external rotation and shortening of his left leg. His vital signs are stable. The most appropriate treatment for this patient includes

Oxygen if hypoxemia, spinal motion restriction precautions, an IV line of normal saline, stabilization of his hip with pillows, fentanyl if needed, and transport

Gout

Swollen, red, acutely painful great toe joint

Which of the following should you use on an unstable patient with a known femur fracture?

Vacuum splint

While palpating an extremity, you note a pulsatile expanding hematoma, diminished distal pulses, and a palpable thrill over the site of the injury that correlates with the patients heartbeat. You recognize that these are signs of:

an arterial injury

Olecranon

back of elbow

greenstick fracture

bending and incomplete break of a bone; most often seen in children

impacted fracture

broken bone ends are forced into each other

Which type of fracture is unique to children and is most commonly seen in the distal radius?

buckle

shoulder girdle

clavicle and scapula

segmental fracture

consists of a segment of the shaft isolated by proximal and distal lines of fracture

Myalgia

muscle pain

Which of the following is a risk factor for developing a stress fracture?

endocrine dysfunction

Bursitis

inflammation of a bursa

Osteomyelitis

inflammation of bone and bone marrow

septic arthritis

inflammation of the joint caused by infection

Placing a fractured extremity in an anatomic position accomplishes which of the following?

it decreases pain

Calcaneus Fracture

landing after a jump/fall from a height

You arrive at the scene of a motorcycle crash and find the rider lying supine approximately 20 feet from his bike he is still wearing his helmet. As you approach him, you note that he is bilaterally deformed femurs. You should:

manually stabilize his head and assess his airway

What type of fracture occurs at an angle across the bone and is typically caused by direct or twisting force?

oblique

What is considered the best method for immobilizing an ankle fracture?

pillow splint

Compartment syndrome occurs when:

pressure in the fascial compartment leads to impaired circulation, sensory changes, and progressive muscle death.

You are treating a 17-year-old involved in a snowboarding accident. The patient's left shoulder is in an unusual position and looks to be out of the socket. How should you treat this injury?

splint the joint in the position found

acromioclavicular joint

the joint where the acromion and the clavicle meet

The method of splinting should be dictated by __________.

the severity of the patient's condition