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Similar to complications of fracture MBBS Part 1.pptx
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complications of fracture MBBS Part 1.pptx
- 2. By the end of • Definition • Classification • Hypovolemic shock • ARDS • Fat Embolism • DVT and Pulmonary embolism • Crush Syndrome • Injury to major blood vessels/nerves/muscles/tendons/joints/viscera
- 4. College Life
- 5. Complication : In medicine, a medical problem that occurs during a disease, or after a procedure or treatment. The complication may be caused by the disease, procedure, or treatment or may be unrelated to them.
- 6. Orthopedic Example Images taken from Reddit and Radiopedia
- 7. Complications of Fracture Classification Immediate Early Late
- 9. Hypovolemic Shock (Haemorrhagic) • Hemorrhagic shock is present when the systolic blood pressure is less than or equal to 90 mm Hg in a patient with blood loss due to trauma • Commonest cause of death after major bone # • About 1.9 million people worldwide die because of hemorrhagic shock every year • Hemorrhagic shock is the most common preventable cause of early mortality in polytrauma patients.
- 12. Management • Fluid (RL) • Blood • Splinting (Traction, slab, Ex-fix) • Correct the metabolic derangements (Acidosis and coagulopathy) • Close the tap of the pot(Stop bleeding) (external pressure/Intervention radiology – angiography and embolization)
- 13. ARDS • Acute respiratory distress syndrome (ARDS) is a life- threatening lung injury that allows fluid to leak into the lungs. • Mechanism: Widespread inflammation in the lung leads to damage to the wall of alveoli. • Causes: sepsis, pancreatitis, TRAUMA, pneumonia, and aspiration.
- 14. Embolism • An embolism is a blocked vessel caused by a foreign body, such as a blood clot or an air bubble/fat/amniotic fluid
- 16. Treatment • No specific treatment, only supportive treatment – High flow O2 • IV LMWH • Ventilatory support • Corticosteroids
- 17. DVT – Deep Venous Thrombus
- 18. DVT and Thromboembolism • Leg pain • Swelling (Tense red shiny skin) • Pain on passive stretching • Paraesthesia • Pulselessness
- 19. DVT Cont. • Dx: • Clinical • Blood test : D – dimer • US deep veins • CTPA • Rx: • LMWH • O2 • IVC Filter
- 21. Crush Syndrome • Massive muscle damage ( Earth quake, wars, rollover injuries, long duration of tourniquet) • Releases K+, MGB, LDH, CK- MB– ATN • Rx: ARF
- 22. Injury to Major blood vessel • Common vascular injuries • Popliteal A. (Knee dislocation) • Brachial A. (SC humerus #) • Consequences of Injury: • Extent and duration of Injury • Dx: • Clinical: 5P’s • Inx: Doppler, CT Angiography • Rx: depends on grade
- 26. Thank You
Editor's Notes
- Breadth not the depth Not all subtopics today is entirely comes in ortho but related to ortho
- Circumstances/ situations makes outcome/treatment difficult Side effect
- Makes the outcome difficult to achieve
- Circumstances/ situations makes outcome/treatment difficult Side effect
- Nerve injury, open#, injury to vessel due to #
- At the time of frature Within few days Long time after #
- Hypovolemia can happen because of prolonged vomiting/ third space loss/ non traumatic haemorrhage 1st/2nd/3rd space Talk about Pre-hospital care 1500 ml in femur #
- - Femur # 1500 ml blood loss - Acidosis and coagulopathy
- - More in GM and critical care
- Pathogenesis: Release of FFA which induces toxic vasculitis-platelet fibrin thrombus. Actual obstruction by fat globules
- - Virchow triad (Damage to Vessel wall, Turbulence, hypercoagulability) - Peripheral heart
- GM or Critical care Liaise
- Plastic surgeon/ Vascular surgeon Close proximity to bone – therefore vulnerable to get injured
- SDL