Summery of common fractures in ED and its management

1. Common Fractures
in ED
SWBH induction Program
3/2/2022
Dr. Rashid Abuelhassan
MBBS, MRCEM, EMRTP

2. Content
• Simple or Not
• The dark room experience
• Common UL
• Common LL
• What about this puncture
• Deadly Injuries
• ATLS principles
• Trauma Teams

4. Core Principle & General Rules
1.Ensure pulses are present and symmetric
2.Ensure sensation is present
3.compartment syndrome?
4.Splint for comfort until reduction can be completed
5.Consider Regional/hematoma blocks if possible
6.Recheck for compartment syndrome, pulses, and sensation
following splinting and document it
7.Look at contralateral anatomy for reference points.
8.Apply analgesia, sedation, or block.

5. Who Needs T&O ?
• Open Fractures
• Reductions that have persistent angulation
• Articular steps post-reduction greater than 2mm
• Highly comminuted fractures
• Fractures where length, alignment, and rotation
cannot be restored.
• Patients who otherwise cannot go home.

6. BASELINE MATERIALS
• Stockinette
• Padding
• Plaster
• Upper extremity: 8–10 layers
• Lower extremity: 10–12 layers
• Elastic bandaging
• Bucket/receptacle of water
(the warmer the water, the
faster the splint sets)
• Scissors

7. Applying a cast

8. Volar Sp.

9. Post Long Arm sp.

10. Sugar Tong Splint

11. Double Sugar Tong Sp.

12. Radial Gutter Sp.

13. Thumb Spica Sp.

14. Ulnar Gutter Sp.

15. Finger/Mallet Sp.

16. Post Knee Sp.

17. Post Ankle/Stirrup Sp.

18. DVT
prophylaxis
for AKBS

21. Scan my Dinosaur
For Adults
For Paeds

22. • Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 26814

23. Salter Harris

24. Common
UPPER LIMB
Fractures

25. Case courtesy of Dr Maciej Debowski, Radiopaedia.org, rID: 66146

26. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 12382

27. • Case courtesy of Dr Wasif Mohammed, Radiopaedia.org, rID: 86104

28. • Case courtesy of Dr Ayush Goel, Radiopaedia.org, rID: 25784

29. • Case courtesy of Dr Jeremy Jones, Radiopaedia.org, rID: 6382

30. Case courtesy of The Radswiki, Radiopaedia.org, rID: 12221

32. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 8012

34. • Case courtesy of Dr David Cuete, Radiopaedia.org, rID: 27557

35. • Case courtesy of Amanda Er, Radiopaedia.org, rID: 74739

37. • Case courtesy of Assoc Prof Craig Hacking, Radiopaedia.org, rID: 63792

38. • Case courtesy of eduardo bravo, Radiopaedia.org, rID: 55586

39. • Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 28560

40. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 35855

41. • Case courtesy of Dr Dalia Ibrahim, Radiopaedia.org, rID: 29211

42. • Case courtesy of Dr Derek Smith, Radiopaedia.org, rID: 47448

43. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 23999

45. • Case courtesy of Dr Pir Abdul Ahad Aziz Qureshi, Radiopaedia.org, rID: 69354

46. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 10356

47. • Case courtesy of Dr Samir Benoudina, Radiopaedia.org, rID: 47828

51. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 18281

52. • Case courtesy of Dr Lindsay Davidson, Radiopaedia.org, rID: 6374

53. • Case courtesy of Dr Maulik S Patel, Radiopaedia.org, rID: 55891

54. Common
Lower limb
Fractures

55. Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 3560

56. • Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 76421

57. • Case courtesy of Dr Maulik S Patel, Radiopaedia.org, rID: 13920

58. • Case courtesy of Dr Matt Skalski, Radiopaedia.org, rID: 23868

59. • Case courtesy of Dr Maulik S Patel, Radiopaedia.org, rID: 9239

60. Case courtesy of Dr Balint Botz, Radiopaedia.org, rID: 74925

64. • Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 12641

71. Open fracture
Gustilo-Anderson classification

73. Head injury & Neck injury
• Look for the Proforma

75. Thermal Injuries

76. Ake home message
• Don’t forget pain control
• Don't forget referred pain
• Asking for help does not mean you are stupid
• Go systematic
• Use the tools that you have
• Don't forget ABx & Anti-tetanus in OF
• Remember Surgical support Is cross site, but
Sandwell based
• Hand over bleep do not leave it on the table

77. Thank you
References