Open fracture 5th year medical student tcd
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This document discusses the management of an open leg fracture in a 25-year-old male involved in a motor vehicle accident. Key points include: - The patient presented with right leg pain, swelling, deformity and reduced range of motion. - Radiographs showed a tibia fracture. Assessment of vascular status and risk of compartment syndrome was needed. - Management involved intravenous antibiotics, debridement of the wound, and fixation of the tibia fracture with intramedullary nailing after plastic surgery coverage. - Complications of open fractures discussed were infection, non-union, compartment syndrome, and neurovascular injury.
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Open fracture
An open fracture occurs when a broken bone pierces the skin, exposing the fracture site. Left untreated, open fractures can lead to high rates of infection, wound complications, and failure of the bone to heal properly. Gustilo-Anderson classification grades open fractures based on wound size, soft tissue damage, level of contamination, and fracture pattern, with higher grades indicating more severe injuries associated with worse outcomes. Proper management of open fractures involves emergency wound care, antibiotics, splinting or stabilization of the fracture, and often surgical debridement and irrigation to reduce the risk of infection.
Management of open fracture
This document discusses the historical basis and current management of open fractures. It describes Pierre Desault in the 18th century who promoted early debridement of wounds to prevent infection. During World War II, the widespread availability of penicillin improved treatment outcomes for open fractures. The document outlines classification systems for open fractures including the Gustilo-Anderson system. It emphasizes the importance of thorough debridement, irrigation, antibiotic treatment, and initial wound stabilization and coverage in managing open fractures. Later stages may involve definitive fixation, bone and soft-tissue reconstruction, and rehabilitation.
Open fracture
1. Open fractures are classified using the Gustilo-Anderson Classification based on the wound size and degree of soft tissue damage.
2. Essential treatment of open fractures includes administration of antibiotics, prompt wound debridement and irrigation, stabilization of the fracture, and early definitive wound cover.
3. Potential complications of open fractures include infection, osteomyelitis, compartment syndrome, and vascular injury which may require further intervention.
ortho 01 management of open fracture-update by kk 31052010
The document discusses the management of open fractures, including their classification, principles of treatment, debridement and irrigation procedures, fracture stabilization methods, wound coverage techniques, and antibiotic protocols. Open fractures expose the bone and surrounding tissues to contamination and have higher risks of infection, soft tissue damage, and bone and functional loss compared to closed fractures. Gustilo-Anderson classification determines treatment choices and prognosticates complications based on factors like wound size, bone loss, and high-energy mechanisms. Management involves early debridement and irrigation to remove nonviable tissue and contamination, assessing injury extent, repairing structures, stabilizing fractures, and providing wound coverage.
Management of open fractures
This document discusses the management of open fractures. It begins by defining an open fracture and classifying open fractures using the Gustilo and Tscherne systems. It then outlines the treatment principles of open fractures which include antibiotic prophylaxis, wound debridement, and fracture stabilization. The initial management, primary surgery including further debridement, irrigation, and skeletal stabilization are described. Factors determining limb salvage versus amputation are provided. The document concludes with discussions on external fixation, internal fixation, and wound closure approaches.
Managment of Open fractures
1. Open fractures require urgent evaluation, debridement within 6 hours, and antibiotic therapy.
2. Initial debridement removes contaminated tissue, copious irrigation is used, and repeat debridement occurs within 24-72 hours.
3. Fracture stabilization is determined initially while leaving the wound open. Early bone grafting and aggressive rehabilitation of the extremity are also recommended.
Management of compund fractures
This document discusses the management of compound fractures. It begins with a historical anecdote and then discusses causes of compound fractures like vehicle accidents and sports. It covers pathophysiology, classification systems like Gustilo-Anderson and AO, and limitations. It then introduces the Ganga Hospital scoring system. Key steps in treatment are discussed - the "Golden Hour" concept of urgent care, "Silver Day" concept of quick response, and thorough debridement including exploration, excision, and removal of foreign materials. Antibiotics, closure techniques, bone stabilization, and potential complications are also summarized.
Open fractures ppt
This document provides information on classifying and managing open fractures. It begins by noting that open fractures are usually caused by high-impact trauma and other life-threatening injuries should be ruled out first. It then discusses the Gustilo classification system for open fractures in three levels of severity from I to III. Type III is further divided into IIIA, IIIB and IIIC. Guidelines recommend aggressive debridement and irrigation, fracture stabilization, antibiotic treatment within 3 hours, and wound closure within 7 days to reduce infection risk. Various case examples are provided to illustrate different types of open fractures.
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Open fracture
An open fracture occurs when a broken bone pierces the skin, exposing the fracture site. Left untreated, open fractures can lead to high rates of infection, wound complications, and failure of the bone to heal properly. Gustilo-Anderson classification grades open fractures based on wound size, soft tissue damage, level of contamination, and fracture pattern, with higher grades indicating more severe injuries associated with worse outcomes. Proper management of open fractures involves emergency wound care, antibiotics, splinting or stabilization of the fracture, and often surgical debridement and irrigation to reduce the risk of infection.
Management of open fracture
This document discusses the historical basis and current management of open fractures. It describes Pierre Desault in the 18th century who promoted early debridement of wounds to prevent infection. During World War II, the widespread availability of penicillin improved treatment outcomes for open fractures. The document outlines classification systems for open fractures including the Gustilo-Anderson system. It emphasizes the importance of thorough debridement, irrigation, antibiotic treatment, and initial wound stabilization and coverage in managing open fractures. Later stages may involve definitive fixation, bone and soft-tissue reconstruction, and rehabilitation.
Open fracture
1. Open fractures are classified using the Gustilo-Anderson Classification based on the wound size and degree of soft tissue damage.
2. Essential treatment of open fractures includes administration of antibiotics, prompt wound debridement and irrigation, stabilization of the fracture, and early definitive wound cover.
3. Potential complications of open fractures include infection, osteomyelitis, compartment syndrome, and vascular injury which may require further intervention.
ortho 01 management of open fracture-update by kk 31052010
The document discusses the management of open fractures, including their classification, principles of treatment, debridement and irrigation procedures, fracture stabilization methods, wound coverage techniques, and antibiotic protocols. Open fractures expose the bone and surrounding tissues to contamination and have higher risks of infection, soft tissue damage, and bone and functional loss compared to closed fractures. Gustilo-Anderson classification determines treatment choices and prognosticates complications based on factors like wound size, bone loss, and high-energy mechanisms. Management involves early debridement and irrigation to remove nonviable tissue and contamination, assessing injury extent, repairing structures, stabilizing fractures, and providing wound coverage.
Management of open fractures
This document discusses the management of open fractures. It begins by defining an open fracture and classifying open fractures using the Gustilo and Tscherne systems. It then outlines the treatment principles of open fractures which include antibiotic prophylaxis, wound debridement, and fracture stabilization. The initial management, primary surgery including further debridement, irrigation, and skeletal stabilization are described. Factors determining limb salvage versus amputation are provided. The document concludes with discussions on external fixation, internal fixation, and wound closure approaches.
Managment of Open fractures
1. Open fractures require urgent evaluation, debridement within 6 hours, and antibiotic therapy.
2. Initial debridement removes contaminated tissue, copious irrigation is used, and repeat debridement occurs within 24-72 hours.
3. Fracture stabilization is determined initially while leaving the wound open. Early bone grafting and aggressive rehabilitation of the extremity are also recommended.
Management of compund fractures
This document discusses the management of compound fractures. It begins with a historical anecdote and then discusses causes of compound fractures like vehicle accidents and sports. It covers pathophysiology, classification systems like Gustilo-Anderson and AO, and limitations. It then introduces the Ganga Hospital scoring system. Key steps in treatment are discussed - the "Golden Hour" concept of urgent care, "Silver Day" concept of quick response, and thorough debridement including exploration, excision, and removal of foreign materials. Antibiotics, closure techniques, bone stabilization, and potential complications are also summarized.
Open fractures ppt
This document provides information on classifying and managing open fractures. It begins by noting that open fractures are usually caused by high-impact trauma and other life-threatening injuries should be ruled out first. It then discusses the Gustilo classification system for open fractures in three levels of severity from I to III. Type III is further divided into IIIA, IIIB and IIIC. Guidelines recommend aggressive debridement and irrigation, fracture stabilization, antibiotic treatment within 3 hours, and wound closure within 7 days to reduce infection risk. Various case examples are provided to illustrate different types of open fractures.
Openfracture
This document discusses the principles of operative fracture management for open fractures. It defines open fracture classifications according to the Gustilo system and outlines approaches for emergency assessment, wound excision and debridement, antibiotic therapy, wound management, soft tissue coverage, fracture stabilization, and rehabilitation. The key goals are to prevent infection, promote soft tissue and bone healing without complications, and restore function of the injured extremity.
Managment of open fractures
1. This document provides guidelines for the management of open fractures of the lower limb. It outlines 20 principal recommendations covering topics such as specialist center referral criteria, emergency department management, antibiotic prophylaxis, wound excision timing, debridement, classification, skeletal stabilization, soft tissue reconstruction, and complications.
2. Recommendations include referring complex open fractures to specialist centers, administering IV antibiotics within 3 hours of injury, performing wound excision and debridement within 24 hours, temporarily dressing wounds with VAC or antibiotic beads, stabilizing fractures with external or internal fixation depending on contamination level, and reconstructing soft tissues within 7 days.
3. Factors that increase risk of complications include inadequate debride
Open fructures
An open fracture is a serious bone fracture where broken bone fragments pierce the skin. Open fractures are caused by high-energy trauma and can lead to infection. They are classified based on wound size and soft tissue damage. Diagnosis involves clinical exam, imaging, and assessing neurovascular status. Management includes wound cleaning, temporary stabilization, antibiotics, and definitive fixation once the wound is healthy. Complications can include infection, neurovascular injury, and compartment syndrome.
Management of open fractures final
Open fractures involve a break in the bone that communicates with the external environment through a break in the skin and soft tissue. They are often caused by high-energy trauma like traffic accidents or falls. The initial management involves thorough debridement to remove all non-viable tissue, irrigation to clean the wound, fracture stabilization, and antibiotic treatment. Further debridement may be needed over subsequent days to fully clean the wound. The goal is to prevent infection while stabilizing the fracture and achieving soft tissue coverage. Outcomes depend on adequate initial management and reconstruction as needed.
Open fractures
Open fractures are unique, complex, and emergently presenting injuries that expose sterile bone to the contaminated environment.
Because a fracture disrupts the intramedullary blood supply, the additionally stripped soft tissue envelope further devitalizes the bone.
The more severe the soft tissue injury or open wound, the more severe the osseous injury.
Historically, open fractures were associated with infection, delayed union, nonunion, amputation, or death.
Compound fractures
The document discusses the principles of managing compound fractures of the lower limb. It defines compound fractures as fractures where the broken bone communicates with an external wound. It describes the Gustillo classification system for open fractures based on wound size and soft tissue damage. Grade I fractures have a wound less than 1 cm while Grade III fractures have extensive soft tissue stripping. The key priorities in emergency management are resuscitation of the patient, assessment of limb vascularity and compartment syndrome, thorough wound debridement and splinting without reduction, and use of broad spectrum antibiotics. Surgical management involves thorough debridement of all devitalized soft tissues and temporary stabilization using external fixation to allow wound healing before definitive fixation.
Compound fracture sagar
This document provides information on the assessment and treatment of compound fractures where the bone is exposed to the external environment. It defines compound fractures and discusses their pathophysiology, risk factors, initial assessment including examination of the wound and injured limb, antibiotic treatment, classification systems, treatment options including debridement, stabilization, and wound management. Treatment is aimed at achieving a stable skeletal fixation and environment conducive to fracture and soft tissue healing.
openfracture management
Dr. Suman Paul provides a historical overview of the treatment of open fractures. Early civilizations like Egyptians recognized the need to cover open fracture wounds to minimize morbidity. Through the 19th century, amputation was often used for treatment after open fractures. Advances in the 20th century included debridement and stabilization principles from World War I, and the introduction of local antibiotics in World War II which reduced wound sepsis rates. The Gustilo classification system, introduced in 1976, provides guidelines for prognosis and treatment of open fractures based on the degree of soft tissue injury. Later classifications like the Bowen system in 2005 incorporated host risk factors to better predict infection risk. Common bacteria associated with open fractures include staph, strep,
Open fractures
This document provides guidelines for the treatment of open fractures. It defines open fractures and classifies them based on wound contamination and soft tissue injury. It emphasizes the importance of early intravenous antibiotics within 3 hours, serial examinations, vascular repair within 6 hours, and treatment by a multidisciplinary team for complex fractures. The guidelines recommend early wound debridement and stabilization, along with wound coverage within 7 days to prevent infection.
Open Fractures Classification and Management.
Presentation on open fractures classification, diagnosis, primary and definitive management and possible complications.
Management of open fracture true ppt
This document discusses the historical basis and current management of open fractures. It reviews key figures like Desault who coined the term "debridement" and emphasized early debridement to prevent infection. Current management involves thorough debridement and irrigation, antibiotic administration, initial wound management, and definitive stabilization of the fracture, either through external or internal fixation depending on the injury. Proper initial management and wound care can help prevent complications and allow for later reconstruction if needed.
Open fractures
Type 1 open fractures have a small wound less than 1cm with minimal soft tissue damage. Type 2 fractures have a wound over 1cm with moderate soft tissue damage. Type 3 fractures are high energy injuries with severe soft tissue damage and bone comminution. The classification correlates with infection risk, healing time, and need for flap coverage. For open fractures, the goals of treatment are to preserve life and limb through debridement, antibiotics, fracture stabilization, and early wound coverage.
Open Fractures
The document discusses open fractures, defining them as fractures where a break in the skin leads directly into the fracture site. It covers the classification system for open fractures, management approaches including prevention of infection, soft tissue coverage, and fracture stabilization, and acute compartment syndrome caused by increased pressure within a confined anatomical space.
Open fractures
1) An open fracture involves both a soft-tissue injury and a bone fracture. Immediate management includes radical surgical debridement of the wound, administration of antibiotics, and splinting of the limb.
2) Surgical treatment consists of extensive irrigation, debridement of nonviable tissue, and stabilization of the fracture. The wound is then covered temporarily until later reconstruction if needed.
3) Multiple stages of reconstruction may be required, including bone and soft-tissue procedures, skin grafting or flaps to achieve closure, with the goals of preventing infection, achieving union, and restoring function.
Open fracture
This includes the basics of open fracture including classifications and treatment.
References are from the latest edition of rockwood and greens fracture in adults.
G13 mangled extremity
This document discusses fractures with associated soft tissue injuries. It begins by explaining that the prognosis of such fractures depends on the amount of energy transferred to the soft tissues and bone, the degree of contamination, and patient factors. It then classifies closed fractures based on the Tscherne classification of soft tissue injuries. This is followed by a discussion of open fractures, including the Gustilo-Anderson classification system. The document outlines principles for the treatment of closed and open fractures, including controlling swelling, serial examination for compartment syndrome, appropriate fixation, and antibiotic treatment. Surgical treatment principles like debridement, irrigation, and wound management are also described.
Openfracture
The document provides information on the management of open fractures. It defines open fractures as fractures where there is a breach in the soft tissue envelope exposing the fracture site. Key aspects of management include thorough initial assessment, adequate irrigation and debridement within 6 hours, appropriate antibiotic therapy, and stabilization of the fracture either through external or internal fixation. Complications of open fractures discussed include infection, hypovolemic shock, compartment syndrome, fat embolism, acute respiratory distress syndrome, and neurovascular injuries.
Principle of fracture management
This document discusses the principles of fracture management. It begins by defining a fracture and outlining the main treatment principles of recognition, resuscitation, reduction, immobilization, follow up, and rehabilitation. It then describes different types of fractures clinically and radiologically. Key points covered include the emergency management and types of open fractures, as well as management of pathological fractures and fractures in children. Throughout, it emphasizes the importance of thorough initial assessment and stabilization of the patient before addressing the fracture itself.
L09 open tibia
This document discusses open fractures of the tibial diaphysis (shaft). It notes that open tibia fractures account for about 1/4 of all tibial fractures and occur more commonly in the tibia than any other long bone. Treatment involves thorough debridement and irrigation of the soft tissue wound, antibiotics, and stabilization of the bone fracture, which may be via internal or external fixation depending on the fracture pattern and soft tissue injury severity. Complications include infection, nonunion, malunion, and compartment syndrome. Outcomes depend highly on the severity of soft tissue and neurovascular damage based on the Gustilo-Anderson classification.
Soft tissue injury
This document discusses different types of soft tissue injuries and classifications systems used to categorize them. It describes closed wounds like contusions and hematomas versus open wounds. Classification systems like Gustilo and Tscherne grade soft tissue damage and help determine appropriate treatment and prognosis. The goal is to effectively communicate injury severity and anticipate complications to improve patient outcomes.
OPEN FRACTURES.pptx
An open fracture is a break in the bone that communicates with the outside environment through a wound in the skin. Open fractures are classified using the Gustilo-Anderson classification system based on the size of the wound and extent of soft tissue damage. Treatment involves initial management following ATLS principles including controlling bleeding, antibiotics, irrigation, debridement, and stabilization. Definitive treatment options include external or internal fixation after serial debridement allows wound closure. Complications can include infection, nonunion, and amputation.
Compartment syndrome in orthopaedics
Compartment syndrome occurs when increased pressure within a closed muscle compartment compromises blood flow, and if left untreated, causes tissue damage. It is most commonly caused by fractures, but can result from other injuries. The diagnosis is based on pain out of proportion to the injury that is worsened with passive stretching of the muscles. Measurement of compartment pressure is the diagnostic standard, with fasciotomy (surgical release of fascial compartments) required if pressure is over 30 mmHg. Timely fasciotomy is crucial to prevent permanent nerve and muscle damage.
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Openfracture
This document discusses the principles of operative fracture management for open fractures. It defines open fracture classifications according to the Gustilo system and outlines approaches for emergency assessment, wound excision and debridement, antibiotic therapy, wound management, soft tissue coverage, fracture stabilization, and rehabilitation. The key goals are to prevent infection, promote soft tissue and bone healing without complications, and restore function of the injured extremity.
Managment of open fractures
1. This document provides guidelines for the management of open fractures of the lower limb. It outlines 20 principal recommendations covering topics such as specialist center referral criteria, emergency department management, antibiotic prophylaxis, wound excision timing, debridement, classification, skeletal stabilization, soft tissue reconstruction, and complications.
2. Recommendations include referring complex open fractures to specialist centers, administering IV antibiotics within 3 hours of injury, performing wound excision and debridement within 24 hours, temporarily dressing wounds with VAC or antibiotic beads, stabilizing fractures with external or internal fixation depending on contamination level, and reconstructing soft tissues within 7 days.
3. Factors that increase risk of complications include inadequate debride
Open fructures
An open fracture is a serious bone fracture where broken bone fragments pierce the skin. Open fractures are caused by high-energy trauma and can lead to infection. They are classified based on wound size and soft tissue damage. Diagnosis involves clinical exam, imaging, and assessing neurovascular status. Management includes wound cleaning, temporary stabilization, antibiotics, and definitive fixation once the wound is healthy. Complications can include infection, neurovascular injury, and compartment syndrome.
Management of open fractures final
Open fractures involve a break in the bone that communicates with the external environment through a break in the skin and soft tissue. They are often caused by high-energy trauma like traffic accidents or falls. The initial management involves thorough debridement to remove all non-viable tissue, irrigation to clean the wound, fracture stabilization, and antibiotic treatment. Further debridement may be needed over subsequent days to fully clean the wound. The goal is to prevent infection while stabilizing the fracture and achieving soft tissue coverage. Outcomes depend on adequate initial management and reconstruction as needed.
Open fractures
Open fractures are unique, complex, and emergently presenting injuries that expose sterile bone to the contaminated environment.
Because a fracture disrupts the intramedullary blood supply, the additionally stripped soft tissue envelope further devitalizes the bone.
The more severe the soft tissue injury or open wound, the more severe the osseous injury.
Historically, open fractures were associated with infection, delayed union, nonunion, amputation, or death.
Compound fractures
The document discusses the principles of managing compound fractures of the lower limb. It defines compound fractures as fractures where the broken bone communicates with an external wound. It describes the Gustillo classification system for open fractures based on wound size and soft tissue damage. Grade I fractures have a wound less than 1 cm while Grade III fractures have extensive soft tissue stripping. The key priorities in emergency management are resuscitation of the patient, assessment of limb vascularity and compartment syndrome, thorough wound debridement and splinting without reduction, and use of broad spectrum antibiotics. Surgical management involves thorough debridement of all devitalized soft tissues and temporary stabilization using external fixation to allow wound healing before definitive fixation.
Compound fracture sagar
This document provides information on the assessment and treatment of compound fractures where the bone is exposed to the external environment. It defines compound fractures and discusses their pathophysiology, risk factors, initial assessment including examination of the wound and injured limb, antibiotic treatment, classification systems, treatment options including debridement, stabilization, and wound management. Treatment is aimed at achieving a stable skeletal fixation and environment conducive to fracture and soft tissue healing.
openfracture management
Dr. Suman Paul provides a historical overview of the treatment of open fractures. Early civilizations like Egyptians recognized the need to cover open fracture wounds to minimize morbidity. Through the 19th century, amputation was often used for treatment after open fractures. Advances in the 20th century included debridement and stabilization principles from World War I, and the introduction of local antibiotics in World War II which reduced wound sepsis rates. The Gustilo classification system, introduced in 1976, provides guidelines for prognosis and treatment of open fractures based on the degree of soft tissue injury. Later classifications like the Bowen system in 2005 incorporated host risk factors to better predict infection risk. Common bacteria associated with open fractures include staph, strep,
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This document provides guidelines for the treatment of open fractures. It defines open fractures and classifies them based on wound contamination and soft tissue injury. It emphasizes the importance of early intravenous antibiotics within 3 hours, serial examinations, vascular repair within 6 hours, and treatment by a multidisciplinary team for complex fractures. The guidelines recommend early wound debridement and stabilization, along with wound coverage within 7 days to prevent infection.
Open Fractures Classification and Management.
Presentation on open fractures classification, diagnosis, primary and definitive management and possible complications.
Management of open fracture true ppt
This document discusses the historical basis and current management of open fractures. It reviews key figures like Desault who coined the term "debridement" and emphasized early debridement to prevent infection. Current management involves thorough debridement and irrigation, antibiotic administration, initial wound management, and definitive stabilization of the fracture, either through external or internal fixation depending on the injury. Proper initial management and wound care can help prevent complications and allow for later reconstruction if needed.
Open fractures
Type 1 open fractures have a small wound less than 1cm with minimal soft tissue damage. Type 2 fractures have a wound over 1cm with moderate soft tissue damage. Type 3 fractures are high energy injuries with severe soft tissue damage and bone comminution. The classification correlates with infection risk, healing time, and need for flap coverage. For open fractures, the goals of treatment are to preserve life and limb through debridement, antibiotics, fracture stabilization, and early wound coverage.
Open Fractures
The document discusses open fractures, defining them as fractures where a break in the skin leads directly into the fracture site. It covers the classification system for open fractures, management approaches including prevention of infection, soft tissue coverage, and fracture stabilization, and acute compartment syndrome caused by increased pressure within a confined anatomical space.
Open fractures
1) An open fracture involves both a soft-tissue injury and a bone fracture. Immediate management includes radical surgical debridement of the wound, administration of antibiotics, and splinting of the limb.
2) Surgical treatment consists of extensive irrigation, debridement of nonviable tissue, and stabilization of the fracture. The wound is then covered temporarily until later reconstruction if needed.
3) Multiple stages of reconstruction may be required, including bone and soft-tissue procedures, skin grafting or flaps to achieve closure, with the goals of preventing infection, achieving union, and restoring function.
Open fracture
This includes the basics of open fracture including classifications and treatment.
References are from the latest edition of rockwood and greens fracture in adults.
G13 mangled extremity
This document discusses fractures with associated soft tissue injuries. It begins by explaining that the prognosis of such fractures depends on the amount of energy transferred to the soft tissues and bone, the degree of contamination, and patient factors. It then classifies closed fractures based on the Tscherne classification of soft tissue injuries. This is followed by a discussion of open fractures, including the Gustilo-Anderson classification system. The document outlines principles for the treatment of closed and open fractures, including controlling swelling, serial examination for compartment syndrome, appropriate fixation, and antibiotic treatment. Surgical treatment principles like debridement, irrigation, and wound management are also described.
Openfracture
The document provides information on the management of open fractures. It defines open fractures as fractures where there is a breach in the soft tissue envelope exposing the fracture site. Key aspects of management include thorough initial assessment, adequate irrigation and debridement within 6 hours, appropriate antibiotic therapy, and stabilization of the fracture either through external or internal fixation. Complications of open fractures discussed include infection, hypovolemic shock, compartment syndrome, fat embolism, acute respiratory distress syndrome, and neurovascular injuries.
Principle of fracture management
This document discusses the principles of fracture management. It begins by defining a fracture and outlining the main treatment principles of recognition, resuscitation, reduction, immobilization, follow up, and rehabilitation. It then describes different types of fractures clinically and radiologically. Key points covered include the emergency management and types of open fractures, as well as management of pathological fractures and fractures in children. Throughout, it emphasizes the importance of thorough initial assessment and stabilization of the patient before addressing the fracture itself.
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This document discusses open fractures of the tibial diaphysis (shaft). It notes that open tibia fractures account for about 1/4 of all tibial fractures and occur more commonly in the tibia than any other long bone. Treatment involves thorough debridement and irrigation of the soft tissue wound, antibiotics, and stabilization of the bone fracture, which may be via internal or external fixation depending on the fracture pattern and soft tissue injury severity. Complications include infection, nonunion, malunion, and compartment syndrome. Outcomes depend highly on the severity of soft tissue and neurovascular damage based on the Gustilo-Anderson classification.
Soft tissue injury
This document discusses different types of soft tissue injuries and classifications systems used to categorize them. It describes closed wounds like contusions and hematomas versus open wounds. Classification systems like Gustilo and Tscherne grade soft tissue damage and help determine appropriate treatment and prognosis. The goal is to effectively communicate injury severity and anticipate complications to improve patient outcomes.
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Compartment syndrome occurs when increased pressure within a closed muscle compartment reduces blood flow, potentially causing tissue damage. It is caused by factors that increase compartment volume or decrease space such as fractures, contusions, surgery, or prolonged limb compression. Symptoms include pain disproportionate to the injury that is not relieved by pain medications. Diagnosis involves clinical assessment and compartment pressure measurement. Early fasciotomy is the treatment of choice to release pressure and prevent permanent nerve and muscle damage. Complications of untreated compartment syndrome include contractures, weakness, sensory loss, and limb loss.
compartment syndrome.pptx
Compartment syndrome is a condition caused by increased pressure within a closed muscle compartment, compromising circulation and causing tissue damage. It is most often caused by fractures, burns, or crush injuries. Early symptoms include pain disproportionate to the injury that worsens with stretching. Later symptoms include pain, pallor, paralysis and loss of sensation. Diagnosis is made by measuring compartment pressure. Treatment involves promptly decompressing the compartment through fasciotomy, an incision that releases pressure and prevents permanent tissue damage.
2_2019_11_15!10_08_04444444444441_AM.ppt
This document discusses several potential complications that can arise from fractures, including both general complications like shock, respiratory distress, and fat embolism, as well as local complications. Local complications are divided into early complications within the first few days/weeks such as visceral injury, nerve injury, and vascular injury. Late bone complications include delayed or malunion, nonunion, and avascular necrosis. Late soft tissue complications involve joint stiffness, muscle contractures, heterotrophic ossification, nerve entrapment, tendon rupture, and nerve compression. Specific complications like fat embolism, deep vein thrombosis, and compartment syndrome are also discussed in more detail.
Complication of traumatology theme lecture
This document discusses fracture complications from Dr. Utkarsh Shahi of King Faisal University. It begins by outlining immediate, early, and late complications of fractures both locally and systemically. Immediate complications include hemorrhage, vascular injury, and nerve injury. Early complications include infection, compartment syndrome, fat embolism syndrome, and delayed union. Late complications consist of non-union, malunion, avascular necrosis, and arthritis. The document then provides details on diagnosing and treating specific complications like hemorrhage, nerve injury, and compartment syndrome. It emphasizes the importance of early diagnosis and management to prevent long-term issues.
MEQ-Orthopaedic fracture
A 35-year-old motorcyclist was involved in an accident and had an open fracture of the right leg. He was given initial treatment including antibiotics, wound irrigation, and fracture stabilization with an external fixator. After 3 weeks of immobilization, he was discharged but later returned with a diagnosis of non-union fracture, which was treated with internal fixation and bone grafting.
Management of hand injuries &
This document discusses the management of hand injuries and associated infections. Some key points:
- Hand injuries are common, usually affecting young males, and are often caused by domestic or work-related accidents. Proper treatment is important to prevent stiffness.
- Evaluation of hand injuries involves assessing wound characteristics, neurovascular status, and underlying bone or tendon injuries. Management principles aim to preserve the hand and restore function.
- Treatment depends on wound type but typically involves debridement, irrigation, splinting, antibiotics, and reconstruction of tendons, nerves or bone as needed. Complications can include infection, stiffness if not managed properly.
- Specific injuries like bites, foreign bodies, fingertip injuries
Pressure sore management
Pressure sores are localized areas of tissue breakdown in skin and/or underlying tissues that develop when persistent pressure between a bony site and underlying surface obstructs healthy capillary flow.
Constant external pressure over 70 mm Hg for 2 hours produces irreversible ischemic changes.
Synonyms : Pressure ulcer, Decubitus ulcer,
Bed sore.
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Open fracture 5th year medical student tcd
- 1. 5th year Medical Students Trinity College Dublin
- 2. Objectives Understand definition of open fracture. Classification of open fracture Management of open fracture Complications of open fracture
- 3. Case 25 y/o male, involved in RTA. C/O Right leg pain and reduced ROM. BGHx: Nil significant NKDA o/e: leg is swollen, deformed with leg tenderness
- 4. How will you proceed to manage this patient? Why? A,B,C,D,E approach This is an isolated injury.
- 5. Describe X Ray. What else do you need? 2 views 2 joints
- 6. No pulse detected, management? Fracture reduced, pulse returned Further management?
- 7. Patient c/o severe preoperative pain despite IV paracetamol and oral Tramadol 50 mg. Further Rx?
- 8. Acute compartment syndrome of a limb is due to raised pressure within a closed fascial compartment Cardinal symptom for compartment syndrome: 5Ps ain ain ain ain ain
- 9. Pulses are normally present in compartment syndrome. Clinical examination: pain on passive movement of the muscles of the involved compartments
- 10. Management: All circumferential dressings released to skin and the limb elevated to heart level Document dose and rate of analgesia administered. Re-evaluated within 30 minutes If symptoms persist then urgent surgical decompression should be performed
- 11. What to do if in doubt?
- 12. Intra-compartment pressure > 30 OR ∆ P ( Diastolic BP- Intracompatment pressure)< 30
- 13. Wound washout was done in Theatre next day and wound debridement was done. Tissue coverage was done by plastic surgeon performing skin graft. Tibia fracture fixation was done by IM nailing.
- 15. Open fracture / Compound fracture Usually high energy injury A,B,C,D,E approach for management The vascular and neurological status of the limb is assessed systematically Vascular impairment requires immediate surgery within 3-4 hours Compartment syndrome also requires immediate surgery
- 20. Management Intravenous antibiotics are administered, ideally within 3 hours of injury Tetanus toxoid if booster dose less than 5 years Remove gross contamination and photography, then covered in saline soaked gauze and an impermeable film to prevent desiccation Orthoplastic approach for further management ( wound debridement and skletal stabilization)
- 21. Complications of open fracture: 1) Infection 4) Non union 3) Compartment syndrome 2) Neurovascular injury