Extremity and Orthopedic Injuries

First Things First (assess and treat the following)

  • Follow ATLS/ABCs:
    • Primary Survey – quantify obvious injuries and “plug” holes; perform orderly exam (head to toe, front to back, left to right); log roll all patients; assess and provisionally cover open wounds; order/obtain x-rays of injured limbs along with trauma series
    • Secondary Survey – more detailed examination of patient; diagnose the non-obvious orthopaedic injury; obtain correct x-rays; palpate every bone, move every joint
  • Potential orthopaedic emergencies (life- and/or limb-threatening) to be recognized early:
    • Unstable pelvic fracture associated w/ hemodynamic instability
    • Extremity injury w/ vascular injury
    • Acute compartment syndrome
    • Open fracture
    • Joint dislocation
    • Septic arthritis/acute osteomyelitis in clinically septic patient
    • Acute spinal cord injury/neurologic compromise w/ associated spine fracture

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Last updated: May 5, 2010