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  • A-ATLS
  • R-REDUCE
  • R-RESTRICT
  • R-REHABILITATE

PRIMARY SURVEY

Airway +C-SpINE

Breathing

CIRCULATION

Disability

EXPOSURE

SECONDARY SURVEY

Fracture Management: Principles

  • Head to toe
  • Front to back
  • Look at patient's SOCS:
  • Surface, Orifices, Cavities, Skeleton

Principles

REDUCTION-if necessary

1. Manipulation

2.Mechanical traction

3. Open operation

Indications for OPEN OPERATION

1. Closed reduction fails

2. Large articular fragments

3. Avulsion fractures

4. Operation needs assoc. injuries

5. Requires internal fixation to hold it anyways

FRACTURES HURT: ARRR!

DONE BY: SABAHAT IQBAL, MEDICAL STUDENT

GENERAL HEALING TIME FOR ADULTS

  • Upper Limb-6 to 8 weeks
  • Lower Limb-12 to 16 weeks

OPEN FRACTURE

#Children: Halved respectively

METHODS

1. Active use

2. Active Exercise

3. Coordinate with physiotherapy

-Begin as soon as fracture has had definitive treatment

-Two step process

1. Preserve function as much as possible while fracture

is uniting

2. To restore function to normal once fracture has united

  • To prevent displacement or angulation of fractures
  • To prevent movement that might interfere with union
  • To relieve pain

-Encourage pts. to help themselves

RESTRICTION:

METHODS

SUMMARY

EXTERNAL FIXATION

SUSTAINED TRACTION

-TRACTION BY GRAVITY

-BALANCED TRACTION

-FIXED TRACTION

FUNCTIONAL BRACING

INTERNAL FIXATION

CAST SPLINTAGE

  • Screws
  • Wires- Kirschner Wires
  • Plates and screws
  • Intramedullary nails

]

R

A

R

  • Seek senior help
  • Check distal circulation and sensation
  • Analgesia (IV Morphine)
  • Take a digital photo
  • Cover the wound with iodine soaked swabs
  • Start IV antibiotics (Co-amoxiclav) & review tetanus status
  • X-Ray
  • Refer urgently to orthopaedics

Restriction

Treat the patient according to ATLS Guidelines

REHABILITATION

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