Orthopedic InjuriesBoard Review Questions of the Week
Orthopedic injuries affecting bones and joints can be caused by degenerative conditions such as arthritis or sudden trauma from a fall or collision. Dislocations, sprains, strains, fractures, ligament damage etc, all carry their own set of treatment challenges and potential complications.
From the musculoskeletal point of view, the major complications of traumatic orthopedic injuries in are acute respiratory distress syndrome (Fat embolism syndrome), multisystem organ failure, thromboembolic disease, atelectasis, compartment syndrome, sepsis, and ectopic bone formation.
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Orthopedic Injuries Case:
Three hours after you have discharged a 5-year-old patient with a thumb spica-forearm cast but no analgesia for a baseball-related thumb fracture, the mother brings him back because he is complaining of increasing pain in the hand.
On re-examination, the patient is crying, his hand is swollen, and passive motion of the uninjured fingers is painful.
In this orthopedic injuries case, how would you treat this patient during his second visit?
Bivalve the cast with a cast saw, cut the stockinet and padding with scissors, and inspect the extremity
Add oral pain relief
Provide parent education about rest, ice, and elevation at home
Repeat x-ray through the cast to rule out missed fractures or displacement of the thumb fracture
See the answer...
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