Extremity trauma: Difference between revisions
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==Background== | ==Background== | ||
*Can result in soft tissue, neurovascular, muscular, and ligamentous damage | |||
==Clinical Features== | ==Clinical Features== | ||
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*Severity of shock | *Severity of shock | ||
==Workup== | ==Differential Diagnosis== | ||
{{Extremity trauma DDX}} | |||
==Evaluation== | |||
===Workup=== | |||
*ATLS | *ATLS | ||
*X-rays | *X-rays | ||
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==Management== | ==Management== | ||
ATLS protocols if unstable | *ATLS protocols if unstable | ||
*Consider use of [[tourniquet]] | |||
*Can be an excellent adjunct to control bleeding | **Can be an excellent adjunct to control bleeding | ||
Tetanus | *Tetanus | ||
Antibiotics | *Antibiotics | ||
*Cefazolin 2g IV | **[[Cefazolin]] 2g IV | ||
*Consider adding Gentamycin | **Consider adding [[Gentamycin]] or [[Tobramycin]] | ||
Additional treatments depending on specific findings | *Additional treatments depending on specific findings | ||
==Disposition== | |||
*May require admission with trauma team with consultation from ortho and/or vascular surgery | |||
==See Also== | ==See Also== | ||
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==External Links== | ==External Links== | ||
http://www.mdcalc.com/mangled-extremity-severity-score-mess-score/ | *[http://www.mdcalc.com/mangled-extremity-severity-score-mess-score/ MDCalc Mangled Extremity Severity Score (MESS)] | ||
== | ==References== | ||
<References/> | |||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 23:00, 16 February 2018
Background
- Can result in soft tissue, neurovascular, muscular, and ligamentous damage
Clinical Features
Limb salvage is based of several features (See calculator below):
- Age
- Severity of skeletal and soft tissue injury
- Severity of limb ischemia
- Duration of limb ischemia
- Severity of shock
Differential Diagnosis
Extremity trauma
- Compartment syndrome
- Contusion
- Crush syndrome
- Degloving injury
- Fracture
- Laceration
- Myositis ossificans
- Open joint injury
- Peripheral nerve injury
- Rhabdomyolysis
- Tendon injury
- Vascular injury
Evaluation
Workup
- ATLS
- X-rays
- Trauma labs with close attention to K, Creat, and CK
- Consider CTA or conventional angiography if evidence for vascular compromise
Management
- ATLS protocols if unstable
- Consider use of tourniquet
- Can be an excellent adjunct to control bleeding
- Tetanus
- Antibiotics
- Cefazolin 2g IV
- Consider adding Gentamycin or Tobramycin
- Additional treatments depending on specific findings
Disposition
- May require admission with trauma team with consultation from ortho and/or vascular surgery