Extremity trauma

Background

In traumatic limb injuries can result in soft tissue, neurovascular, muscular, and ligamentous damage. There are a few principles that apply to these injuries that differ from management of more common conditions.

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

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 Tourniquet

• Can be an excellent adjunct to control bleeding

Tetanus Antibiotics

• Cefazolin 2g IV
• Consider adding Gentamycin

Additional treatments depending on specific findings

Links

http://www.mdcalc.com/mangled-extremity-severity-score-mess-score/

Associated Topics

• Compartment Syndrome
• Compartment Pressure Measurement
• Rhabdomyolysis
• Fractures (Main)
• Open Fracture

Sources

Uptodate