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Ortho Injuries (Hand fx (Named Fx younger pt :boy::skin-tone-2:…

- - - - Posterior Dislocation
        
        Anterior Dislocation
        
        Fracture
        
        Pt: Pain, swelling
        
        open fx: skin is broken
        
        Dx: Get 2 XR perpendicular
        
        Tx:
        
        open reduction internal fixation (ORIF)
        
        indicated in Open, Angular, Comminuted
        
        Open fx req. emergency washout :ocean:
        
        1 more item...
        
        Path: Any trauma :explode:
        
        Shoulder dislocates forward
        
        ABducted position, external rotation
        
        ("Shaking hands")
        
        possible Axillary n trauma
        
        deltoid paresthesia
        
        Dx: Clinical Dx, Can get XR
        
        Tx: Relocate & sling
        
        Path: Massive trauma :explode::explode:
        
        MVA :blue_car: thrown from vehicle
        
        Seizure :rotating_light:
        
        Lightning strike :lightning:
        
        ( :zap: muscle has so much force it dislocates shoulder)
        
        ABducted, internal rotation
        
        Dx: XR
        
        Tx: Relocate & sling
      - Pt: Old lady :older_woman::skin-tone-3: falls on outstretched wrist
        
        common in osteoporosis
        
        Fx of radius & ulna
        
        dorsal :dolphin: displacement
        
        Dx: XR
        
        Tx: Cast or surgery
    - - Pt: Blocking upward w/ arm from a downward blow
        
        ulna breaks
        
        radius dislocated
        
        Dx: XR
        
        Tx: Surgery or cast
    - - Pt: downward blow on supine arm
        
        radius breaks
        
        ulna dislocates
        
        ( Dustyn says downward block on upward blow, but thats confusing since the upward blow is receiving the fx)
        
        Dx: XR
        
        Tx: Surgery or cast
  - - - Dx: XR
        
        normal on day 1
        
        distal part of fx will necrose
        
        Tx: Cast it anyway
        
        F/u XR: Positive for fx
- - - - :pencil2:Make sure there's intact sensation, pulses, motion distal to injury
        
        :pencil2: Location of fx dictates specialized surgery (out of scope)
        
        :warning: Femoral head fx requires prosthesis
        
        tenuous vascular supply
        
        Intratrochanteric fx: use plates
        
        Shaft: use rods
        
        Open: Emergency washout :ocean:
        
        Traction helps during transport :ambulance: to keep bone on bone grinding
        
        f/u: Rehab
  - - - Dx: MRI
        
        Tx: Surgery if Athlete (insert famous :football:player name here)
        Everyone else: casting just as effective but longer :calendar::calendar:
    - - Valgus = Lateral stress = MCL
        Vargus = medial stress = LCL
        
        :pencil2:note to self: you have torn your MCL 2x, and the only word you remember is Valgus.
        
        Dx: MRI
        
        Tx: Surgery if :football:
        Everyone else : Hinge cast
      - Meniscus
        
        Pt: Knee px
        
        "click" on extension
        
        Dx: MRI
        
        Tx: Arthroscopic repair :hocho::telescope:
        
        removal (sometimes indicated) causes OA
        
        Stress fx
        
        Pt: Weekend warriors :boat: :woman-playing-handball:& soldiers on "forced" marches :boot::camping:(ie all marches).
        
        overuse causes tiny fx
        
        Dx: XR probably normal
        
        Tx: Cast anyway & crutches
        
        F/u XR is positive :check:
        
        Tib/Fib Fx
        
        Tib is strong/Fib weak: if you have Tib fx, likely also Fib fx.
        
        Pt:
        
        Fall from height or
        
        lots of trauma :explode: to side of shin
        
        (struck pedestrian :runner::car:)
        
        Dx: XR
        
        1 more item...
        
        Ankle Fx
        
        Over eversion/inversion can fx ankle. But could just be sprain.
        Fx:
        
        Px and swelling
        
        Non-ambulatory (if they can walk, it isn't broken)
        
        Dx: XR
        
        1 more item...
        
        Achilles Tendon
        
        Runner hears a "pop", then limp
        
        behind ankle there is a gap where tendon should be
        
        1 more item...
        
        Compartment Syndrome
        
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