Ballarat EMET Hub Cases

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Presentation transcript:

Ballarat EMET Hub Cases Ankle injury Ballarat EMET Hub Cases

History 24 yo male, injured ankle at footy Jumped for mark and landed badly Deformed ankle, taken to a regional Hospital What is immediate management in ED? And how is this done?

What action is required?

Do I have to reduce it? Yes This is a very unstable injury Therefore it is actually very easy to reduce Traction, return ankle to 90 degrees Some nitrous and opiate such as fentanyl is a safe combination if concerned re over sedation post reduction (when reduced pain is massively reduced) E.g Fentanyl reversed with Naloxone PRN Nitrous oxide is short acting

That looks a lot better…

Management Deformity was reduced under anaesthetic / sedation. Back-slab applied Post reduction Xray showed:

Xray

Report X-RAY RIGHT ANKLE There is marked talar shift with widening of the syndesmosis and some associated Weber A comminuted right distal fibular fracture, extending supereolaterally by approximately 65mm proximal to the ankle joint. The talar dome appears to be intact.

Ongoing management Patient then transferred to Ballarat for orthopaedic R/V and definitive care