Case Report Jonathan Kneib PGY-2.  19 yo male wth no significant PMH comes in to ED s/p texting while on a pogo stick and sustaining a fall. Patient.

Slides:

Advertisements

Similar presentations

Chapter 18 Review The Ankle and Lower Leg.

Advertisements

Lower Extremity H&P: Foot/Ankle Exam

Fracture Description & Classification

Topic: Ankle Injuries.

Ankle Anatomy and Exam.

Procedures: Splinting

Saving Lives By Strengthening Our Region’s Trauma Care System December 5, 2013 JASON SANSONE, MD CASE STUDIES IN ORTHOPEDIC INJURY.

Extremity Injuries CPT James R. Rice, PA-C Program Manager Tactical Combat Medical Care.

Common Injuries of the Foot and Ankle. Sprain Definition: A sprain is a stretch or tearing of one or more ligaments of the ankle. Sprains are generally.

Anatomy of The Foot & Ankle

The ANKLE and the FOOT TRAUMA MI Zucker, MD.

Fracture Classification & Description Kishore Tipirneni MD.

FALL Review Questions. If a bone injury is suspected the AT should.

Open Fractures Management and Classification Presented by Dr Atif Labban Supervised by Dr M.Abbas.

Jeff Allen Director of Sports Medicine University of Alabama.

THE ANKLE AND FOOT.

Foot, Ankle, and Lower Leg Chapter 15. The Foot The three major groups of bones are –Tarsals –Metatarsals –Phalanges A grand total of 28 bones in the.

POSTOPERATIVE MANAGEMENT OF ORTHOPEDIC PATIENTS THE SURGEONS PERSPECTIVE ED SZALAPSKI JR., M.D. TWIN CITIES ORTHOEDICS.

LOWER LEG, FOOT & ANKLE ANATOMY, RECOGNITION, TREATMENT, THERAPY TIM AMSHOFF LAT MOORE TRADITIONAL SCHOOL.

Chapter 8 Foot and Ankle Bones of the Foot and Ankle 28 bones: 28 bones: Tarsals (7) Tarsals (7) Metatarsals (5) Metatarsals (5) Phalanges (14) Phalanges.

Prof.Dr. Gehan Mosaad. Clinical Cases Study Case 1 KB is a 45-year-old male patient with mild low back pain two months ago due to falling; however, there.

Mrs. Marr. Injuries Remember that most injuries fall into basic categories : –Contusions –Sprains Ligaments –Strains Muscles –Fractures –Chronic vs. Acute.

Open Fracture Management

Ms. Bowman. 26 bones Phalanges-toes; proximal, middle, and distal Metatarsals-5; between phalanges and tarsals Tarsals-calcaneus, talus, navicular, cuboid,

Management of Open Fractures

Prof. Mamoun Kremli AlMaarefa Medical College Open Fractures Principles of Management.

Disaster First Aid 1. Identify the “killers.” 2. Apply techniques for opening airways, controlling bleeding, and treating for shock. 3. Fractures/ Splinting.

Orthopedic Assessment Jan Bazner-Chandler CPNP, CNS, MSN, RN.

Joints, Palpations, & ROM

Principles of Fracture Management for Primary Care Physicians Ed Schwartzenberger PGY 3 Orthopaedics.

Fractures Treatment and Complications

General principles of fractures IV.  More correctly 'restore function' - not only to the injured part but also to the patient as a whole. The objectives.

Extremity Trauma. Anatomy Bones Joints Nerves Soft tissue.

Vascular Trauma Basic Science Conference May 31, 2006.

Examination and Management of Acute Pathologies ATHT 305.

Module 5-3 Injuries to Muscles and Bones. Review of the Musculoskeletal System Injuries to Bones and Joints Injuries to the Spine Injuries to the Brain.

Chapter 12 SOFT TISSUE INJURIES. Soft Tissue Injuries - Closed Wounds Bruises (Ecchymosis) Contusions Hematomas Internal Lacerations Internal Punctures.

Ankle Evaluation. History How did this injury occur? –Mechanism of injury When? Where does it hurt? Did you hear any sounds or feel a pop? Any previous.

Injuries to Hands & Feet. Overview Intro Hand Foot.

CHAPTER 22 SOFT TISSUE TRAUMA LIGAMENT INJURIES

Dr. Maria Auron, Ilembula 2014

M M U U L L T T I I - - Q Q ! ! Multi- Q Introd uction Question & Answer Review Game Designed for Use in the Classroom M M U U L L T T I I - - Q Q ! !

Foot, Ankle, & Lower Leg Anatomical Structures. Bones 28 bones in the foot Toes = phalanges (14 bones) Sesamoids Metatarsals (5 bones) Cuboid, Navicular,

by ANDRE R. GAZDAG, and ANDREA CRACCHIOLO

Complication of p.o.p : 1- tight cast lead to vascular compression and

Joints, Palpations, & ROM

Chapter 5 The Ankle and Lower Leg. Clinical Anatomy  VERY IMPORTANT! Pages  Bones and bony landmarks  Articulations and ligamentous support.

FRACTURES FIRST AID AND EMERGENCY CARE LECTURE 9.

TIBIA FRACTURES. The tibia is subcutaneous.

1. 2 Treatment of open fractures (compound) 3 4 Patient with open fractures have multiple injuries and severe shock. At the site accident the wound.

WOUND ASSESSMENT Lesley Wayne Chapter 31. Introduction This presentation explores the history, ‘red flags’ and examinations pertaining to wound assessment.

OPEN (compound) FRACTURES Prof. M. Ngcelwane

Foot, Ankle, & Lower Leg Injuries. Great Toe Sprain  At the 1 st Metatarsal-phalangeal joint  Hyper extension or hyper flexion  Pain, tenderness, and/or.

Jeopardy Foot Anatomy Muscles Ankle Injuries Q $100 Q $200 Q $300 Q $400 Q $500 Q $100 Q $200 Q $300 Q $400 Q $500 Final Jeopardy Ankle/Lower Leg Anatomy.

Sports Medicine II FOOT, ANKLE, AND LOWER LEG TAPING.

Basic Athletic Training Chapter 6 Foot, Ankle, and Lower Leg

SOFT TISSUE INJURIES.

Management of compound fractures

Orthopaedic Emergencies

INTRODUCTION TO FRACTURES

PHED 120 Krzyzanowicz- Fall ‘12

Ankle Anatomy Athletic Training 2017.

The Ankle and Foot.

PLACEHOLDERS AND 7TH DIGIT CODE ASSIGNMENTS

Lower Limb Injuries February 2019.

Foot, Ankle, & Lower Leg Injuries.

Open Fractures Principles of Management

Presentation transcript:

Case Report Jonathan Kneib PGY-2

 19 yo male wth no significant PMH comes in to ED s/p texting while on a pogo stick and sustaining a fall. Patient has an obvious ankle deformity.

Vitals  Temperature 37  HR 82  BP 125/82  O2 99% on RA

Secondary Survey  1. check distal pulses, capillary refill  2. sensation  3. ROM

Ankle Inspection  Palpate base of 5th metatarsal (Jones, Dancers)  Palpate navicular  Palpate Achilles tendon and do Thompson test (Achilles rupture)  Palpate bony prominences (medial and lateral malleoli)  Palpate proximal fibula (Maisonneuve) Think referred pain  -see reference 1

Things to Do  Antibiotics and tetanus  XR  Remove gross contamination and apply moist sterile dressing  Photograph  Reduce/Splint the limb  Arrange for urgent surgical debridement/washout and stabilization of the fracture

Gustillo Type I  - less than 1 cm and relatively clean, no crushing injury

Gustillo Type I

Gustillo Type II  - longer than 1 cm with moderate contamination, slight to moderate crushing

Gustillo Type II

Gustillo Type III  - extensive damage to soft tissue and high degree of contamination and a great deal of communtion and instability

Gustillo IIIA  - IIIA: soft tissue can cover bone

Gustillo Type III A

Gustillo IIIB  IIIB: loss of soft tissue and will require flap

Gustillo Type IIIB

Gustillo III C  IIIC: arterial injury, regardless of degree of soft tissue loss

Gustillo Type III C

Antibiotics  Gustillo I and II  - 1st generation cephalosporin (Ancef)  - if allergy: clindamycin or vancomycin  Gustillo III  - in addition to above add an aminoglycoside (Gentamycin)  If a farm injury or open bowel contamination  - add penicillin (to cover clostridium)

Pearls  When covering an open fracture use pads soaked in saline

Pearls  Six Hour Golden Rule  Orthopedic goal to have operative repair of open fracture within 6 hours

Work Cited  Here?, -Why Are You, -General Tips, -Pearls And Pitfalls From Head To Toe, and -Summary Of Really Important Stuff. ORTHOPEDIC PEARLS & PITFALLS (n.d.): n. pag. Web.  "Gustilo Classification." - Trauma. N.p., n.d. Web. 03 Aug