See “ Nerve injuries in the upper body.”.Purpose: detecting early signs of limb ischemia, peripheral nerve injury, or compartment syndrome.Obtain preoperative diagnostics if fractures are likely to require urgent operative treatment.Īny findings that suggest neurovascular injury or open fracture should prompt urgent orthopedic consultation.įractures associated with gross deformities and/or crepitus should be splinted prior to imaging.Consider advanced imaging (CT or MRI) in consultation with orthopedics (e.g., for suspected occult fractures).Obtain x-rays of the affected extremity in at least two orthogonal views.Perform a neurovascular assessment to check for neurovascular injury and compartment syndrome.Conduct a thorough history and physical examination.Vertebral fractures (including compression fracture).Jones fracture: fracture at the base of the shaft of the fifth metatarsal bone.Midfoot fracture ( Lisfranc fracture): a tarsometatarsal fracture may involve damage to the cartilage of the midfoot joints.Metacarpal fractures (e.g., b oxer's fracture).Wrist fractures ( distal radius fractures). įor common fractures in children (e.g., greenstick fractures), see “ Pediatric fractures.” Upper extremity fractures closed, Location, Angulation-Alignment-Articular, Rotation, Displacement. To describe the features of a fracture, think NOLARD: Neurovascular status, Open vs. Growth plate involvement ( pediatric fractures): Salter-Harris fractures.High risk of displacement after reduction and of complications or compromised healing.Bone fragments are significantly displaced, misaligned, or shifted from normal anatomical position.Low risk of progression to dislocation or conversion to open fractures.Bone fragments remain in their normal anatomical alignment without significant displacement from their original position.Closed fracture (simple fracture does not come into contact with the outside environment).Segmental fracture: two fracture lines with a bone fragment between the proximal and distal portions of the bone.Comminuted fracture: more than two fracture lines resulting in multiple bone fragments.
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