Fracture — General Principles

Orthopedics

Break in bony continuity; classify by site, pattern, displacement, open/closed, neurovascular status.

Investigations

  • • X-ray two views including joints above and below
  • • CT for complex articular/spine/pelvis
  • • MRI for occult / soft-tissue injury

Management

  • • ATLS if polytrauma
  • • Open fracture: IV co-amoxiclav + tetanus + photograph + saline cover; theatre within 24 h
  • • Closed reduction + immobilisation OR internal/external fixation
  • • Analgesia, DVT prophylaxis

Complications

  • • Compartment syndrome (pain out of proportion, pain on passive stretch)
  • • Neurovascular injury
  • • Non-union, malunion, fat embolism

Clinical pearls

  • • Compartment syndrome diagnosis is clinical — fasciotomy without delay

References

  • • BOAST 4 Open fractures

Educational — verify locally.

WardRound

WardRound

Clinical Decisions in Seconds