Chapter 32: Orthopedic Injuries

Introduction

• Focuses on musculoskeletal system injuries.
• Understand assessment and treatment of fractures, sprains, dislocations.
• Learn emergency treatments including splints and traction.

Musculoskeletal System Overview

• Provides posture, movement, and protects organs.
• Injuries lead to disability but rarely fatal.

Types of Muscles

• Skeletal Muscle: Voluntary, striated, largest muscle mass.
• Smooth Muscle: Involuntary, found in tubular structures.
• Cardiac Muscle: Involuntary, own regulatory system.

Skeleton Overview

• Made of ~206 bones.
• Protects organs and produces blood cells.
• Key structures: Skull, thoracic cage, pectoral girdle, pelvis.

Types of Musculoskeletal Injuries

• Fractures: Open vs. closed; displaced vs. non-displaced.
• Dislocations: Bone ends no longer in contact.
• Sprains: Stretching/tearing of ligaments.
• Strains: Pulled muscles.
• Amputations: Complete severing of limb.

Complications

• Orthopedic injuries can lead to systemic changes.
• Prevent contamination and infection.
• Importance of assessing severity and rapid transport.

Patient Assessment

• Scene Size-Up: Ensure safety, evaluate needs.
• Primary Assessment: Life threats, AVPU scale, XABCs priority.
• Transport Decision: Rapid transport if needed.
• History Taking: SAMPLE, OPQRST.
• Secondary Assessment: DCAP-BTLS approach.
• Reassessment: Every 5 minutes for unstable patients.

Emergency Care

• Splinting: Use splints to stabilize injuries.
  • Rigid Splints: Prevent motion.
  • Formable Splints: Mold around injuries.
  • Pelvic Binders: Reduce hemorrhage and pain.
• Transport: Prioritize based on injury severity.

Specific Injuries and Management

• Clavicle and Scapula: Common fractures, potential neurovascular compromise.
• Shoulder Dislocation: Stabilize in comfortable position.
• Elbow Injuries: Fractures/dislocations, check for neurovascular function.
• Forearm and Wrist: Common in children/elderly, use splints for stabilization.
• Pelvis Fractures: Life-threatening blood loss, stabilize with backboard.
• Hip Dislocations: Forceful injuries, splint in position found.
• Femoral Shaft Fractures: Significant blood loss, treat with traction splint.
• Knee and Ankle Injuries: Splint in position found, assess circulation.
• Foot Injuries: Potential lumbar spine fracture, assess neurovascular function.

Compartment Syndrome

• Limb-threatening condition from swelling.
• Signs: Pain, pallor, decreased power.
• Treat by splinting and providing prompt transport.

Review Questions

• Covered throughout the lecture, focusing on identification of muscle types, injury responses, and proper splinting techniques.

Key Takeaways

• Understand anatomy of musculoskeletal system and injury mechanisms.
• Proper assessment and emergency treatment are critical.
• Splinting is essential to prevent further injury and manage pain.
• Rapid and appropriate transport can significantly impact outcomes.