Outline
Treatment of closed fractures Treatment of open fractures
Reduce fracture
Hold reduction
Exercise
Closed # m(x)
Adequate apposition
Normal alignment
Reduce fracture
Reduce fracture
Extra articular fracture – relative stability
Reduce fracture
Intra articular fractures – MUST obtain absolute stability
Preferably 3 people
Adequate sedation essential
Continuous monitoring
Closed reduction
Hold reduction
Traction
Hold reduction
Casts
Hold reduction
Functional bracing
Hold reduction
Internal fixation
Hold reduction
External fixation
To restore function to injured part and patient as a whole
Objectives:
Reduce oedema
Preserve joint movement
Restore muscle power
Guide patient to normal activity
Exercise
Elevate and exercise
Never dangle, never force
Prevent oedema
Helps to:
Pump away oedema
Stimulate circulation
Prevent soft tissue adhesion
Promotes fracture healing
On cast – static muscle contraction
Off cast – mobilize joints and build muscle
Active exercise
Especially in fractures around the joint
Assisted movement
Once fracture healed enough, normal daily activity
need to be retaught:
Walking
Getting in and out of bed
Bathing
Dressing
For hand injuries: role of occupational therapists
Functional activity
Fracture communicates with external environment
High risk of infection
Definition
Antibiotic prophylaxis
Adequate debridement
Fracture stabilization
Wound coverage
Principles
Remove all dead/dying tissue
Dilute any contaminants
Debridement
Usually with
external fixation
To facilitate wound management
Fracture stabilization
To convert open fracture to close fracture
Wound coverage
What is Malaysia’s pre-hospital concept in managing trauma?
Question 1
Fill in this colour coded system used in A&E
Question 2
Describe the methods of clearing an airway
of a trauma victim from the simplest to the most complex
Question 3
Describe the clinical features of the condition
demonstrated by the following x-ray
Question 4
Describe how would you stop a profusely bleeding
upper limb wound
Question 5
Describe the method for performing a closed
manipulative reduction
Question 6
Describe this method of holding a fracture reduction and its benefits
Question 7
Describe how to prevent oedema in a post-traumatic limb
Question 8
Describe the benefits of active exercise in post-
traumatic limb and how to perform this in a patient on cast
Question 9
Name this machine and describe its benefits
Question 10