Essentials 1 The life-threatening differential diagnoses of acute coronary syndrome (ACS, [CR] ), pulmonary embolism (PE; Chapter 5.5 ) and thoracic aortic dissection ( Chapter 5.10 ) should be considered in all presentations of chest pain. 2 ACS is common,…
Essentials 1 Staphylococcus aureus is the most frequent pathogen in all age groups. 2 Surgery, trauma and diabetes predispose to chronic infection in adults. 3 Diagnosis may be difficult, relying on a combination of clinical features, imaging studies and microbiological…
Essentials 1 Most calcaneal fractures are intra-articular; they are associated with a Bohler angle of less than 20 degrees and are at risk of developing compartment syndrome. 2 Major talar fractures have a significant risk of subsequent avascular necrosis. 3…
Essentials 1 Ankle injuries are common and occur as isolated injuries or in relation to high-energy multitrauma. 2 Lateral malleolar fractures are the most common ankle fracture. 3 The Ottawa ankle rules (OAR) are used to determine the need for…
Essentials 1 Tibial shaft fractures are the commonest long bone fracture, with the subcutaneous nature of the tibia leaving it vulnerable to open injury. 2 Neurovascular injury and compartment syndrome are risks in tibial shaft fractures. 3 Proximal fibular fractures…
Essentials 1 The knee is the most commonly injured joint in the body. 2 Knee injuries often occur in the young, usually associated with sport. 3 The mechanism of injury is an essential part of the history. 4 Immediate joint…
Essentials 1 Early reduction of femoral fractures and immobilization in traction reduces mortality. 2 Haemorrhagic shock is a major complication; with a closed femoral fracture the average blood loss is 1200 mL. 3 Fractures of the femoral shaft are associated…
Essentials 1 Fracture of the hip is a major cause of morbidity and mortality in the elderly, with a large impact on health care and resources. 2 Hip injuries are frequently a pathological disease of the elderly. However, hip fractures…
Essentials 1 Pelvic fractures account for 3% of skeletal fractures. 2 Fractures are either stable or unstable. Unstable fractures result from considerable mechanical force; they are associated with concomitant injuries and with a significant overall mortality. 3 Understanding the mechanism…
Essentials 1 Hand injuries are common, and most, if treated early and competently, carry a good prognosis. 2 A comprehensive knowledge of hand anatomy and function is essential for appropriate management of the injured hand. 3 Aftercare and rehabilitation, ideally…